Are maternal and child care programs reaching the poorest regions in the Philippines?

Objective: To demonstrate the inequity in access to maternal and child health services across regions and economic classes in the Philippines Methodology: Using the National Demographic and Health Survey, concentration index for each program indicator which includes prenatal care, iron supplementation, skilled birth attendance, delivery in medical facility and fully immunized child is computed to measure the extent of inequality. Findings: Results show inequality in maternal and child health services utilization across economic classes and across regions. Pregnant women in richest quintile are two times more likely than the pregnant women in the poorest quintile to have prenatal check up, 4 times more likely to have skilled attendance during child birth and 9 times more likely to deliver in a medical facility. However, there is not much difference between the richest and poorest quintiles in accessing iron supplementation during pregnancy and full immunization for children under one year of age. Patterns of exclusion within each region are also examined. For regions where highly urbanized cities are located, high utilization rates and high concentration indices are observed. The two poorest regions have low utilization rates but different patterns of inequality is discerned: one has massive deprivation for all income levels in health care access leading to low levels coverage while another has only the richest quintile accessing health care. Conclusions:While the uptake of maternal and child health services in the Philippines has been reasonably satisfactory, the focus on the poor remains low as shown by vast differences in patterns of utilization across economic classes and across regions. It is possible that as the national average for health service utilization shows improvement, it is likely that only those in the richest quintile are showing improvement while the poor remain to be marginalized. Knowing the patterns of inequality within an area can help in determining appropriate policies to improve access to health care.