A systems approach to improving maternal health in the Philippines

Huntington, Dale; Banzon, Eduardo; Recidoro, Zenaida Dy

doi:10.2471/blt.11.092825

Cited by 23 publications

(23 citation statements)

References 9 publications

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“…However, the poorly developed health information systems and lack of referral emergency-care facilities in remote coastal and isolated mountain communities were the challenges that remained to be addressed. 26 The results of the present study indicated reductions in the inequality of ANC use. This translates to substantial ANC use among women at the lowest living standard quintile.…”

Section: Discussionsupporting

confidence: 56%

Reduction in inequality in antenatal-care use and persistence of inequality in skilled birth attendance in the Philippines from 1993 to 2008

et al. 2013

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ObjectiveTo assess changes in the inequalities associated with maternal healthcare use according to economic status in the Philippines.DesignAn analysis of four population-based data sets that were conducted between 1993 and 2008.SettingPhilippines.ParticipantsWomen aged 15–49 years who had a live-birth within 1 year in 1993 (n=1707), 1998 (n=1513), 2003 (n=1325) and 2008 (n=1209).OutcomesAt least four visits of antenatal care, skilled birth attendance and delivery in a medical facility.ResultsThe adjusted OR for antenatal-care use when comparing the highest wealth-index quintile with the lowest quintile declined from 1993 to 2008: 3.43 (95% CI 2.22 to 5.28) to 2.87 (95% CI 1.31 to 6.29). On the other hand, the adjusted OR for the other two outcome indicators by the wealth index widened from 1993 to 2008: 9.92 (95% CI 5.98 to 16.43) to 15.53 (95% CI 6.90 to 34.94) for skilled birth attendance and 7.74 (95% CI 4.22 to 14.21) to 16.00 (95% CI 7.99 to 32.02) for delivery in a medical facility. The concentration indices for maternal health utilisation in 1993 and 2008 were 0.19 and 0.09 for antenatal care; 0.26 and 0.24 for skilled birth attendance and 0.41 and 0.35 for delivery in a medical facility.ConclusionsOver a 16-year period, gradients in antenatal-care use decreased and the high level of inequalities in skilled birth attendance and delivery in a medical facility persisted. The results showed a disproportionate use of institutional care at birth among disadvantaged Filipino women.

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Section: Discussionsupporting

confidence: 56%

Reduction in inequality in antenatal-care use and persistence of inequality in skilled birth attendance in the Philippines from 1993 to 2008

et al. 2013

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“…The restriction give results on the low MMR and the high institutional delivery for region that implementing the restriction. 2 The availability and access to maternal health services, especially maternal delivery, also contributed to the increasing institutional delivery in Bangladesh. 1 The results also found that proportion of health insurance ownership was 45%.…”

Section: Discussionmentioning

confidence: 99%

“…10 The increase in institutional delivery through health insurance becomes important, considering that delivery at health facilities plays an important role to reduce maternal mortality. 1,2 By increasing access to health facility, health insurance has potential to increase maternal and child outcome.…”

Section: Discussionmentioning

confidence: 99%

“…Institutional delivery plays an important role on maternal mortality rate (MMR) reduction. 1,2 Global Burden of Disease study in 2015 reported that maternal mortality is in the fourth place of all mortality causes. 3 Globally, MMR decreases by 45% from 380 maternal deaths per 100,000 live births in 1990 to 210 maternal deaths per 100,000 live births in 2013.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Health Insurance on Institutional Delivery in Indonesia

