BACKGROUND

This study explores the professional functions and experiences of male midwives in the Province of Aurora, highlighting their roles, challenges, and contributions to maternal and child healthcare in a traditionally female-dominated profession.

This study aims to investigate the professional functions and lived experiences of male midwives in the Province of Aurora.

This research employed a qualitative ethnographic design using semi-structured interviews to collect data. Participants were six male midwives practicing in Aurora. Data collection was conducted via mobile phone interviews from August to September 2024. A purposive sampling technique was utilized to select participants. The study adhered to ethical guidelines, receiving approval from the University of Northern Philippines Ethics Review Committee Code: 2024-251, and informed consent was obtained from all participants. Data were analyzed using qualitative content analysis. Qualitative inductive content analysis as described by Padgett was utilized to allow for data-driven analysis without pre-defined themes, making it suitable for exploring the diverse experiences of male midwives.

Analysis revealed six key themes: Diverse professional functions, gender bias and stereotyping, patient reluctance and shyness, cultural influences, experiences of discrimination and prejudice, and daily challenges and rewards in practice. The findings underscore the commitment of male midwives to providing quality care despite societal and professional barriers. Under the Functions theme, male midwives described their roles as not only caregivers but also as advocates for gender inclusivity in midwifery. In terms of experiences, some reported feelings of isolation and the need to prove their competence in a field dominated by women. However, they also shared empowering stories of camaraderie with female colleagues and the satisfaction derived from breaking down gender barriers.

Male midwives play a vital role in maternal and newborn healthcare, navigating challenges such as gender bias and patient hesitancy. Strengthening administrative support, promoting inclusivity, and updating policies can enhance their professional integration. Advocacy efforts from professional organizations are necessary to address workplace challenges and recognize their contributions to healthcare.

BACKGROUND

This study explores the professional functions and experiences of male midwives in the Province of Aurora, highlighting their roles, challenges, and contributions to maternal and child healthcare in a traditionally female-dominated profession.

This study aims to investigate the professional functions and lived experiences of male midwives in the Province of Aurora.

This research employed a qualitative ethnographic design using semi-structured interviews to collect data. Participants were six male midwives practicing in Aurora. Data collection was conducted via mobile phone interviews from August to September 2024. A purposive sampling technique was utilized to select participants. The study adhered to ethical guidelines, receiving approval from the University of Northern Philippines Ethics Review Committee Code: 2024-251, and informed consent was obtained from all participants. Data were analyzed using qualitative content analysis. Qualitative inductive content analysis as described by Padgett was utilized to allow for data-driven analysis without pre-defined themes, making it suitable for exploring the diverse experiences of male midwives.

Analysis revealed six key themes: Diverse professional functions, gender bias and stereotyping, patient reluctance and shyness, cultural influences, experiences of discrimination and prejudice, and daily challenges and rewards in practice. The findings underscore the commitment of male midwives to providing quality care despite societal and professional barriers. Under the Functions theme, male midwives described their roles as not only caregivers but also as advocates for gender inclusivity in midwifery. In terms of experiences, some reported feelings of isolation and the need to prove their competence in a field dominated by women. However, they also shared empowering stories of camaraderie with female colleagues and the satisfaction derived from breaking down gender barriers.

Male midwives play a vital role in maternal and newborn healthcare, navigating challenges such as gender bias and patient hesitancy. Strengthening administrative support, promoting inclusivity, and updating policies can enhance their professional integration. Advocacy efforts from professional organizations are necessary to address workplace challenges and recognize their contributions to healthcare.

Chemical exposure during prenatal development has significant implications for both maternal and child health. Compared to blood, saliva is a non-invasive and less resource-intensive, alternative. Given the temporal variability of xenobiotic metabolites (XM), repeated sampling is essential. Therefore, saliva offers a valuable tool for the longitudinal assessment of prenatal exposomes. Despite its potential, no studies have explored saliva for XM measurement. This study pioneered using saliva to assess XM detectability and investigate the associations between prenatal XM and endogenous metabolomes in pregnant women. Saliva samples were analysed using mass spectrometry from 80 pregnant women at 24-34 weeks gestation. Metabolomes and exposomes were annotated using the Human Metabolome and U.S. Environmental Protection Agency databases. Metabolome-XM associations were clustered using Glay community clustering. Linear regression models, adjusted for age, estimated associations between catecholamines and XMs. XM levels were validated in a cohort of women (n = 14) with and without preeclampsia. Our study identified 582 metabolomes and 125 XM in saliva, demonstrating its potential as a matrix for exposure measurement. After false discovery rate correction, 18 109 significant metabolome-XM associations were identified. Community clustering revealed 37 connected clusters, with the largest cluster (238 nodes) enriched in tyrosine and catecholamine metabolism. Food-contact-chemicals and food-additives were significantly associated with higher catecholamine and their metabolite levels. Subgroup analyses revealed higher concentrations of these chemicals in women with preeclampsia compared to healthy controls. This study demonstrates that saliva contains valuable molecular data for measuring exposomes. Food-related chemicals were associated with higher catecholamine levels, which may be relevant to the prevalence of hypertensive crises in pregnancy.
Humans ; Female ; Pregnancy ; Saliva/metabolism* ; Pre-Eclampsia/metabolism* ; Xenobiotics/analysis* ; Adult ; Metabolome ; Maternal Health ; Mass Spectrometry

BACKGROUND

Social determinants of health are wider set of forces and systems that greatly influence an individual’s health outcomes.

This study aims to determine the socio-economic indicators that influence certain health indicators focusing on maternal and children under-5 health.

