Feature: Reducing maternal mortality in Region 8

Tacloban City (August 31) — In order to achieve the Millennium Development Goal on maternal mortality reduction from 209 to 52 per 100,000 live births by 2015, there is a need for quick action from the legislative bodies in the local government units to enact an ordinance regulating the practices of traditional birth attendants in Region 8, as the Department of Health in the Region has been advocating.

However, as the title of the ordinance is somewhat negative, perhaps, what the Department of Health should emphasize is its advocacy to strengthen facility-based services for pregnancy and childbirth by providing local governments with a strategy for implementation and strengthening public-private partnerships.

Thus, a legislation must be passed, to the effect that pregnant women must only give birth in a health facility under the care of the Barangay team the focus of which is providing proper Maternal Health care.

The lifetime risk of maternal death in the Philippines is 1 in every 140, according to UNICEF’s State of the World’s Children 2009 report. Each day, about 11 Filipino mothers, or 4,500 each year, die because of hypertensive disorders, severe hemorrhage or other labor or abortion-related problems. The country is also part of a group of 68 countries where 97% of worldwide maternal, neonatal and child health deaths occur.

“We need to understand why despite the available health care services for them, many of our pregnant women choose to deliver without the proper care of skilled health workers,” the UNICEF representative. A huge effort is needed to improve public reproductive and maternal health services and educate mothers, that is why UNICEF seeks involvement through partnering with government and non-government actors, as well as other U.N. agencies in building capacities and upgrading facilities to serve pregnant women and newborn babies, she said.

The major factors underlying the medical causes are the lack of political commitment and inadequate financial and technical input; poor quality of care and referral system; and childbirth with untrained personnel.

True enough, of the total births in Region 8, only 42.9 percent were attended by health professionals such as doctors and midwives. The remaining 54.5 percent were attended by a hilot.

This was shown in the result of the 2006 Family Planning and Maternal Mortality Survey conducted by the National Statistics Office, which noted that the country has a high maternal mortality ration of 162 per 100,000 live births.

The same survey showed that only 29.9 percent of births in the 5 years preceding the survey were delivered in health facilities while the remaining 70.1 percent were home deliveries.

The percentage of births attended by trained health personnel is a process indicator of maternal health status. The low percentage of trained personnel in attendance during delivery does correlate with the level of Maternal Mortality Rate.

In the past, two basic strategies have highlighted efforts to address high maternal mortality ratios. These are the risk approach which focused on identification of high risk pregnancies for referral during the prenatal period and the training of traditional birth attendants. However, these strategies failed to reduce maternal mortality ratio in the country.

Thus, because of the above premises and the fact that the Philippines has committed to achieve the Millennium Development Goal on maternal mortality reduction from 209 to 52 per 100,000 live births by 2015, the Department of Health Region 8 submitted to the Regional Development Council of Eastern Visayas, its proposed resolution entitled “A Resolution Strongly Requesting the Sangguniang Panlalawigan, Panglungsod and Bayan to Enact an Ordinance Requiring all child deliveries must only be done in health facilities under the care of trained health personnel.

Reducing maternal mortality requires coordination and long-term efforts. Actions are needed within families and communities, in society as a whole, in the health system and at the level of legislation and policy making.

Furthermore, interactions and interventions such as legislative and policy action, long term political commitment, is an essential prerequisite. When decision makers are determined to address maternal mortality, the resources needed will be mobilized and the essential policy decisions or legislation will be taken. (PIA