Geographical disparities in maternal healthcare and mortality in the Philippines: a 10-year comparison.

Background: Although the Philippines launched its Maternal, Neonatal, and Child Health and Nutrition strategy in 2008 to reduce maternal mortality, its impact on maternal health services (MHS) utilization and maternal mortality ratio (MMR) remains unclear. This study examines MHS utilization trends and their association with MMR across the Philippines from 2010 to 2019.

Methods: We conducted an ecological study using panel data in the Philippines during 2010-2019. Secondary analyses took place on datasets from the Department of Health and the Philippine Statistics Authority. Multivariate analyses were performed to investigate the association between MHS utilization and MMR.

Results: From 2010 to 2019, national mean MMR declined from 74.85 to 57.19 deaths per 100 000 live births. Facility-based deliveries increased by 39.57% and births attended by medical doctors by 19.01%. Results from fixed-effects models revealed no significant association between MHS utilization and change in MMR over the 10-y period. However, utilization of antenatal care in Luzon (β=-1.528, p=0.005) and postpartum care in Mindanao (β=-1.604, p=0.020) was attributable to MMR reduction in 2019.

Conclusions: While a national decline in MMR was observed from 2010 to 2019, significant regional disparities in MMR existed. The impact of MHS utilization varied over time and location.