Following recent reports regarding the increase in maternal and newborn mortalities from 2021 to 2022, the Department of Health (DOH) emphasized the importance of implementing Primary Care as the flagship reform under Universal Health Care (UHC) that will address underlying illnesses that increase the likelihood of complications during pregnancy, as well as long-standing issues on accessibility of healthcare services–particularly maternal and newborn healthcare services–which primarily drive mortalities among mothers and newborns.

“Based on previous DOH assessments, the majority of maternal mortalities directly result from pregnancy complications that occur during labor, delivery, and the postpartum period. These complications include hypertension, post-partum hemorrhage, severe infections, and other medical problems arising from poor birth spacing, maternal malnutrition, unsafe abortions, and the presence of concurrent infections like TB, malaria, and sexually transmitted infections as well as lifestyle diseases like diabetes and hypertension,” Health OIC Secretary Maria Rosario Singh-Vergeire said. “These are all complications that could be detected and prevented if we ensure adequate prenatal visits for all expecting mothers,” she added.

Recognizing the drivers of maternal and newborn mortality, the DOH continues to implement safeguards to protect the health of mothers as they navigate motherhood, beginning with ensuring that Maternal, Newborn, and Child Health and Nutrition (MNCHN) services are accessible. Towards this end, the DOH is expanding the provision of services under the MNCHN Core Packages by designating facilities and providers in healthcare provider networks that will deliver services during pre-pregnancy, pregnancy, delivery, postpartum, and newborn periods. Likewise, the DOH is ensuring that all identified providers have the capacity to provide relevant MNCHN services such as but not limited to family planning, micronutrient supplementation, and newborn care.

With these in mind, the DOH highlighted that beyond implementing targeted MNCHN interventions, the key to addressing maternal and newborn mortalities is advocating for the primary care reform envisioned under UHC, and establishing reliable healthcare provider networks anchored on primary care that provides MNCHN services alongside other essential primary care services. In parallel, for those requiring more specialized care, the DOH is likewise working with its regional counterparts to establish more specialty hospitals and health facilities that will cater to specific needs of patients all over the country, thereby ensuring accessibility of the full continuum of care for mothers and newborns–starting from the community level, basic emergency obstetrics and newborn care (BEmONC)–capable facilities, up to the CEmONC-capable end referral facilities.

“Alam natin na ang primary care ay napakahalaga, sapagkat sa pagsulong natin nito, sinisiguro natin na ang ating mga serbisyo ay health promotive and preventive in nature. Ibig sabihin, sa primary care, mas fino-focus natin ang pag-detect at pag-manage sa mga sakit bago pa ito lumala o maging sanhi ng mga komplikasyon tulad nang nakikita natin sa ating mga maternal and newborn mortalities,” the Health OIC expressed. “Sa pamamagitan ng primary care, masisiguro natin na ang lahat ng mga nanay, anumang estado nila sa buhay, ay makararanas ng komprehensibo at dekalidad na serbisyong pangkalusugan–sa ganitong paraan lamang natin tunay na matutugunan ang maternal and infant mortalities,” she added.

Moreover, the DOH underscored that the implementation of essential primary care services, including MNCHN service, will require Local Government Units (LGUs) to step up their implementation of Primary Care. To support LGUs in this shift, the DOH is implementing the Safe Motherhood Program which provides rational and responsive policy direction to local government partners in delivering quality maternal and newborn health services with integrity and accountability using proven and innovative approaches.

“Sa pagbuo ng primary care-focused health system na poprotekta sa ating mga ina at kanilang mga anak, napakalaki po ng papel ng ating mga lokal na pamahalaan, sapagkat alinsunod sa UHC Law, ang ating mga LGU ang may pangunahing responsibilidad na bumuo ng health systems at primary care provider networks sa kani-kanilang mga lokalidad,” the Health OIC said.


Note: The MNCHN Core Packages consist of interventions that have been found to be effective in preventing deaths and in improving the health of mothers and children, particularly:
1. pre-pregnancy: iron and folate supplementation, provision of family planning counseling and services and prevention and management of infection and lifestyle-related diseases,

2. pregnancy: prenatal care throughout the course of pregnancy, supplementation, tetanus immunization, counseling on health lifestyle and breastfeeding,

3. delivery: skilled birth attendance/skilled health professional-assisted delivery and facility-based deliveries,

4. post partum: postpartum check ups for bleeding and infection, supplementation, counseling on family planning, maternal nutrition, and breastfeeding,

5. newborn care until the first week of life: immediate drying, skin to skin contact, cord clamping, early initiation of breastfeeding, and

6. child care: immunization, micronutrient supplementation, exclusive breastfeeding up to 6 months, oral health, integrated management of childhood illnesses.