Report - Social Watch Philippines

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New policies and programs meant to fast-track progress, such as emergency neonatal care, have yet to show positive impact. With infant and under-fi ve mortality still unacceptably high, there is much reason to challenge the government claims of a high probability of achieving Millennium Development Goal 4. Indicators for MDG 4 on reducing child mortality include both under-fi ve and infant mortality rates, together with the proportion of 1 year-old children immunized against measles. To achieve this goal, and the target of reducing child mortality by two-thirds, there is an urgent need to mount effective and adequate responses. Status, causes and trends The Philippines is one of 68 countries where 97 percent of all neonatal, child and maternal deaths worldwide occur. 1 Children born in the Philippines are at a greater risk of dying than those born in other Asian countries. .2 Annually 82,000 children under fi ve die in the country. In 1990, the under-fi ve mortality rate was 80 deaths per 1,000 live births; the goal is to reduce this by two-thirds come 2015. The infant mortality rate and the proportion of 1-year-old children immunized against measles are indicators of the progress in eliminating under-fi ve mortality. Neonatal mortality (NN): the probability of dying within the first month of life Postneonatal mortality (PNN): the difference between infant and neonatal mortality Infant mortality (1q0): the probability of dying before the first birthday Under-five mortality (5q0): the probability of dying between birth and fifth birthday. All rates are expressed per 1,000 live births Table 1. MDG 4 Indicators Status 1 State of the World’s Children 2009 report. 2009. United Nations Children’s Fund (UNICEF). 2 UNICEF. 76 SOCIAL WATCH PHILIPPINES Under-fi ve, infant and neonatal mortality rate, and immunization status Under-fi ve mortality rates (U5MR) in the country decreased by more than half since 1990 (see Figure 1). However, the drastic drop in U5MR only took place from 1990 to 1993, and slowed down soon after. Overall, the base estimate decreased by only 34 percent to the current estimate of 34 deaths per thousand. This current U5MR (2008), although still way above the current regional average of 22 deaths per 1,000 live births, seems on track towards reaching the target of 26.7 (see Table 1). But a closer look at the data shows risks of reversing the decrease. Figure 1. Infant and Child Mortality in the Philippines (Per 1,000 live births) Source: 1990 and 1993 National Demographic Survey; 1998, 2003, 2008 National Demographic Health Survey Infant mortality, which contributes to almost 70 percent of all under-fi ve deaths, registered the barest improvements over the past two decades. As with U5MR, infant mortality rates (IMR), underwent a sharp decrease from 1990 to 1993, when the rate fell from 57 infant deaths per 1,000 live births to 34. But in 1998, the IMR increased slightly to 35, then slowly declined to 29 in 2003, until it reached 25 deaths in 2008 (see Table 1). The current rate is still high MDG4 Indicator (in percent) 1990 1993 1998 2003 2008 2015 Government Assessment Under-five mortality rate 80 54 48 40 34 26.7 High Infant mortality rate 57 34 35 29 25 19 High Proportion of 1 year-old children immunized against measles Source: 1990 and 1993 National Demographic Survey 1998, 2003, 2008 National Demographic Health Survey 78 71 70 76 100 High
compared to other countries in the region – Vietnam, Brunei, Singapore, Thailand, and Malaysia. From 1990 to 1993, under-fi ve and infant mortality rates decreased by 43 percent and 32 percent respectively. The sharp drop can be attributed to the massive, nationwide campaign on vaccination launched by the Department of Health (DOH) to achieve the Universal Child Immunization Goal. One of the most popular and successful was Oplan Alis Disease launched by then DOH Secretary Juan Flavier. However, the decline in the past decade of fully immunized children may have eroded MDG 4 gains. As indicated in the last decade, progress in reducing U5MR and IMR has decelerated. Newborn deaths Further analysis of the infant mortality rates show that up to 70 percent are caused by neonatal deaths. Sixteen neonates in a thousand live births in the Philippines die before they reach their fi rst month of life (see Figure 2). Figure 2. Infant Mortality Ratio Composition Source: 2008 National Demographic Health Survey Neonatal and post-neonatal deaths decreased the slowest over the past 20 years, with a rate of less than 10 percent from 1990 to 2008. Causes of under-fi ve, infant, and neonatal mortality Globally, under-nutrition has been found to cause more than one-third of child deaths. The majority of under-fi ve mortalities are due to neonatal complications, pneumonia, diarrhea, measles, meningitis, and other diseases, coupled with malnutrition. For infant deaths, the three most common causes are bacterial sepsis, pneumonia, and disorders related to short gestation and low birth weight. Neonatal deaths in the Philippines were caused by preterm birth (28 percent), asphyxia (23 percent), sepsis/pneumonia (26 percent), congenital anomaly (8 percent), tetanus (7 percent) and diarrhea (3 percent). Indirect causes are maternal-related risk factors, newborn-related risk factors, and low birth weight (13 percent) due to pre-maturity and poor intra-uterine growth rate. Disparities in infant and under-fi ve mortality Under-fi ve and infant mortality rates registered the highest in the Autonomous Region in Muslim Mindanao (ARMM), followed by Eastern Visayas, 3 throughout the 10 years preceding the 2008 offi cial data. Both U5MR and IMR cut across demographic differences but are most prevalent in the rural areas and among the poorest sections of society. In every 1,000 live births, 59 poor children die before they turn 5 years of age; while 40 poor infants barely reach their 1st year (see Figure 3). The U5MR and the IMR are 2.7 and 2.3 times higher, respectively, amongst the poorest households compared to those in the highest income quintile. The same pattern is seen in the rate of neonatal deaths. In the rural areas, the ratios are 49 in 1,000 births for U5MR and 35 in /1,000 births for IMR. Figure 3. Child Mortality Rates by Wealth Status Disabling factors Links have been found between the mothers’ educational attainment and child mortality rates. Approximately 1 in every 10 children (or 136 in 1,000) 3 In ARMM, under-fi ve mortality rate is highest at 94 deaths per 1000 live births, while infant mortality is at 56 deaths per 1000 live births. Eastern Visayas comes in second with 64/1000 for under-fi ve mortality, and 45/1000 for infant mortality. Winning the Numbers, Losing the War: The Other MDG Report 2010 77
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Winning the Numbers, Losing the War
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ACKNOWLEDGEMENT Many deserve our th
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CLEEP Comprehensive Livelihood and
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MOA-AD Memorandum of Agreement on A
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ABOUT THE AUTHORS/CONTRIBUTORS Leon
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FOREWORD By ISAGANI R. SERRANO This
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An urgent MDG message: Inadequate f
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The use of the budget instrument fo
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MDG chances: stability and vulnerab
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may mean a short honeymoon period.
