Nursing Prof Study Shows NegOr 4Ps Beneficiaries Register High Health Compliance

Mother beneficiaries of the government’s conditional cash transfer program in Negros Oriental have recorded almost perfect compliance with the health conditionalities under the Pantawid Pamilyang Pilipino Program (4 Ps),  saying they were doing this not so much for the cash as for the value of disease prevention and good health,  according to a study at Silliman University.

The author of the study, Dr. Maria Theresa C. Belciña Jr. of the 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%) are submitting for pre-natal check-up, a big majority (71.98%) is availing of the post-natal care services, and majority of the mothers (50.72%) is attended by skilled or trained health practitioner during childbirth.”

In 2016, Dr. Belciña surveyed for her dissertation  seven municipalities  (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 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% 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% 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 9 times a year. In this study, 0-12 months old registered 84% full compliance; 1-5 yrs old, 90% compliance;  6-11 yrs old, 65% compliance;  and 12-18 years old, only 17% compliance.

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% of the mothers cited the importance of maintaining good health; while only 9% cited  cash gift as a motivation,  and another 10% said because 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%), while others said they were “ busy at work” (19%), “couldn’t leave the house” (14%), and  “herbal and alternative medication alleviated their ailments” (12%).

The Philippines enacted 4Ps  into law in 2010 as a poverty reduction and social development strategy, providing conditional cash of up to P15,000 annually to extremely poor families.

In 2016 the government allocated more than 50 billion pesos to 4Ps, benefitting some 4.4 million households.

The premise is that keeping children healthy and in school could break the cycle of poverty between generations.

In exchange, the beneficiaries need to meet health and education requirements.

In education, the condition is that 3 to 5 years old go to daycare/pre-school, attending at least 85% of the time, and  6 to 14 years old enroll and attend school also at least 85% of the time.

Pregnancy and childbirth are among the leading causes of death, disease and disability in women of reproductive age in developing countries.

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).

Dr. 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.

The researcher herself 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. (by Celia E. Acedo, Silliman University Research and Environmental News Service)