ABSTRACT OF THE THESIS
Recent Pregnancies of Filipino Mothers: The Link Between Maternal Health Status and Health Care Utilization
by Nancy M. Landicho, Master of Arts in Demography (November 2006)
The objective of this study was to examine quantitatively the link between the maternal health care utilization and maternal health status of Filipino women using the 1993 Philippine Safe Motherhood Survey. It aimed to examine such link on the last pregnancies of mothers which occurred in the last three years before they were interviewed. The health status during pregnancy, childbirth and postpartum were derived by separating women who experienced obstetric complications from those who did not. In each reproductive stage, if the mother experienced an obstetric complication, she was categorized under with complications, and vice versa. On the other hand, the health care utilization during pregnancy, childbirth and postpartum period were identified as prenatal, delivery and postpartum care services, respectively. Using the recommendations set by the World Health Organization and the Department of Health, each of the health care utilization indicators further categorized the women as those who followed the recommended health care services from those who did not. The study focused on exploring the prevalent pattern displayed by Filipino mothers in utilizing prenatal, delivery and postnatal health care services – whether being unhealthy or the experience of obstetric complications which compelled the women to seek health care services or is it their utilization of health care services that prevented them from experiencing such obstetric complications.
Bivariate analyses were made in order to identify the socio-demographic and attitudinal variables which had a significant effect on the health care use and health status of the women. Multivariate analysis using logistic regression was employed to establish the determinants of maternal health status and health care utilization taken separately as well as analyzing the link between the two by considering one as the dependent and the other as the independent variable. Two models were run, the full model, taking all the hypothesized predictors, and the parsimonious model, taking only the emerging significant predictors in the full model. The forward conditional method in the SPSS was used in the parsimonious model. The parsimonious model was the basis in the interpretation of the effects of the emerging significant predictors on maternal health status and health care utilization.
The results confirmed the positive and significant influence of the mother’s level of education and their residential location on all the maternal health care utilization variables. For the health status, pregnancy wantedness was found to have a direct and inverse effect, respectively, on the possibility of not having any obstetric complications during pregnancy and childbirth. Women who lived in urban areas were found to be more likely to experience obstetric complications than their counterpart. Finally, the maternal health care-seeking behavior of the women in this study indicated a pattern of being curative rather than preventive.
Bivariate analyses were made in order to identify the socio-demographic and attitudinal variables which had a significant effect on the health care use and health status of the women. Multivariate analysis using logistic regression was employed to establish the determinants of maternal health status and health care utilization taken separately as well as analyzing the link between the two by considering one as the dependent and the other as the independent variable. Two models were run, the full model, taking all the hypothesized predictors, and the parsimonious model, taking only the emerging significant predictors in the full model. The forward conditional method in the SPSS was used in the parsimonious model. The parsimonious model was the basis in the interpretation of the effects of the emerging significant predictors on maternal health status and health care utilization.
The results confirmed the positive and significant influence of the mother’s level of education and their residential location on all the maternal health care utilization variables. For the health status, pregnancy wantedness was found to have a direct and inverse effect, respectively, on the possibility of not having any obstetric complications during pregnancy and childbirth. Women who lived in urban areas were found to be more likely to experience obstetric complications than their counterpart. Finally, the maternal health care-seeking behavior of the women in this study indicated a pattern of being curative rather than preventive.