Fertility rate down but more mothers dying

MANILA, Philippines—The good news on total fertility rate (TFR) in the Philippines is that it has been cut by more than half in a span of five decades.

The bad news is that it remains the highest among the 10 member countries of the Association of Southeast Asian Nations (Asean).

Another bad news is the substantial increase in the number of Filipino mothers dying during childbirth in the last decade—a problem a senior economic manager attributed to the country’s high fertility rate.

From 7.2 births per woman in 1960, the country’s total fertility rate declined to 3.1 births in 2010, according to a November 2012 report prepared by Jose Ramon Albert, then secretary general of the National Statistical Coordination Board (NSCB).

The figure is projected to decrease even more to within the range of 1.73 to 2.31 in 2030-2040, according to government data.

A comparison using data from the United Nations and the NSCB showed that the Philippine TFR—the average number of children that a woman would bear at the end of her reproductive years—was the highest in the Asean.

The TFR in Cambodia was 2.6 in 2010. It was 2.1 in Indonesia; 2.8 in Laos; 2.6 in Malaysia; 2.0 in Burma (Myanmar); 2.0 in Brunei; 1.8 in Vietnam; 1.6 in Thailand, and 1.3 in Singapore.

In general, the TFRs of Asean countries declined from 1960 to 2010.

The world’s TFR, according to UN data, has also been halved over the past 50 years.

The United Nations Population Fund, in its report “Aging in the Twenty-First Century: A Celebration and a Challenge,” said the TFR had fallen from 5 children per woman in 1950-1955 to 2.5 children in 2010-2015, with the number expected to decline further.

Arsenio Balisacan, director general of the National Economic and Development Authority (Neda), on Wednesday said more and more women, particularly those who were poor, were denied access to proper healthcare during their pregnancy because of the state’s stretched medical resources.

“[This reflects] the urgency [of] aggressively implementing reforms in the health sector in order to ensure equitable access to quality healthcare,” he said.

The results of the government’s latest Family Health Survey (FHS), conducted in 2011, showed that 221 of 100,000 mothers died during childbirth, topping the previous maternal mortality ratio of 162 out of 100,000 in the previous survey, taken in 2006.

Balisacan said the government wanted to bring down the maternal mortality rate to 50 per 100,000 births by 2016 as part of its Millennium Development Goals. “We remain challenged by our country’s high fertility rate,” he said.

In 2012, the Philippines passed the Responsible Parenthood and Reproductive Health Act, which provides for universal access to contraceptives and sexual education in schools.

Opponents challenged the law in the Supreme Court, which affirmed its legality recently.

“The government will implement more focused programs and projects in line with the objectives of the Philippine Development Plan or PDP Midterm Update,” Balisacan said.

He said a separate survey showed a glimmer of hope. Preliminary results of the 2013 National Demographic and Health Survey (NDHS) found that 60 percent of all deliveries were being done by health professionals, higher than the 44 percent in 2008.

“The (NDHS) survey results will aid in our advocacy for responsible parenthood and family planning,” Balisacan said.

Births delivered by a health professional also increased from 62 percent in 2008 to 73 percent in 2013.
Across regions, the percentage of births delivered in a health facility ranged from 12 percent in the Autonomous Region in Muslim Mindanao to 76 percent in Metro Manila.

Eight regions registered significant increases. These are Eastern Visayas (33.7 percent to 61.6 percent), Soccsksargen (23.5 percent to 47.9 percent), Central Visayas (45.7 percent to 71.6 percent), Ilocos region (42.1 percent to 67.2 percent), Caraga (30.1 percent to 55 percent), Cordillera Administrative Region (CAR) (51.1 percent to 75 percent), Cagayan Valley (28.9 percent to 50.6 percent) and Bicol region (32.4 percent to 50.4 percent).

Only three regions had remarkable improvement in terms of the percentage of births delivered by a health professional. These are Eastern Visayas (43 percent to 67 percent), Soccsksargen (36 percent to 56 percent) and CAR (67 percent to 85 percent).

Final results of the 2013 NDHS, a nationally representative survey of almost 16,000 households and 19,000 women ages 15 to 49, will be published in the last quarter of the year.

The survey was conducted from Aug. 12 to Oct. 16 last year. –Ana Roa, Inquirer Research, Paolo G. Montecillo, Philippine Daily Inquirer

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