Abstract
BackgroundDespite achieving some success, wealth-related disparities in the utilisation of maternal and child health services persist in the Philippines. The aim of this study is to decompose the principal factors driving the wealth-based utilisation gap.MethodsUsing national representative data from the 2013 Philippines Demographic and Health Survey, we examine the extent overall differences in the utilisation of maternal health services can be explained by observable factors. We apply nonlinear Blinder-Oaxaca-type decomposition methods to quantify the effect of differences in measurable characteristics on the wealth-based coverage gap in facility-based delivery.ResultsThe mean coverage of facility-based deliveries was respectively 41.1 % and 74.6 % for poor and non-poor households. Between 67 and 69 % of the wealth-based coverage gap was explained by differences in observed characteristics. After controlling for factors characterising the socioeconomic status of the household (i.e. the mothers’ and her partners’ education and occupation), the birth order of the child was the major factor contributing to the disparity. Mothers’ religion and the subjective distance to the health facility were also noteworthy.ConclusionsThis study has found moderate wealth-based disparities in the utilisation of institutional delivery in the Philippines. The results confirm the importance of recent efforts made by the Philippine government to implement equitable, pro-poor focused health programs in the most deprived geographic areas of the country. The importance of addressing the social determinants of health, particularly education, as well as developing and implementing effective strategies to encourage institutional delivery for higher order births, should be prioritised.
Highlights
Despite achieving some success, wealth-related disparities in the utilisation of maternal and child health services persist in the Philippines
In the Philippines, substantial variations in health services and outcomes continue across wealth quintiles despite national reductions in child mortality rates [2, 3]
For example, suggest that the percentage of women from the richest quintile delivering their child with a skilled provider was 96 %, compared to only 42 % for women in the poorest quintile [9]. Such discrepancies are common in the Philippines and the factors responsible for the wealth-based utilisation gaps remain unknown
Summary
Wealth-related disparities in the utilisation of maternal and child health services persist in the Philippines. Many low- and middle-income countries are beset by wealth-based disparities in the use of reproductive, maternal, newborn and child health (RMNCH) services and outcomes [1,2,3]. For example, suggest that the percentage of women from the richest quintile delivering their child with a skilled provider was 96 %, compared to only 42 % for women in the poorest quintile [9] Such discrepancies are common in the Philippines and the factors responsible for the wealth-based utilisation gaps remain unknown. We focus on the utilisation of institutional birth delivery This service is a complex intervention provided for a standard purpose and recommended for all women. Institutional delivery can usefully represent facility-based care for RMNCH more generally
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
