UNFPA at Work: Six Human Rights Case Studies

6.THE PHILIPPINESGattaran, with a population of 50,269 in 2007, is a municipality in Cagayan province where the maternal death rateis down to zero. It has been that way for the past seven years. Aggressive local government efforts and strong supportby residents have combined to vastly improve the chances of survival for mothers. The municipality has exceeded itstarget for pregnant women seeking early prenatal check-ups by 10–20 per cent. Immunization of expectant mothersis at 100 per cent, and deliveries in birthing centres have gone up to 95 per cent. Other side benefits reaped from thestrategy include a 15 per cent increase in the number of new acceptors of family planning, a decrease in the percentageof teenage marriages from 75 to 40 per cent and the observable sustained enthusiasm of male motivators.Midwives, who are on the frontlines of the reproductive health campaign, say their role in the community has expanded.One of them says, “We are into everything – including ensuring a healthy water system, garbage disposal, everything.”Such things, after all, affect the health of a family. And, “primary health care begins at home”.Demonstrating that birthing is really a community concern, barangays in Gattaran have set up a ‘pregnancy watch’system where advocates and motivators serve as ‘lookouts’. This ensures that expectant mothers are availing themselvesof prenatal services. For this function, a village health worker and a councillor are in charge. So involved are localofficials in the health of their constituents that Nabaccayan barangay chairman Isaac Mateo Jr. relates, “In case ofemergency, I take the pregnant women to the hospital myself!”— Excerpted and adapted from ICPD at 10 Magazine, a special publication produced in the Philippines for the 10th anniversary of the1994 International Conference on Population and Development.The Gattaran success story demonstrates multiple aspects ofthe local government’s strategy to improve the health andwell-being of Filipino people. The municipality’s reproductivehealth campaign combined many important elements, including:highly committed local government officials, doctors,health-care providers and community members; improvementsin health-care infrastructure and resources; planning onhow to meet expenses; and a far-reaching community outreachand education programme (see box on next page).UNFPA began working in the Philippines in 1969. Despitewidespread poverty, the island nation has long maintaineda highly engaged civil society. This engagementhas often been reflected in people’s eagerness to partnerto improve reproductive health initiatives at the locallevel. Local public institutions and residents in communitiesthroughout the Philippines have been importantactors in the successful implementation of many suchactivities over the years.9 Local government in the Philippines is composed of provinces, cities, municipalities and barangays, the last being the smallest administrative unit. Governors areelected to head the provinces, mayors for the cities and municipalities and captains or chairmen for the barangays.THE PHILIPPINES41