Angara seeks DOH update on foreign-funded program

MANILA, Philippines – As the world observes Mother’s Day today, Sen. Edgardo Angara urged his colleagues at the Senate to look into cases of maternal and newborn deaths in order to prevent further increase in the country’s maternal mortality ratio (MMR).

Citing high MMR in the country, Angara sought a report from the Department of Health (DOH) on the outcome of the multimillion-peso-funded First Women’s Health and Safe Motherhood Program, which was implemented in 1995 to address maternal and infant deaths.

“This abysmal lack of data reveals a seeming indifference to and a profound lack of understanding of the problems that lead to maternal deaths; consequently maternal deaths constitute a gray area with several unknowns that could hardly be dealt with through policies and programs,” he said.

The senator from Quezon province wants a report particularly on the actual expenditures and results achieved by the program, which was funded by grants and loans from the World Bank, Asian Development Bank, Australian Agency for International Development, European Commission and Kreditanstalt Fur Wiederaufbau.

While the DOH has completed the first program, Angara noted that there was no apparent decline in MMR despite the building and renovation of health facilities, and training for traditional birth attendants and midwives.

He also called on the DOH to make a report on the progress of local government implementation and explain the processes of assessing the technical assistance in the selection of the providers of such assistance necessary to implement the Second Women’s Health and Safe Motherhood Program.

Angara wants the facts known three years since the DOH started the Second Women’s Health Safe and Motherhood Program funded by an investment loan of $16 million from the World Bank in 2005 with counterpart funding from the Philippine government of $22 million.

The reduction of maternal mortality is one of the targets of the Millennium Development Goals of the Millennium Declaration that the Philippines signed in 2000. However, the number has not declined since the 1990s, Angara said.

The 1998 National Demographic Health Survey placed the country’s MMR at about 172 per 100,000 live births with a confidence interval of 120 to 224, while the 2006 Family Planning Survey estimates that MMR is 162 per 100,000 live births with a confidence interval of 128 to 196.

With such wide confidence intervals inherent in the difficulties of measuring MMR in the country, the “drop” of 10 points is insignificant.

Data show that only 25 percent of the causes of maternal deaths have been identified and these are hypertension (13 percent), post-partum hemorrhage (eight percent), and the complications of unsafe abortion (four percent).

“Women who survive difficult pregnancies acquire disabilities that compromise their well-being. A maternal death, while tragic by itself, has severe consequences for infants and children; it has been established that when a mother dies, the prospects for her children (become) dim,” Angara said.

Studies on child outcomes for mothers who died while in labor report that all the newborn babies died within one year of birth; children under age 10 are up to 10 times more likely to die following the death of their mothers than those whose mothers were alive; the risk of death for children under five years is doubled if their mothers die at childbirth; and at least 20 percent of the burden of disease among children under the age of five is attributable to conditions directly associated with poor maternal health and the quality of obstetric and newborn care.