4Ps beneficiaries show high health compliance
Mother-beneficiaries in Negros Oriental of the government’s conditional cash transfer program (CCT), under the Pantawid Pamilyang Pilipino Program (4Ps) have recorded almost perfect compliance with the program’s health conditionalities.
According to a study at Silliman University, these beneficiaries were doing this not so much for the cash but for the value of disease prevention and good health.
The author of the study, Dr. Maria Theresa C. Belciña Jr. of the SU College of Nursing, wrote in her dissertation: “The health services utilization of the beneficiaries of the CCT program in Negros Oriental is remarkably good. Almost all mothers (94.69 percent) are submitting for prenatal check-up, a big majority (71.98 percent) is availing of the post-natal care services, and majority of the mothers (50.72 percent) is attended by skilled or trained health practitioner during childbirth.”
In 2016 Belciña surveyed seven towns—Ayungon, Basay, Bindoy, Jimalalud, La Libertad, Tayasan, and Vallehermoso—and asked 207 mother-respondents, aged 25 years and above, what motivated them in (or hindered them from) availing themselves of health services under 4Ps.
Her survey also covered 768 children considered for preventive check-up and 294 children, 0-5 years old, for immunization.
In child immunization, 84 percent of children, aged 0–12 months, were reported to have been fully immunized (given 14 to 16 shots of required vaccines); but those 1 – 5 years old recorded only 11.07 percent full immunization, partly because immunization for the latter age group was not required and partly due to lack of vaccines.
For preventive check-up, the children needed to be brought to the health center once a month or at least nine times a year. In this study, 0-12 months old registered 84 percent full compliance; 1-5 years old (90 percent compliance); 6-11 years old (65 percent); and 12-18 years old (17 percent).
The older children registered low compliance with check-up mostly because they needed to be in school while the check-ups were done. Regarding positive health motivation, 55 percent of the mothers cited the importance of maintaining good health; while only 9 percent cited cash gift as a motivation, and another 10 percent said the services are free.
On the other hand, respondents who failed to avail of the health services said bad weather and long distance from the health center was a hindrance (34 percent), while others said they were “busy at work” (19 percent), “couldn’t leave the house” (14 percent), and “herbal and alternative medication alleviated their ailments” (12 percent).
The law on 4Ps was enacted in 2010 as a poverty reduction and social development strategy, providing CCT of up to P15,000 annually to extremely poor families. In 2016, the government allocated more than P50 billion to 4Ps, benefitting some 4.4 million households.
In 1990, the Philippines recorded 209 maternal deaths per 100,000 live births, worsening in 2011 to 221 per 100,000 (higher than government’s target limits) from pregnancy complications, high blood pressure, hemorrhage, and abortive outcomes.
Deaths of children under 5 years in the Philippines decreased from 80 per 1,000 live births in 1990 to 28 per 1,000 live births in 2015; but the World Health Organization said these figures were higher compared to other countries in the region. More than half of under-five deaths are deaths of newborns, in the first week of life, from complications from prematurity, birth asphyxia, and infections (sepsis and pneumonia).
Belciña said studies proved that essential maternal and newborn care could save lives of mothers and newborn babies. In addition, good health practices required under 4Ps could “ingrain” better health consciousness and behavior in the next generation, as the children beneficiaries become parents themselves.
The mothers in this study, however, voiced three current problem areas of 4Ps: understaffed health centers, lack of supply of vaccines and medicines, and lack of functional health centers especially in upland barangays.
Belciña then calls on government to provide more education in preventive health care for children, ensure full coverage of children’s immunization, and fully provide for adequate health care facilities.