Urban complexities of healthcare for women

By Jesse Pizarro Boga

Pregnancy and all its implications can all together be difficult to bear by women who live in varying social and economic conditions.

To some it’s a joy; to others, it’s a result of cascading life situations that seem to be out of control.

Pregnancy covers health, social and psychological issues that many women have long been living with.

In time for the International Day of Action for Women’s Health, Gabriela representative Luzviminda Ilagan said that there is a need to look into health access for women.

“Filipino women’s access to healthcare services and malnutrition have gone from bad to worse in the past few years,” she said. “Unemployment, poverty and hunger have resulted to widespread malnutrition among Filipino mothers and their children.”

Ilagan expressed her alarm over a recent survey released by the Food and Nutrition Research Institute (FNRI).

She said the study revealed that one of every four pregnant Filipino mothers is nutritionally at risk. The same survey revealed that the incidence of malnutrition increases among the younger mothers and especially among those in the lowest income brackets.

According to a Gabriela press release, “almost four out of ten or 37.2% of young pregnant women aged 20 years old and below are nutritionally at risk. The prevalence of malnutrition among women in the lower income bracket is at 30% and 14.4% among women in the higher income brackets.”

“Amid such malnutrition and poverty exacerbated by the inaccessibility of healthcare services, it is not surprising that maternal mortality rate in the Philippines is now at 221 for every 100,000 live births,” said Ilagan.

Gabriela also pointed out that malnutrition among pregnant women, the lack of key nutritional supplements, deficiencies in iron, iodine, and calcium have been found to have adverse effects on a women’s pregnancy and delivery. The risk of mortality due to hemorrhage and eclampsia is high among malnourished women.

Gabriela held a women’s health fair last May 28 at the Davao Medical School Foundation to commemorate the International Day of Action for Women’s Health.

Ilagan said that there is no sufficient access to affordable healthcare throughout the country—especially now that private sectors and big businesses are integrating control into public hospitals.

It also doesn’t help that more and more women continue to suffer the cascading problems brought about by insurgencies and displacement, creating hostile situations for them—even in evacuation centers.

The potential solution that she sees is to ensure that the budget for health is properly allocated and is set as a priority as it trickles from the national level to the local areas.

To her, women’s health encompasses well-being. It also covers the important process of pregnancy—and all the other issues that surround it.

This was the main topic of various stakeholders this week when they all gathered to come up with an action plan to address healthcare access and teenage pregnancies.

The need to be educated

CHO population officer Jeff Fuentes said that teenage pregnancy reflects other problems in the community; its increase is attributed to the lack of access to correct information of teens. There is also an interplay of cultural tradition (by tribal) women in this increase.

This is proposed to be solved by conducting special health dialogues and making information campaigns to specific groups of people regarding pregnancy.

And when not enough care and concern is given to these teenage mothers-to-be, maternal deaths are inevitable.

Maternal deaths continue to recur, but CHO chief Josephine Villafuerte is hoping that one, day, this will end.

“No woman should ever die because of childbirth,” she said. To her, everything about pregnancy—from conceiving to raising a child—should be thoroughly prepared.

Contrary to Ilagan’s statement, Villafuerte said there is more than enough budget to cover women’s health but “it’s the national government that handles this and not the local government.”

One of the challenges that Villafuerte sees is the lack of manpower. She said that the number is just not enough.

Women’s access to health, she said, is different when they’re in the poblacion area as compared to when they’re in Marilog where they have to walk long distances.

The health center situations vary per districts; in some remote areas, it’s the doctors who traverse long distances on specific occasions to deliver medical services. On regular days, the patients themselves have to make the long journey.

Three women who live far from the city’s downtown area narrated their experiences in accessing health services from their side of the city.

Panacan resident Alma Tilos, 41-year-old mother of three, said that there is a health center near their barangay, except that their definition of “near” is a distance that requires two or three rides to traverse.

She lives in barangay Ilang, a community of about 10,000 individuals within a 3.9-hectare area.

Their health center offers basic services and has made medicines and immunization shots available for pregnant women like her. For Tilos, however, the distance to the health center is a challenge. Fare and time are luxuries that she can’t afford, especially when