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 another important barrier in improving maternal health in the country is the public’s knowledge and utilization of available community health programs. For instance, although the national insurance has been offering maternity care package since 2001, only a few are aware of and utilize the benefits of the program (Reyes et al., 2020). However, this may vary across different communities. In Eastern Visayas, for example, there is high access to antenatal and delivery care, but significantly low for postpartum care (Perez et al., 2020). These evidences emphasize our role as future nurses and care providers in communicating and facilitating available community health resources for our clients.
Another study found the need to improve the referral system in maternal health service delivery (Cagayan et al., 2020). As we move towards better implementation of universal health care, health professionals should be well-equipped with knowledge and training on navigating the local health systems. Furthermore, understaffed health facilities, family support and roles, and traditional health beliefs negatively influence access to maternal health services in the country (Titus, 2018).
These evidences point out that improving equity in maternal health care largely involves intensified efforts on health education, health workforce development, and policymaking and program implementation.
2. What are the top 3 causes of maternal mortality ratio in the Philippines? Top 3 maternal morbidity?
According to the Philippine Department of Health (2019), the three leading causes of maternal mortality are eclampsia (16%), gestational hypertension with significant proteinuria (14.7%), and other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth, and puerperium (10.5%). As for maternal morbidity, the top three causes were hemorrhage, infection, and hypertension (Sorra-Viñas et al., 2015).
References:
Cagayan, M. S. F., Ang-Bon, R. M., Garcia, F., San Juan, F., Llave, C., Banwell, C., & Llamas-Clark, E. (2020). Barriers to an effective maternal health service delivery network: A qualitative study among health providers in Legazpi City, Albay. Acta Medica Philippina, 54(5). https://doi.org/10.47895/amp.v54i5.664
Department of Health. (2019). The 2019 Philippine health statistics. Department of Health Epidemiology Bureau.
Perez, A., Pagatpatan, J. C., & Ramirez, C. M. (2020). Incentivizing (and disincentivizing) mothers to utilize maternal health services: A focus group study. Philippine Journal of Nursing, 90(1), 27-36.
Reyes, K. A. V., Verdolaga, R. M. C., Cloma-Rosales, V., Yason-Remonte, M. A., Silvestre, M. A. A., & Castillo, M. (2020). Utilization of social health insurance for maternal health services in the Philippines. Southeast Asian Journal of Tropical Medicine and Public Health, 51, 108-125. doi: 10.13140/RG.2.2.28201.11362
Sorra-Viñas, M. P. M., Tamor, L. L., & Nicomedes, M. M. T. S. (2015). Status and prospects of maternal health care in the Philippines. Dunong, 2015, 106-128.
Titus, A. T. (2018). Maternal access to health services by pregnant mothers in Bacnotan, La Union, Philippines. Health Notions, 2(2), 151-158. https://doi.org/10.33846/hn.v2i2.113