Selected data from from the World Health Organization (WHO), World Bank, and International Labor Organization (ILO) were primarily used to model health outcomes such as mortality rates, disability-adjusted life years, and deaths and injuries due to occupational injuries. A total of 194 countries were considered as respondents in this study. Linear hierarchical multiple regression was used to determine the relationship of social determinants of health on life expectancy at birth, maternal mortality ratio (per 100,000 live births), under-5 years mortality ratio, prevalence of overweight in children under-5 years, and death rate (per 100,000 population).

Data from 194 countries shows that the global average life expectancy is 55.7 years. The global average maternal mortality ratio is 1119.509 per 100,000 live births, and maternal mortality is significantly increased by factors such as increase in total vulnerable employment, total unemployment, and CPIA gender equality rating. Focusing on children’s health outcomes, the global average under-5 mortality rate was 102.247 per 100,000 live births. Mortality rate for children under-5 increases with total vulnerable employment and total unemployment, while adult literacy rate, 1 medical doctor per 10,000 population, and food safety level decreases under-5 mortality rates. The global overweight prevalence in children under-5 is 10.389%. The increase in average monthly earnings of employees working in service and sales increases its prevalence. For death rate, the global average is 682.818 per 100,000 population. This is further positively affected by an increase in rural population and total unemployment. On the other hand, adult literacy rate decreases death rate.

Socio-economic factors such as income, education, employment, and government support influence maternal and children under-5 health indicators. Thus, programs, projects, and activities that aim to positively affect the health of the public should be holistic and should also focus on positively altering the health behavior of the public.

BACKGROUND

Antenatal care (ANC) is a key maternal health intervention designed to prevent poor pregnancy outcomes, while pregnancy tracking by community healthcare workers (CHWs) serves as an important strategy to monitor its effective implementation and utilization. In Mati City, Davao Oriental, Philippines, a consistent decline in ANC quality and a rise in maternal and infant mortality have been observed, which may be linked to gaps in the implementation of maternal healthcare programs.

To address this concern, the study aims to analyze the strategies and challenges faced by CHWs in pregnancy tracking, assess the perceptions of health officials regarding these gaps, and recommend governance strategies to enhance the overall quality of ANC services.

A qualitative research design was employed, using purposive sampling to select Barangay Health Workers, midwives, and nurses for the focus group discussions, while the City Mayor, City Health Officer, and City Councilor on Health participated as key informants. Thematic analysis was conducted on manually transcribed data while adhering to strict ethical considerations.

Findings revealed that proper implementation and monitoring of maternal healthcare services are crucial for effective pregnancy tracking. CHWs play a significant role in health service delivery; however, gaps such as weak health promotion efforts adversely affect community engagement, health-seeking behavior, and sociocultural dynamics, highlighting the need for stronger policy enforcement and sustained local government support. Systemic and logistical challenges must also be addressed to improve service delivery. Effective maternal healthcare requires robust policy implementation and close collaboration among local government units. A sustainable maternal health system further depends on depoliticized legislative processes, improved health financing, and continuous investments in primary healthcare and infrastructure. Based on these findings, the study developed the Strengthen, Empower, Engage, and Key Policy Reforms Framework – an innovative governance approach aimed at reducing maternal healthcare disparities through multisectoral collaboration, depoliticized legislative action, and evidence-based maternal health interventions.

Adopting the SEEK framework may enable local governments to ensure equitable access to high-quality ANC and ultimately improve maternal and infant health outcomes.

BACKGROUND

Facility-based delivery (FBD) is a key intervention for reducing maternal and neonatal mortality. Despite policies discouraging home births, 11% of all deliveries in the Philippines occur outside health facilities. The health belief model (HBM) suggests that healthcare-seeking is influenced by perceived risks, benefits and barriers, and cues to action.

To examine how HBM indicators are associated with the likelihood of FBD and to assess the added value of increasing antenatal care (ANC) contacts from four to eight in line with recommendations by the World Health Organization.

Using data from the 2017 National Demographic and Health Survey, we ran logistic regression models on a sample of 6551 women with a recent live birth to estimate how HBM indicators were linked to the probability of FBD.

FBD was more likely among women with higher pregnancy risks (first birth and delivery complications) and those facing fewer barriers to health care (higher education, wealthier households, public health insurance coverage, urban residence, and not Muslim). Being Muslim had the largest negative impact on the probability of FBD (-19% points). Having at least eight (instead of four) ANC contacts increased the probability of FBD by 6% points.

FBD in the Philippines is shaped by perceived risks, socioeconomic and cultural barriers, and ANC contacts as cues to action. Increasing antenatal contacts was associated with a higher likelihood of FBD. Policies should therefore prioritize expanding affordable, accessible, and culturally responsive maternal healthcare services to reduce inequalities, rather than penalizing home births.

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

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

Maternal morbidity and mortality remain major global concerns in developing and underdeveloped countries. Various international interventions have been made over the last 50 years but with essentially the same targets and indicators. This review traced the development of programs on maternal and child health based on major global policies, from the 1978 Declaration on Primary Health Care to the Millennium and Sustainable Development Goals, and related the approach they engendered to the Philippine experience. Health outcomes have not significantly improved despite adherence to recommended goals and programs. New strategies purportedly propose novel and innovative methods, but are burdened by essentially the same old presumptions: government resources are limited, and interventions need to be supported by whatever funds are available. Preference for low-cost and measurable programs providing minimal essential care persists with the current socio-economic conditions characterized by neoliberal and conservative policies. There is a need to return to the fundamentals of the Comprehensive Primary Health Care, linking the health of vulnerable groups, like women and children, to social and economic development. Inter-agency and multi-sectoral approach, community participation and empowerment, real political commitment and major rethinking are needed in national and international discourses on health not just to attain better maternal and child health but to achieve health for all.
Maternal Health ; Child Health ; Primary Health Care