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Missing Targets: An alternative MDG midterm report
More than any other facet of health services, good
interpersonal relations was emphasized time and again
as an important factor in poor women’s continued use
of a health service. Services that were inadequate—meager
facilities, insufficient medical supplies and limited
personnel—were as critical an issue as health service
providers who did not treat them with dignity and
respect. Women responded feeling degraded and widely
exposed in an assembly line-like delivery.
The geographic maldistribution, the generally low
quality and underfunded government facilities, and the
burden of paying for services deny poor women and
children effective access to critical health interventions
during pregnancy, particularly before and after childbirth.
In urban slums, women are near hospital facilities
but they do not utilize.
This is where it is probably most pronounced but
GPS data conservatively show that over half of home
deliveries occur near a health facility.
Health facility delivery in ARMM and Zamboanga
Peninsula are lower than the rest of Mindanao, which
in turn are lower than the Philippine average.
richest quintile had home births. (WHO Fact Sheet,
2007). More so, less than 20 percent of poor mothers
were assisted during delivery by trained health professionals,
e.g., a doctor, nurse or midwife, while more
than 80 percent of mothers from the richest quintile
received assistance.
A tale of disparities: An issue of poverty,
gender and inequity
Statistics are blind to inequity. Disparities are
hidden in the national averages which fail to show
the picture of maternal and child mortality in the
country.
Poor women and children consistently are not
able to access services. Access to health care services is
fast becoming an issue of inequity, with poor Filipino
women unable to access the services, information,
supplies and facilities that could prevent and reduce
maternal and child mortality. The services are inaccessible
because often they cannot afford treatment or,
because as women, do not have the time or the social
support to avail themselves of the service.
1998 2003 ARMM
Health Facility 34 38
Zamboanga
Peninsula
Mimaropa
Eastern
Visayas
Home 66 61 88.4 83.8 83 79.3 76.3
Govt. Hospital 6.3 10.9 13 14.7 15.7
Govt. Health Center 0.5 1.0 0. 6 0.7 0.7
Private 3.9 3.7 2.1 5.3 5.5
Source: NSO, DOH, and Macro International Inc., 1999
Bicol
2003 NDHS reveal 38 percent of live births were
delivered in a health facility, and 61 percent were born
at home. These figures show an increase in the proportion
of births occurring in a health facility (34 percent
in 1998) and a decline in the percentage of births
delivered at home (66 percent in 1998) (NSO, DOH,
and Macro International Inc., 1999).
Delivery in a health facility is most common in
NCR (70 percent). On the other extreme, only 6 percent
of births in ARMM are done in health facilities.
In 10 regions, at least 70 percent of births occurred
at home, with ARMM (88 percent), Mimaropa (83
percent), and Zamboanga Peninsula (84 percent) registering
the highest percentage.
Over 90 percent of women from the poorest quintile
gave birth at home while a mere 20 percent of the
Improving equity within countries would prevent
40 percent of all child deaths.
Poverty and maternal
and under-five child mortality
The disproportionate number of women and
under-five child mortality among poor households is
borne by the environmental risk and hazards that the
poor mostly endure in their living areas. The major
causes of child deaths in developing countries, in
particular in South Asia and Southeast Asia, reveal the
link between maternal and child mortality and poverty.
Major causes of deaths in the region are found to have
been largely contracted and transmitted in conditions
of poverty such as crowded living quarters, intergenerational
malnutrition, indoor and outdoor air pollu-
40 S O C I A L W A T C H P H I L I P P I N E S