Mukhlisa

Pujiyanto

2018

Kesmas: National Public Health Journal

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Institutional delivery has an impact on the decline in maternal mortality rate. In Indonesia, institutional delivery increases every year, but there are still 30%-37% mothers who deliver at home. Unfortunately, the increase is not in line with maternal mortality reduction, so that Indonesia does not achieve the fifth MDGs goal. To achieve Universal Health Coverage, Indonesia implements National Health Insurance (NHI). NHI integrates four types of health insurance, namely Askes/ASABRI, Jamsostek, Jamkesmas and Jamkesda. One of its benefits is maternal health services. Health insurance can address financial barriers on delivery in health facility. By using secondary data of National Basic Health Research 2013 and Village Potential 2011 data, this study aimed to analyze effect of health insurance on institutional delivery in Indonesia. Samples were 39,942 women aged 15-49 years old who gave birth to their last child during 2010-2013. The study used econometric approach by applying probit and bivariate probit as estimation model to estimate the effect with consideration to endogeneity issue of health insurance. The results found that health insurance was likely to increase institutional delivery by 39.52%. In conclusion, women who have health insurance prefer to deliver birth at health facility compared to those who do not have health insurance.AbstrakPemanfaatan pelayanan persalinan di fasilitas kesehatan berdampak pada menurunnya angka kematian ibu (AKI). Di Indonesia, persalinan di fasilitas kesehatan mengalami peningkatan setiap tahunnya, tetapi masih terdapat sekitar 30% ibu yang bersalin di rumah. Sayangnya, peningkatan pemanfaatan pelayanan persalinan di fasilitas kesehatan tersebut tidak diimbangi dengan penurunan AKI, sehingga Indonesia tidak berhasil mencapai target MDGs. Untuk mencapai Universal Health Coverage, Indonesia mengimplementasikan program Jaminan Kesehatan Nasional (JKN) yang mengintegrasikan empat jaminan kesehatan, yaitu Askes/ASABRI, Jamsostek, Jamkesmas, dan Jamkesda. Jaminan kesehatan dapat mengatasi kendala biaya pada persalinan di fasilitas kesehatan. Dengan menggunakan data Riset Kesehatan Dasar 2013 dan data Potensi Desa 2011 sebagai sumber data, penelitian ini bertujuan menganalisis bahwa kepemilikan jaminan kesehatan meningkatkan pemanfaatan pelayanan persalinan di fasilitas kesehatan di Indonesia. Sampel penelitian berjumlah 39.942 perempuan berusia 15-49 tahun yang melahirkan anak terakhir dalam periode waktu 2010-2013. Penelitian ini menggunakan pendekatan ekonometri dengan model estimasi probit dan bivariat probit untuk mengestimasi efek jaminan kesehatan dengan mempertimbangkan isu endogenitas pada jaminan kesehatan. Hasil penelitian menunjukkan bahwa kepemilikan jaminan kesehatan meningkatkan persalinan di fasilitas kesehatan sebesar 39,52%. Sebagai kesimpulan, ibu yang memiliki jaminan kesehatan akan lebih memanfaatkan fasilitas kesehatan saat persalinan dibandingkan dengan ibu yang tidak memiliki jaminan kesehatan.

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“…Concrete examples of this kind of research include a study to determine the effect of a performance-based payment scheme for public sector providers of reproductive health services in Egypt [108] and an evaluation of the impact of health system improvements on pregnancy outcomes in the Philippines [109]. …”

Section: The Work Of the Programmementioning

confidence: 99%

The Special Programme of Research in Human Reproduction: Forty Years of Activities to Achieve Reproductive Health for All

Benagiano¹,

d’Arcangues²,

Requejo³

et al. 2012

Gynecol Obstet Invest

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The Special Programme of Research in Human Reproduction (HRP), co-sponsored by the UNDP, UNFPA, WHO, and the World Bank, is celebrating 40 years of activities with an expansion of its mandate and new co-sponsors. When it began, in 1972, the main focus was on evaluating the acceptability, effectiveness, and safety of existing fertility-regulating methods, as well as developing new, improved modalities for family planning. In 1994, HRP not only made major contributions to the Plan of Action of the International Conference on Population and Development (ICPD); it also broadened its scope of work to include other aspects of health dealing with sexuality and reproduction, adding a specific perspective on gender issues and human rights. In 2002, HRP’s mandate was once again broadened to include sexually transmitted infections and HIV/AIDS and in 2003 it was further expanded to research activities on preventing violence against women and its many dire health consequences. Today, the work of the Programme includes research on: the sexual and reproductive health of adolescents, women, and men; maternal and perinatal health; reproductive tract and sexually transmitted infections (including HIV/AIDS); family planning; infertility; unsafe abortion; sexual health; screening for cancer of the cervix in developing countries, and gender and reproductive rights. Additional activities by the Programme have included: fostering international cooperation in the field of human reproduction; the elaboration of WHO’s first Global Reproductive Health Strategy; work leading to the inclusion of ICPD’s goal ‘reproductive health for all by 2015’ into the Millennium Development Goal framework; the promotion of critical interagency statements on the public health, legal, and human rights implications of female genital mutilation and gender-biased sex selection. Finally, HRP has been involved in the creation of guidelines and tools, such as the ‘Medical eligibility criteria for contraceptive use’, the ‘Global handbook for family planning providers’, the ‘Definition of core competencies in primary health care’, and designing tools for operationalizing a human rights approach to sexual and reproductive health programmes.

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A systems approach to improving maternal health in the Philippines

Cited by 23 publications

References 9 publications

Reduction in inequality in antenatal-care use and persistence of inequality in skilled birth attendance in the Philippines from 1993 to 2008

Reduction in inequality in antenatal-care use and persistence of inequality in skilled birth attendance in the Philippines from 1993 to 2008

The Effect of Health Insurance on Institutional Delivery in Indonesia

The Special Programme of Research in Human Reproduction: Forty Years of Activities to Achieve Reproductive Health for All

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