Abstract
BackgroundThe Philippines failed to achieve its Millennium Development Goal (MDG) commitment to reduce maternal deaths by three quarters. This, together with the recently launched Sustainable Development Goals (SDGs), reinforces the need for the country to keep up in improving reach of maternal and child health (MCH) services. Inequitable use of health services is a risk factor for the differences in health outcomes across socio-economic groups. This study aims to explore the extent of inequities in the use of MCH services in the Philippines after pro-poor national health policy reforms.MethodsThis paper uses data from the 2008 and 2013 Demographic and Health Survey (DHS) in the Philippines. Socio-economic inequality in MCH services use was measured using the concentration index. The concentration index was also decomposed in order to examine the contribution of different factors to the inequalities in the use of MCH services.ResultsIn absolute figures, women who delivered in facilities increased from 2008 to 2013. Little change was noted for women who received complete antenatal care and caesarean births. Facility deliveries remain pro-rich although a pro-poor shift was noted. Women who received complete antenatal care services also remain concentrated to the rich. Further, there is a highly pro-rich inequality in caesarean deliveries which did not change much from 2008 to 2013. Household income remains as the most important contributor to the resulting inequalities in health services use, followed by maternal education. For complete antenatal care use and deliveries in government facilities, regional differences also showed to have important contribution.ConclusionThe findings suggest inequality in the use of MCH services had limited pro-poor improvements. Household income remains to be the major driver of inequities in MCH services use in the Philippines. This is despite the recent national government-led subsidy for the health insurance of the poor. The highly pro-rich caesarean deliveries may also warrant the need for future studies to determine the prevalence of medically unindicated caesarean births among high-income women.Trial registrationNot applicable.
Highlights
The Philippines failed to achieve its Millennium Development Goal (MDG) commitment to reduce maternal deaths by three quarters
Using data from two consecutive Demographic and Health Surveys (DHS) in the Philippines, this study focuses on key Maternal and Child health services use indicators
Supporting the implementation of strategies to achieve Universal Health Care (UHC) in the Philippines, this study shows the importance of monitoring equality in the use of maternal and child health (MCH) services
Summary
The Philippines failed to achieve its Millennium Development Goal (MDG) commitment to reduce maternal deaths by three quarters. This, together with the recently launched Sustainable Development Goals (SDGs), reinforces the need for the country to keep up in improving reach of maternal and child health (MCH) services. The advent of global development agendas have clearly pushed countries beyond limits to commit and invest in specific goals. One of these is the goal to reduce maternal deaths by three quarters between 1990 and 2015 (Millennium Development Goals). Reducing the global mortality ratio to 70 deaths per 100,000 live births requires countries like the Philippines to scaleup efforts to effectively improve maternal and child health conditions. Evidence suggest improving Maternal and Child Health (MCH) services has an effect on the reduction of maternal deaths but extends to impact reduction in neonatal and post neonatal mortality rates [2]
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