ABSTRACT OF THE THESIS
Mind the Gap: An Analysis of the Discontinuity Between Antenatal Care and Facility-Based Delivery Among Filipino Mothers
by Denise Hyacinth Joy B. Musni (2022)
Maternal mortality is among the top causes of death among Filipino women. Compared to neighboring countries, the maternal mortality rate in the Philippines has been declining at a painfully slow rate. To prevent these deaths, global and national health agencies recommend that pregnant women undergo antenatal care (ANC) assisted by skilled health professionals and consequently deliver in a health facility. However, while most pregnant Filipino women are able to have some form of ANC, some of them still end up delivering outside health facilities. The primary objective of this study is to uncover the factors associated with facility-based delivery, with a view to examining the gap that exists between ANC and facility-based delivery in the Philippines.
Using data from the 2017 National Demographic and Health Survey, this research was conducted on a sample of 6,294 Filipino women who had at least one ANC check-up for their most recent pregnancy (ANC-seeking mothers) leading to live birth. Binary logistic regression revealed that increasing levels of education of both the mother and her husband/partner, being a PhilHealth beneficiary, higher socioeconomic status, and lower birth order are associated with greater odds of facility-based delivery. Adding the characteristics of ANC received as covariates improved the fit of the regression model. Among ANC-related variables, a higher frequency of ANC contacts and a higher frequency of basic ANC services received are associated with higher odds of facility-based delivery.
This research suggests that in the context of the country’s commodified healthcare system, education and financial capacity, including having health insurance, are key to greater access to maternal healthcare services. The ability to frequently have ANC checkups and utilize ANC services also serves as indicators of how likely a mother will be able to deliver in a health facility. Recommendations provided in this study include enhancing healthcare infrastructure, strengthening public healthcare through additional subsidies for healthcare costs, and focusing on the improvement of the quality of ANC services. Several research recommendations are also outlined in this work.