Philippine docs probe nationwide maternal death rate

BAGUIO CITY—Doctors have started an audit of the country’s rate of maternal deaths after discovering alarming discrepancies due to different measurement standards used by government and private hospitals.

Health Secretary Enrique Ona supported the review on Monday when he led the first of a series of consultations on universal health care for northern and central Luzon health workers.

When asked, Ona said the audit should not affect the debate over a controversial reproductive health bill, which uses poor maternal health conditions in the provinces to justify a law that grants Filipinos full access to information about sexuality and reproductive health.

A solid foundation of information about maternal deaths in the Philippines would help the campaign for reproductive health and may improve the country’s targets as it tries to fulfill its 2015 Millennium Development Goals (MDG), Ona told reporters here.

The MDG is a United Nations program that requires member-states to improve their educational, social and health conditions in order to reduce poverty.

The Philippines has aimed to reduce maternal deaths or deaths during childbirth to 52 per 100,000 live births in the next four years. But reckoning from 2006 figures, Ona said the country has a lot of catching up to do because 162 mothers still die for every 100,000 live births recorded in the country.

The United Nations Development Program (UNDP) classifies the progress of this target as “low,” and said this was “the least likely to be achieved for the Philippines.”

Ona addressed the discrepancy in maternal death figures when government doctors in Apayao reported that the province’s seven maternal deaths, which were recorded by local hospitals and health centers in 2010, included women who died outside the province.

Dr. Thelma Dangao, Apayao health officer, said her office was instructed to use a system that counts the health condition of residents even though they were hospitalized or treated outside the province.

Dr. Maria Lourdes Otayza, chief of hospital of the Mariano Marcos Memorial Hospital and Medical Center in Batac City, Ilocos Norte, said their personnel have begun an audit of the province’s maternal death figures after they observed the discrepancies that were attributed to flaws in collecting and preserving data.

Otayza offered the Department of Health full use of a software her team had designed to collate and assess prenatal and childbirth information that would be supplied by public and private health facilities.

Ona said improving natal care is crucial because it “reflects the quality of care in our localities.”

He said previous administrations tried to correct the system by increasing the number of midwives in the provinces.

Ona said this program only encouraged home births, “which proved to be bad” because few houses offer the sanitary conditions required for safe births.

“Some births occur at night and even with professional midwives [prepared to respond at any hour], some homes have no electricity or clean water supply to offer the sterile conditions a mother truly needs,” Ona said.

His solution is to increase the number of birthing facilities or units equipped with basic tools required for safe delivery. The facilities may be set up in rural health units or may be built in remote communities.

Full access to reproductive health is also an MDG target, but the UNDP also indicated that the Philippines has a low probability of achieving this target.

Different figures
Ona said the debates over House Bill 4244 (the proposed Responsible Parenthood, Reproductive Health and Population Development Act of 2011) have paid little attention to the five million “poorest of the poor” families whose fertility rate measured 5.2 percent. The fertility rate of Filipino families belonging to the middle class and educated but low-income groups dropped to 0.9 percent, he said.

This means that average Filipino families have fewer children than families classified as “very poor,” Ona said.

He said the government’s quest for better information also involves universal health insurance.

President Aquino wanted every Filipino to be covered by health insurance in three years, but Ona said he promised to fulfill that goal in 2012.

But Ona said he was confronted by three different figures that supposedly reflect the membership of the Philippine Health Insurance Corp.

PhilHealth claims it has achieved an 87 percent coverage, but a University of the Philippines (UP) audit showed that only 37 percent of the population has health insurance, Ona said.

Another UP study commissioned by PhilHealth showed that 54 percent of the population uses health insurance, he said. –Vincent Cabreza, Inquirer Northern Luzon