Reducing Maternal Mortality in the PhilippinesRural Women and the Millennium Development Goals
By Ernesto Ordoñez (14th March 2008)
Article Source: Philippine Daily Enquirer
Today, we discuss rural women in the context of the Eight Millennium Development Goals (MDGs) that address the world’s main development challenges. The MDGs were drawn from the actions and targets contained in the Millennium Declaration that was adopted by 189 nations, and signed by 147 heads of state and governments during the United Nations Millennium Summit in 2000. When we examine the progress toward these goals, we find that rural women have been the most neglected.
Of the eight MDGs, Goal No.5: “Improved Maternal Health” has the slimmest chance of being met. Francisco Songane, the director of the Partnership for Maternal, Newborn and Child Health, hosted by the World Health Organization (WHO), states: “Maternal mortality—deaths of women in pregnancy and childbirth—remains at almost the same level as 20 years ago.”
Songane adds an important perspective: “Women play an essential role in their homes and communities, as well as in the global economy. They lead 25-30 percent of all households as sole income earners. When we fail to save their lives, we are not only leaving families and communities with tragic and irreplaceable losses, but also missing an enormous opportunity for human development.”
Upon further research, we find that the Philippines has five times the maternal mortality rate of Malaysia, and 1.4 times that of Thailand. The accompanying table details relevant information to show the differential impact on rural as compared to urban women.
Department of Health initiatives
The Department of Health (DoH) should be congratulated for no longer having to record 182 deaths for every 100,000 pregnancies like it did from 2001 to 2005. In 2006, which is the most recent data it has, this has decreased to 162. A source in the DoH that I interviewed last week stated that this was expected to have decreased further in 2007, with increasing success in the next few years. This can be attributed primarily to a change in strategy in addressing maternal morbidity.
Instead of just training the traditional “hilots” on better maternal care, DoH formed partnerships with different groups such as the Department of Social Welfare and Development, local government units, and nongovernmental organizations (NGOs).
The objective of this partnership was to emphasize the importance of bringing the pregnant women to healthcare facilities, which was the single most important factor in preventing maternal morbidity.
Considering that 80 percent of rural women do not avail themselves of this opportunity, it is imperative that they be given special attention.
The Pambansang Koalisyon ng Kababaihan sa Kanayunan [National Association of Rural Women], or PKKK, a leading member of the Alyansa Agrikultura [Agricultural Alliance], recommends the immediate approval of the Magna Carta of Women sponsored by Senator Pia Cayetano.
PKKK president Trining Domingo states: “This is specially important because it addresses squarely the problem of maternal morbidity, with special attention given to rural women.” Meanwhile, farmer and fisher organizations can already act on this problem. My DoH source said a big part of the problem was in having to transport the pregnant woman to the healthcare facility.
The answer would therefore be to have many small healthcare facilities specializing in family planning and childbirth services. These organizations can propose where these facilities can be set up. One successful model that has not been adequately exposed is that of the Well Family Midwife Clinic Partnership Foundation, Inc. (WPFI).
This is an NGO that nurtures “a network of excellent community-based clinics and health service providers that ensure family wellness through family planning, maternal, and childcare services.” (Website: http://www.wfmc.com.ph/). WPFI President Dr. Warlito Vicente states: “Organized in June 18, 2002, WFPI now has 135 Well-Family Midwife Clinics (WFMCs) spread around the country. We carry a proven franchised solution that is both low-scale and low-cost.”
During Women’s Month, it is suggested that all groups band together to address the fifth Millennium Development Goal, which is to improve maternal health. After all, this is the goal where we have shown the least progress.
The LGUs are especially important in this endeavor. They can catalyze the formation of the partnerships that the DoH recommends, and the formation of small dispersed healthcare facilities.
We must also follow the spirit of the proposed Magna Carta for Women by giving special attention to rural women. As the chart presented here has shown, their maternal care situation is twice as bad as their urban counterparts.DIFFERENTIAL IMPACT ON WOMEN
Indicators Urban Rural
1. No information on dangerous symptoms 61.2% 69.1%
2. No pre-natal care given by doctors/ nurses/midwives 7.4% 19.7%
3. No pregnancy care given by doctors/ nurses/midwives 12.4% 22.9%
4. Delivery done outside healthcare facility 47.7% 80.4%
The author is the chairman of Agriwatch, former secretary for Presidential Flagship Programs and Projects, former undersecretary of agriculture, and former undersecretary of trade and industry. For inquiries and suggestions, email firstname.lastname@example.org or call or fax +632 8522112.
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