Secretary Duque spells out health priorities
Lack of access to health care is forcing one out of two Filipino mothers to give birth at home
Increasing investments in health, ensuring universal access to essential health care, assuring the quality and affordability of health goods and services, and enhancing the performance of the health sector are the priorities of newly appointed Health secretary Francisco Duque III.
The former president and chief executive officer of the Philippine Insurance Corporation (PhilHealth) took over from Manuel Dayrit, who resigned in May to join the World Health Organization starting August 1 as director for human resources, making him the highest-ranking Filipino in the United Nations agency.
Baring his plans at the weekly media forum of the Philippine College of Physicians and Mirror magazine in Quezon City, Duque said he will also review ongoing programs of the health department, including the "Ligtas Buntis" campaign, which has earned the ire of the Catholic Church and so-called prolife advocates. "We will review these programs whether they should be continued or otherwise. On the issue of population, we will consult with various groups in order to get a consensus approach," said Duque.
"There are a lot of things to do, but for sure, I will continue to campaign for low-priced medicines, advanced public health programs, and improved health-management system," Duque assured.
Duque's appointment, however, is being opposed by militant groups Migrante International and Health Alliance for Democracy, which staged a protest rally on Duque's first day on the job on June 1.
In an interview with MEDICAL OBSERVER, Migrante chair Connie Bragas-Regalado said that Duque's move to the Health department is "another bare-faced example of President Gloria Arroyo's political paybacks."
While head of the state-run health-insurance agency, Duque was instrumental to the distribution of four million free PhilHealth cards bearing Arroyo's photos during last year's presidential-election campaign.
Migrante charged that the cards were "used as a ploy to get votes from the largely poor electorate." They also alleged that PhP530 million in Medicare funds of overseas Filipino workers had been transferred from the Overseas Workers Welfare Administration and had been used to help finance Arroyo's campaign in last year's elections.
Citing Duque's "tarnished reputation" and alleged misuse of PhilHealth's funds, Regalado asked: "How can Arroyo proclaim that she does not subscribe to paying political debts to her election benefactors and henchmen? He (Duque) has no moral ground. Cabinet secretaries should be appointed based on a sterling history of service to the people--not to one person."
Critics say that Duque's distribution of the "deceptive" PhilHealth cards during the 2004 elections will give him a tough time at the Commission on Appointments.
Duque graduated from the University of Santo Tomas College of Medicine and Surgery in 1982. He obtained his master's of science degree in pathology in 1987 from Georgetown University. His father, Francisco Jr., served as health secretary to president Diosdado Macapagal.
Under Duque's watch, the government-owned health-insurance corporation's total assets rose from PhP29.5 billion in 2000 to PhP51.5 billion in 2004, with investments income growing from PhP3.2 billion in 2001 to PhP4.419 billion in 2004. PhilHealth membership also increased from 29 million in 2001 to 69.5 million in 2004, of which 31.3 million are indigent Filipinos whose membership is paid for by the national government and local government units.
Arnel Mendoza
WHO, UNICEF call for stronger breast-feeding drive
Only one in six Filipino children is exclusively breast-fed for the first six months of life, and infants are exclusively breast-fed for less than a month on average, according to the recent National Demographic and Health survey.
"This is a worrying decline," noted Dr. Jean-Marc Olivé, representative of the World Health Organization to the Philippines, as he and officials of the United Nations Children's Fund (UNICEF) called for stronger efforts to protect and promote breast-feeding in the country.
Olivé observed that most Filipino mothers give their newborns infant formula. "No wonder 30 percent of Filipino babies are either malnourished or undernourished," he said. He noted that of the 82,000 children--newborn to five years old--who died in the Philippines last year, 16,000 could have been saved by exclusive breast-feeding alone.
"Our agencies believe that renewed and strengthened efforts to save children's lives, protect and support their physical, emotional, and intellectual development through stronger promotion of breast-feeding are urgently needed," he said.
Allaying the fears of the WHO and UNICEF that massive infant-formula advertising is contributing to the drop in breast-feeding rates, former Health secretary Manuel Dayrit assured that there will be no let-up in the country's campaign on breast-feeding and that it is in fact being strengthened.
However, Dayrit admitted that it may take some time before the ideal levels are achieved. He explained that it is a problem that requires collaborative actions from other government agencies like the Department of Labor and Employment (DOLE).
There are at least three laws that promote breast-feeding in the country or regulate the promotion of infant formulas. These are Executive Order 51 or the Marketing Code for Breast-Milk Substitutes (EO 51), which regulates the marketing of infant formulas; the Rooming-in and Breast-feeding Act of 1992, which encourages that newborns stay in the same room with their mothers and be breast-fed immediately after birth; and the Mother and Baby-friendly Hospital law, which encourages hospitals and lying-in clinics to have mother- and baby-friendly facilities and make breast-feeding possible within an hour of an infant's birth.
Arnel Mendoza
HOME DELIVERY
Lack of access to health care is forcing one out of two Filipino mothers to give birth at home
More than half of Filipino mothers are giving birth at home, citing financial problem as the biggest hindrance in accessing care in a health facility, most without the assistance of a health-care professional.
This is among the findings of the 2003 National Demographic and Health Survey (NDHS) results of which were released recently by the Commission on Population (PopCom). The survey also showed that less than 40 percent of deliveries occur in a health facility and among women who deliver at home, only one in three receive postnatal check up within two days of delivery.
The NDHS also reported that only 34 percent of deliveries are assisted by doctors and 25 percent by midwives. About 37 percent are assisted by traditional hilots.
Tomas Osias, executive director of PopCom said that while 90 percent of mothers get at least some antenatal care, close to half of them do not get any care during the first trimester of pregnancy. Six percent, on the other hand, receive no antenatal care at all while 40 percent wait until the first semester of pregnancy to start care.
"This is a sad fact since these visits to the health facility help identify pregnancy complications and chart progression," said Osias.
The Department of Health recommends at least four visits for antenatal care with at least one visit during each trimester.
Since many pregnant women do not receive antenatal care, 51 percent of them were not informed about possible complications while 57 percent were not told where to go in case of problems.
Aside from financial lack, mothers cite not wanting to go alone and distance to the health center as barriers in accessing health care.
"If we want to decrease maternal mortality and at the same time produce healthy babies, we must make health care available and accessible to pregnant women," noted Osias. He added that access to health care is worse in rural areas because many people live far from health-care facilities.
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