Studies show maternal deaths in Philippines in decline

From a war of words to a battle of figures.

The ongoing Senate debate on the reproductive health (RH) bill has shifted to a key question: How many mothers actually die in the Philippines every day?

Senators Miriam Defensor-Santiago and Pia Cayetano, cosponsors of the bill in the upper chamber, have cited the figure of 11 mothers dying daily due to pregnancy-related factors.

The number is supposedly based on a 2006 Family Planning Survey by the National Statistics Office, according to the youth arm of the proadministration Akbayan group.

But two separate studies published in 2010, one of which was conducted by the World Health Organization (WHO), showed a significant decline in the maternal mortality rate in the country.

The WHO study recorded a total of 2,100 maternal deaths in the Philippines in 2008. The figure translates to 5.75 maternal deaths per day, which is half the number being used to push for the RH bill.

The WHO figure was contained in the report titled “Trends in Maternal Mortality: 1990 to 2008.” The group conducted the study together with Unicef, United Nations Population Fund, and World Bank.

A separate study published by the Lancet journal showed an 81-percent decrease in maternal mortality ratio (MMR) in the Philippines from 1980 to 2008.

The study was titled “Maternal mortality for 181 countries, 1980-2008: A systematic analysis of progress towards Millennium Development Goal 5.” Its authors were Margaret Hogan, Kyle Foreman, Mohsen Naghavi, Stephanie Ahn, Mengru Wang, Susanna Makela, Alan Lopez, Rafael Lozano and Christopher Murray.

Sought for comment, Senate Majority Leader Vicento Sotto III on Saturday said the WHO-Unicef-UNFPA-World Bank study and the Lancet article “clearly dispute” the 11 daily maternal deaths being cited by RH advocates.

“But still, 11, five or four maternal deaths mean mothers are dying and that shouldn’t be happening,” he told the Inquirer. “What they need are adequate resources, facilities and services and we can address all these now. We don’t have to be dependent on any RH bill to do these.”

Sotto cited the women and children’s crisis center he put up at the Vicente Sotto Memorial Hospital in Cebu. With an initial fund of P10 million in 2003, the center caters to around 10 patients a day, he said.

The senator said similar centers were in the works in Iloilo and Luzon.

The Likhaan Center for Women’s Health disputed the Lancet findings, saying “it is implausible that the Philippines achieved a record-setting decline in MMR amid all the (economic and political) turmoil (during the 1980s).”

“If Hogan and colleagues estimates were accurate, the great mystery is: How was it achieved?” the group’s Junice Melgar and Alfredo Melgar asked in a letter to Lancet.

“Other indicators of maternal health support a scenario of little progress. For example, the proportion of deliveries by health professionals in the Philippines has risen very slowly—a mere 17 percent over 15 years (53-62 percent from 1993 to 2008), whereas Egypt, a widely accepted success story in MMR reduction, achieved a 94-percent increase in 16 years (41-79 percent from 1992 to 2008).”

Among neighboring countries, East Timor registered the highest MMR at 929 in the Lancet study. Laos had 339, Cambodia 266, Indonesia 229 and Burma 219.

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