MANILA, Philippines – Metro Manila was lauded for its recent achievements in child health but the entire Philippines still has a long way to go.

According to the State of the World’s Mothers report by Save the Children, Metro Manila successfully cut its under-5 mortality rate by half over a 15-year period. (READ: Improved child mortality rates in Metro Manila seen)

Despite this improvement, regional data on children’s mortality rates from the National Demographic and Health Survey (NDHS) in 2013 show there’s still a lot to be done to be at par with Metro Manila.

The country’s average child mortality prevalence stands at 29.9 per 1,000 births.

The Autonomous Region in Muslim Mindanao (ARMM) has the most number of under-5 deaths in the Philippines with 55 per 1,000 live births. This, according to reports, can be attributed to lack of access to basic social services brought about by decades-long conflict in the region. 

Local government units in Metro Manila were able to improve the quality of basic social services, maternal services, public-private partnerships, investment in health workers, and policy reforms, among others.

To spread this to other parts of the country, the improvement of basic social services – encompassing maternal health programs and investing in health workers, among others – should be uniform in all regions across the country.

What will help?

According to the report, there are 3 key recommendations that will lessen the number of child deaths. These will also help improve the lives of the poor – whether urban or rural:

1. Better care for mothers and babies before, during, and after childbirth

The Philippines currently ranks 105^th out of 179 countries when it comes to the welfare of mothers in 2015. This is proof that Metro Manila’s improvement will not matter if other regions do not follow suit.

It is important to address the concerns of places outside highly urbanized areas such as lack of access to better health services – whether physical access or financial-related.

Meanwhile, only 68% of the country’s poorest underwent labor with a skilled attendant present. There is still a prevailing practice of giving birth at home with the help of manghihilots (traditional birth attendant). Despite a “common practice” in most rural areas, it’s deemed dangerous and might increase chances of deaths. (READ: Are home births being banned?)

After labor, a mother might still go through several problems such as those related to breastfeeding. If uninformed about other options, she might resort to buying milk formula for her infant child. The use of infant formula for infants is discouraged by advocates. (READ: The real cost of infant milk formula)

The lack of financial means can also lead to malnutrition-related problems for the family in the long run.

All of these issues can be solved if LGUs give priority to programs and projects that will not only educate mothers but also provide other solutions.

2. Increased use of modern contraception to prevent or postpone pregnancy

The Reproductive Health (RH) Law could be the answer. (READ: DOH revising RH rules; law seen to curb child deaths)

Section 7 of the RH Law mandates that “all accredited public health facilities shall provide a full range of modern family planning methods” especially for the poor.

Unfortunately, its existence is continuously challenged by different groups based on morals and the country’s religious upbringing.

It was declared constitutional in December 2014 but its effects are yet to be felt. (READ: SC declares RH law constitutional)

3. Effective strategies to provide free or subsidized quality health services for the poor

The Save the Children report said that 72% of the poorest mothers in the country were able to visit a doctor at least 4 times before childbirth. Despite being more than half, it is still far from the richest’ prevalence rate of 93%.

The move for free or subsidized health services should be prioritized as most Filipinos – especially members of the 20% poorest sector – do not have access to health services. They also have to compete to gain from the “very limited resources” often found in regions.

Due to lack of financial capacity to access health care, the poor children in the Philippines are twice as likely to die by age 5 than rich children.

This inequality among social classes is deepened by discriminating circumstances. The report said the continuous rise of the cost of health care “despite policy reforms” may hinder improvement in the whole country.

Post-2015

According to the 5th progress report of the Millennium Development Goals (MDG), the Philippines has a “good chance” of reducing child mortality. (READ: PH ‘likely’ to meet education, infant mortality MDGs)

But what is important now is that the country commits to the new Sustainable Development Goals (SDGs) that aim to improve the lives of all children around the world by 2030. 

This can be achieved, according to the proposal, through better health care services and most especially, access to these by the poorest sector. – Rappler.com