Answer the following and post your answers here. Cite references of your answers as much as possible.
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Other than the factors discussed in the lecture, what do you think are other factors affecting the maternal mortality rate in the Philippines?
COVID-19 Pandemic
As the COVID-19 pandemic started, the Commission on Population and Development (PopCom) predicted an increase in the birth rate as families are put into lockdown and family planning methods are limited. However, there has been a significant drop in the number of births by 2020 - the lowest since 1986. The Undersecretary for PopCom, Juan Antonio Perez III, attributed the decline of birth rate to COVID-19 causing fewer marriages, women delaying pregnancies because of the pandemic, and the increase in women using modern family planning methods. Aside from these, the COVID-19 pandemic also has disrupted maternal and newborn health services in the Philippines. The utilization of facilities and services for ante-natal check-ups and delivery is also declining due to COVID-19 causing service disruption, difficulty in commuting, and fear of acquiring the virus. Without questions asked, the direct and indirect effects of COVID-19 subsequently increased the annual maternal deaths compared with the pre-COVID years.
Cultural Factors
In reality, cultural factors play major roles in promoting maternal deaths. The perceived low status and neglect to girls and women, polygamy, early marriages and childbearing, underfeeding and dietary practices during pregnancy and double standards of sexual ethics result in clandestine abortion or prepubertal marriage (Stokoe, 1991). Even up to this day, although less practiced, there are still communities in the Philippines that practice such cultural exercises. For instance, according to the 2017 Philippine National Demographic and Health Survey, 1 in 6 Filipino girls in indigenous and Muslim communities in the country are married before they are 18 years old. Compared to women in their 20s, early childbearing is more likely to lead to death due to complications in pregnancy and childbirth. On the other hand, the chances are quite high for infants to be stillborn or dead by the first month of life (UNICEF Philippines, 2022). Another example, polygamous marriages are recognized in the Philippines, but only for Muslims. These polygamous marriages include the marriage of children as young as 13 years old.
Maternal Education (Sex Education)
Studies have revealed a significant relationship between lower levels of maternal education and higher maternal mortality. Women with no maternal education had a 2.7 times higher risk for maternal mortality. On the other hand, women with maternal education for one to six years had 2 times higher risk for maternal mortality than women with 12 years of education. To put it simply, lower levels of maternal education are associated with higher maternal mortality.
Undoubtedly, maternal education promotes awareness and knowledge about a healthy pregnancy that would ensure optimal health outcomes for both the mother and her child. This may facilitate disease prevention, health promotion, health maintenance, and change of beliefs towards the decrease of maternal mortality.
Human Resources Issues
The current situation of the Philippines’ healthcare system threatens the Filipinos’ maternal health. Ineffective budget allocation for health programs and insufficient manpower in hospitals and health centers detrimentally affect the availability and accessibility of maternal health services. It is also important to note that maternal health services are more limited in rural areas than in urban areas given that 53% of Filipinos live in rural areas (Philippines MNPI n.d.). The disparity in terms of maternal care is wide for urban and rural areas. Thus, these contribute to increased maternal mortality.
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What are the top 3 causes of maternal mortality ratio in the Philippines? Top 3 maternal morbidity?
Top 3 Causes of Maternal Mortality
According to the Department of Health, the top three main causes of maternal mortality in the Philippines by 2010 are:
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Complications related to pregnancy occurring in the course of labor, delivery, and puerperium - account for 38.4% of the 1719 maternal mortality.
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Hypertension complicating pregnancy, childbirth, and puerperium - accounts for 35.2% of the 1719 maternal mortality.
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Postpartum Hemorrhage - accounts for 17.3% of the 1719 maternal mortality.
Top 3 Causes of Maternal Morbidity
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Hemorrhage (31%)
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Infection (19%)
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Unsafe Abortion (16%)
References:
Baccay, K.B. (2022). Prenatal Care and Safe Motherhood Lecture Video PART I. VLE. Retrieved March 17, 2022, from https://drive.google.com/file/d/1SXIWQpPevbtDjGVAOOlWiDtyE9CqJskQ/view
Department of Health. (2013, December 9). Maternal deaths by main cause. Maternal Deaths By Main Cause | Department of Health website. Retrieved March 17, 2022, from https://doh.gov.ph/Statistics/Maternal-Deaths-By-Main-Cause
Karlsen, S., Say, L., Souza, J.-P., Hogue, C. J., Calles, D. L., Gülmezoglu, A. M., & Raine, R. (2011, July 29). The relationship between maternal education and mortality among women giving birth in health care institutions: Analysis of the cross sectional who global survey on maternal and perinatal health - BMC public health. BioMed Central. Retrieved March 18, 2022, from https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-11-606
Philippine News Agency. (2021, October 10). Ph birth rate drop amid pandemic lowest in 34 years. Philippine News Agency. Retrieved March 18, 2022, from https://www.pna.gov.ph/articles/1156192
Philippines MNPI. (n.d.). Maternal and Neonatal Program Effort Index. Retrieved March 18, 2022, from http://www.policyproject.com/pubs/MNPI/Philippines_MNPI.pdf
UNICEF. (2022, January 7). Passage of "Prohibition of child marriage law" is a major milestone for child rights. UNICEF. Retrieved March 18, 2022, from https://www.unicef.org/philippines/press-releases/passage-prohibition-child-marriage-law-major-milestone-child-rights#:~:text=According%20to%20the%202017%20Philippine,Muslim%20communities%20in%20the%20country.
UNFPA Philippines. (2020, August 15). Significant rise in maternal deaths and unintended pregnancies feared because of COVID-19, UNFPA and UPPI Study shows. UNFPA Philippines. Retrieved March 18, 2022, from https://philippines.unfpa.org/en/news/significant-rise-maternal-deaths-and-unintended-pregnancies-feared-because-covid-19-unfpa-and