Background: Since 1976, Bicol Region had higher maternal mortality ratio (MMR) than the Philippine average and became the fourth region with the highest MMR in 2012. Looking at trends of maternal health outcomes and determining risk factors among mothers who died may guide interventions to reduce MMR. Objectives: To determine the changes in maternal mortality ratio (MMR) in the Bicol region from 2004 to 2017 and determine the sociodemographic profile of pregnant women who died from 2015 to 2018. Materials and Methods: A records review of Bicol?s Regional Field Health Services Information System from 2004 to 2017 and maternal death review reports from 2015 to 2018 was done. Changes in MMR was determined using Poisson regression. The sociodemographic characteristics and causes of maternal deaths were analyzed using frequencies and proportion. Results: From 2004 to 2017, MMR of 100.9 remained higher than the regional target of 31.6. Significant reductions in MMR were achieved in 2007 to 2008 and in 2011 to 2012 wherein MMR ranged between 75.3 to 89.3. However, by the end of 2012, maternal deaths again increased which reached 122.5 in 2017. From the maternal death reviews, it was observed that 29.5% of maternal deaths were aged 35 years and above and 7.5% were less than 20 years old. Mothers who had more than five pregnancies were 30.1% of total deaths. In terms of place of death, 15.7% died at home or in-transit to referral facilities. Hemorrhage or hypertension-related causes were the leading reasons for maternal deaths. Conclusion Significant reduction in MMR was not sustained after 2012 and higher deaths were reported in the succeeding years. Maternal deaths can be further reduced by using a systems approach, by promoting family planning, and by strengthening service delivery networks to effectively manage hemorrhage and hypertension-related emergencies.
Maternal Mortality ; Maternal Health

No abstract available.
Maternal Age

Introduction: Nutritional requirements increase during lactation. However, maternal dietary intakes of Malaysian mothers are subjected to restrictions commonly included in traditional postpartum practices. This study aimed to assess the maternal dietary intake status during the recommended six month exclusive breastfeeding (part of which included the traditional confinement) period. Methods: Thirty-two Malay mothers aged 18-35 years, who had delivered full-term (at ≥37 weeks) singleton babies and were exclusively breastfeeding, were included in the study. Maternal dietary intake was assessed using multiple-pass diet recall on Days 10, 30, 60, 90, 120, 150, and 180, postpartum. The average total energy and macronutrient intakes were compared against recommended values. Results: The findings of this study demonstrated that maternal intakes of total energy ranged from 1,500-2,000kcal/day, carbohydrate 189-272g/day, protein 58-72g/day, and total fat 32-70g/day. Total calorie intake was the lowest during confinement period (Days 10 and 30) compared to the rest of the exclusive breastfeeding period. This is similar with total fat consumption. On the other hand, protein intake was the highest during confinement period whereas carbohydrate intake was consistent throughout the six-month period. Despite the increased requirements, intakes of total calories, protein, total fat, dietary fibre, and water, did not meet the recommended values throughout the exclusive breastfeeding period. Conclusion: Mothers’ inability to fulfil their nutritional requirements during exclusive breastfeeding period may be associated with traditional postpartum dietary practices. Dietary advice with consideration for cultural food taboos practiced by local mothers during confinement may help to improve maternal nutritional intakes during this crucial time.
Maternal diet

Background Background. Establishing and integrating Basic Emergency Obstetrics and Newborn Care (BEmONC)-capable facilities into the healthcare delivery system is one of the strategies employed by the Philippine government to address high maternal mortality. Objectives. This study aimed to determine the functionality of BEmONC-capable rural health units (RHUs) in Luzon, the largest island in the country. Methods. The study utilized a researcher-administered facility survey and facility observation using a checklist designed to measure BEmONC functionality. Facilities were selected through a two-stage sampling method. A BEmONC Score Card was used to determine the overall functionality of a facility based on three categories — institutional capacity, service capacity, and personnel capacity. The total scores from the three categories provided the overall functionality score.Results. Of the 245 BEmONC-provider RHUs included in the study, 85 (35%) were adequately functional. The mean functionality score for Luzon (60±25.27) corresponded to adequate functionality. The mean institutional and service capacities were consistently high across all regions on the island. Still, the personnel capacity did not reach the minimum average, pulling down the overall score and leading to low overall functionality. Conclusion. The BEmONC facilities continue to function despite being hampered by factors that can be easily remedied. The provision of BEmONC services remains relevant across all regions in Luzon as they fill in the gaps and serve the needs of mothers and pregnant women. This study should be replicated in the Visayas and Mindanao to obtain a complete representation of the BEmONC program.
Maternal Mortality

