The Municipality of Don Marcelino and the rest of the Davao region saw high maternal deaths in 2014. To respond to this problem, the Department of Health (DOH) Davao Regional Office, WHO, and the Korea International Cooperation Agency (KOICA) are working together to strengthen governance systems in the region.
In the municipality of Don Marcelino in Davao Occidental sits Lapuan, a remote barangay (village) surrounded by rugged terrain. Until about two years ago, poverty, difficulty of access and cultural norms meant that few women in Lapuan and other villages in Don Marcelino sought maternal health services at the health center.
“Women didn’t go to the health center to give birth, they preferred seeking the services of a nearby hilot (traditional birth attendants),” shared Melanie Balibalos, a midwife who has served Lapuan for 25 years.
When a woman does not have access to maternal health services, she is more likely to suffer from complications during childbirth, which could even lead to death. From 2014 to 2015, 249 women died of maternal causes in the Davao Region. In Don Marcelino, there were six maternal deaths from 2014 to 2015.
Mobilizing the local government unit and community leaders
Recognizing the need to reduce the deaths of mothers and newborn babies in their community, barangay officials, health workers, and other stakeholders gathered for a Barangay Leaders Health Summit in 2015.
“At the summit, we shared data on various health indicators including those related to the maternal, neonatal, child heath, and nutrition situation, with the respective barangays,” said Dr. Rustan Parcasio, Don Marcelino’s municipal health officer. He credited the use of this practice – a key component of the Performance Accountability System (PAS) – for promoting awareness on health issues in their town.
“The barangay officials saw the gaps in terms of our health situation so we began to commit ourselves to improve the delivery of basic health services particularly in terms of maternal and infant services,” Lapuan barangay captain Medeline Mallari said. During the summit, the barangay officials also learned that different sectors of the community must converge to ensure that pregnant women deliver in health facilities.
This change in commitment and participation of barangay officials is felt at the municipal level. Dr. Parcasio said: “Barangay captains are now more actively involved and this has resulted in better provision and increased utilization of health services compared to the previous year. The municipal and barangay local governments have become aware of their responsibilities and accountabilities with regards to health.”
The results are already becoming evident. “In 2016, we had zero maternal deaths,” Parcasio shared.
Increasing funding for health
With increased awareness, motivation and commitment to health issues has come greater funding. “Health is most important. If you are a leader, you see to it that your constituents are healthy,” said the mayor of Don Marcelino, Michael Maruya.
Since 2015, the mayor has allocated an increase in their budget for health programs, including augmenting the health budget from other sources such as from the mayor’s discretionary fund and the gender and development fund towards maternal and child care. According to Dr. Parcasio, around Php14 million has been earmarked this year for health programs. There is also a budget allocation for essential medicines for infant health that can be distributed to far-flung areas.
At the policy level, the mayor said that they now have a functioning local health board and an executive and legislative agenda that prioritizes funding support for health programs and services.
Underlining the need for a deeper penetration of health services, he added, “If possible all barangays should have the bahay paanakan (birthing homes) with complete facilities. In interior barangays, in the mountains, there should be paanakan which are closer to homes.” As of mid-2017, there has been no reported case of maternal deaths and the mayor is confident that they will continue to have zero maternal deaths this year.
“Maternal health used to be taken for granted. We will just hear the news of a mother dying. But this time, it is a big deal. Everybody is working hard to save every life, particularly of the mother and her baby,” he said.