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what we got from Annex I countries
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(Php58.6 Billion) of GDP at current
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Fourth Assessment Report provide a
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Losing the war on poverty The Other
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Table 1. Philippines’ MDG progres
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(NER) and medium on both cohort sur
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incidence of 97.46 percent. The las
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special needs; (c) 228,928 women in
Page 41 and 42: cultural structures urgently needin
Page 43: capacity to confront the dreaded cl
Page 46 and 47: MDG Goal 1 Targets 1 and 3: On erad
Page 48 and 49: Table 1. Prevalence of undernutriti
Page 50 and 51: 2007, women’s national unemployme
Page 52 and 53: in the service and production secto
Page 54 and 55: een generally positive—increased
Page 56 and 57: Table 9: Partial Listing of Big Lan
Page 58 and 59: and promote gender equality in all
Page 60 and 61: While many see this as an education
Page 62 and 63: seen in both public and private pre
Page 64 and 65: and therefore, limited coverage. Th
Page 66 and 67: Table 7. Education Expenditure as a
Page 68 and 69: Box 2. Education budget tracking (2
Page 70 and 71: This paper looks at highly vulnerab
Page 72 and 73: to education. 5 In practice, debt p
Page 74 and 75: Table 5. Distribution of Government
Page 76 and 77: Table 7. Average Daily Basic Pay by
Page 78 and 79: in the 80’s, according to Sibal,
Page 80 and 81: eports of female OFW deaths, sexual
Page 82 and 83: Table 13. Trafficked Migrants Assis
Page 84 and 85: plicating overpopulation and poor w
Page 86 and 87: CAN$318.8 billion. While they found
Page 88 and 89: . Women’s economic empowerment i.
Page 90 and 91: statistics-fs-violence-against-fi l
Page 94 and 95: Table 2: Immunization Status 1998 2
Page 96 and 97: Table 4. List of Nutritionally Vuln
Page 98 and 99: percent), who gave birth at home (9
Page 100 and 101: protocol is another comprehensive s
Page 102 and 103: 5. Revamping the health insurance s
Page 104 and 105: Universalizing health care As we po
Page 106 and 107: Progress of work in improving mater
Page 108 and 109: Figure 2. Use of Skilled Birth Atte
Page 110 and 111: In terms of postnatal care, 77 perc
Page 112 and 113: Abortion Worldwide abortion rates h
Page 114 and 115: went down from 9.8 percent in 2005
Page 116 and 117: longer to health care centers in co
Page 118 and 119: However, USAID, with the concurrenc
Page 120 and 121: Box 1. Safe Motherhood: a brief his
Page 123 and 124: The rising challenge of HIV/AIDS an
Page 125 and 126: Sexual transmission remains to be t
Page 127 and 128: national response. Since health was
Page 129 and 130: Figure 7. Frequency distribution of
Page 131 and 132: Table 5. Annual estimated cost for
Page 133 and 134: tion of Public-Private Mix Departme
Page 135 and 136: Not much time, but not without opti
Page 137 and 138: Questions and more questions on the
Page 139 and 140: Figure 1: Biodiversity Hotspots Bio
Page 141 and 142: MDG’s, but more importantly, on b
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8. Organic Agriculture Act of 2010;
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science Bureau (MGB) but funded by
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Problems and gaps Incoherent and cl
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must be able to provide for non-pro
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Trade, debt and aid: MDG retardants
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Table 1. Recent Trade and Investmen
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elated social spending; Three, ille
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eing proposed in Congress. But more
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Results - Developing countries and
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Mindanao situation Mindanao is the
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Table 1.Cohort Survival Rate by Reg
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MTPDP has not gained momentum to ef
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Seven provinces in Mindanao, almost
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a. Lobby for the crafting of laws a
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Moro situation after the Treaty of
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and Palawan movement and Mindanao I
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Appendix B Are the Moros Filipinos?
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Government with respect to the Moro
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legal and political shields behind
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Goals and Targets (from the Millenn
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