Introduction: To address the problem of high maternal death, the Department of Health implemented the Basic Emergency Obstetric and Newborn Care (BEmONC) services at the level of primary care health facilities. These are key life-saving interventions that treat obstetric emergencies. Over a decade later, we need to assess and improve the program’s implementation. Objective: The study aims to select indicators for assessing the functionality of BEmONC facilities. Methods: Electronic Delphi process was used to select the indicators. Results: The two-round Delphi process was accepted by 21 respondents, with a 100% response rate. All 30 proposed indicators were retained following the criteria. Conclusion Thirty indicators to assess the functionality of BEmONC facilities have been selected through the consensus of an expert panel using the Delphi process. These indicators help evaluate BEmONC facilities, formulate policy, and guide new programs that promote maternal health.
Maternal Health

Introduction: Despite implementing various maternal health care programs and integrating these into Service Delivery Networks, the Philippines continues to have high maternal mortality. Identifying factors that impede the utilization of available maternal care services may help reduce maternal morbidity and mortality and bridge the gap between the need and actual use of such services among mothers in the community. Objectives: This study identified barriers, hindrances, and other factors influencing mothers in availing maternal health services in Luzon, the largest island in the country and the area that accounted for more than half of total maternal mortality. Methods: Eight focus group discussions participated in by a total of 78 pregnant women and mothers were conducted across all of the eight regions of Luzon. In each session, the participants were asked to answer questions based on a semi-structured interview guide. The interviews were recorded, translated and back-translated, transcribed, and compiled before analysis by the deductive-dominant approach using NVivo12. Results: Factors affecting maternal health service utilization center on the capacity of health facilities to provide services like evaluation of the progress of pregnancy, laboratory examinations, free medicines, and immunizations; and on region-bound individual factors. The availability of skilled health personnel and lack of financial resources were the most common subthemes. Conclusion This study identified some key factors that deter patients from availing of existing maternal health services in Luzon. Eliminating these barriers will not only help strengthen local health infrastructure and improve service delivery but also promote the utilization of such services, leading to better maternal outcomes.
Maternal Health

Background: Teaching clinics provide low-cost health programs while offering valuable learning opportunities for student clinicians, which then contributes to increasing health care accessibility. To date, there is a paucity of literature exploring the satisfaction of patient seen in rehabilitation teaching clinics in developing countries. The Service Quality (ServQual) Scale is a valid and reliable tool that has been used to measure client satisfaction in different work settings and industries.

Objectives: The aim of this study was to demonstrate the usefulness of ServQual
in measuring the satisfaction of clients in a rehabilitation teaching clinic in a developing country.

Methodology: A cross-sectional survey was conducted for three months among CTS-AA (Clinic for Therapy Services- Adult and Adolescent Section) clients who are at least 18 years old; have attended at least three sessions; and can read. Prior to
administration in CTS-AA, the ServQual scale was translated to Filipino, validated
and pilot tested for reliability.

Results: Thirty-two respondents were included in the analysis. there was no
statistically significant difference between the expectation and the perceptions
of the clients for the domains of reliability (z=1.799, p=0.0721),responsiveness (z=0.839, p=0.4013), assurance (z=1.914, p=0.0556) and empathy (z=1.772, p=0.0764). However, there was a statistically significant difference between the clients' perception and expectation for tangibles (z=4.117, p<0.0001) and between the overall client perception and expectation (z=4.086, p<0.0001).The overall ServQual score for CTS-AA is -0.3782.

Conclusion: The ServQual has been shown to be useful in assessing the satisfaction of clients in rehabilitation clinics and the specific areas that needs improvement. The tool can still be further improved by including items on cost, relationship of students with supervisors and outcomes of treatment.

Introduction: Implementation of Basic Emergency Obstetric and Newborn Care (BEmONC) aims to curb maternal mortality. However, the Philippines failed to significantly reduce the maternal mortality rate (MMR) targeted in the Millennium Development Goals (MDGs). Currently, the country is still far from the targeted Sustainable Development Goals (SDGs). This review describes the historical development of BEmONC in the Philippines over the past 13 years and provides insights on its role in decreasing MMR. Methods: We searched online for journal articles, publications, reports, policies, and other issuances related to BEmONC and maternal health in the Philippines. We accessed updates and data via correspondence with the Department of Health (DOH). Statistics were compiled from public databases. The identified citations were screened, appraised, synthesized, and analyzed in a historical approach. Results: A direct result of the Emergency Obstetric Care Approach, BEmONC was developed to respond to the high MMR in the Philippines, in line with global efforts to improve maternal health. However, BEmONC functionality generally remained inadequate. Conclusions Although the provision of BEmONC services increased facility-based deliveries and skilled birth attendance during childbirth, this failed to decrease MMR and achieve targeted goals substantially. Further capacity-building is needed, especially in rural and resource-poor areas. Government issuances at the national and local levels should be aligned to complement each other. There should be a health systems approach that considers the building blocks of an efficient health care system and the social determinants that impact them.
Maternal Health Services ; Maternal Mortality

No abstract available.
Diagnosis* ; Maternal Age*

No abstract available.
Korea* ; Maternal Death*