A child born in the Philippines is at greater risk of dying than children born in other Southeastern Asian countries, according to the latest results from the 2003 National Demographic and Health Surveys (NDHS) conducted by the National Statistics Office. In the Philippines for every 1000 births, 29 children will die before their first birthday (infant mortality rate), and 40 will die before age 5 (under-five mortality rate) (Table 1). Although the infant mortality rate in the Philippines has decreased slightly since 1998, it is still high compared to other countries in the region—Vietnam, Brunei, Singapore, Thailand, and Malaysia.
Spacing births to at least three years apart and improving maternal and child health services can reduce infant mortality, according to the NDHS. Children born less than 2 years apart are almost twice as likely to die in the first year of life as children born three years apart, the survey found. In the Philippines one of every three births occurs within 2 years of the preceding births (Table 2). Closely spaced births are most common among poor women in the Philippines (Table 3).
Health care during pregnancy is improving, the NDHS reports. Three out of 5 births are assisted by health professionals, an increase from 1993 and 1998 national surveys (Table 4). This still falls short of the Department of Health’s goal of 80%. Women are still more likely to give birth at home than in a health care facility. About 6 in every 10 women had their most recent child at home, the NDHS found (Table 5). Delivery care varies widely throughout the Philippines, according to the survey. Poorer women and women with no education are far more likely to be assisted during delivery by a hilot than wealthier and more educated women. Improving access to and use of health facilities for both mothers and children will play a key role in increasing Filipino children’s well being and survival.
Fertility in the Philippines has declined steadily over the past three decades, especially in the first twenty years during which a decline of one birth every decade was observed (from 6 births per woman in 1970 to 4.1The 2003 NDHS is the eighth in a series of demographic surveys conducted every 5 years since 1968. It covers a national sample of 13,945 women 15 to 49 years old and 5,009 men 15 to 54 years old. The survey is designed to provide up-to-date information on population, family planning and health. This information is intended to assist policy makers and program managers in evaluating and designing programs and strategies for improving health and family planning services in the country. The survey was implemented by the National Statistics Office from June 16 to September 3, 2003. Financial support for the local costs of the survey was provided by the United States Agency for International Development (USAID). ORC Macro provided technical assistance to the project through the MEASURE DHS+ project.
(Sgd.) CARMELITA N. ERICTA
Administrator
Table 1. Infant mortality rate and under-five mortality rate, Philippines 1993-2003
Survey Year | Infant Mortality Rate | Under-five Mortality Rate |
Deaths per 1,000 Live Births | ||
1993 | 34 | 54 |
1998 | 35 | 48 |
2003 | 29 | 40 |
Table 2. Infant mortality rate and under-five mortality rate for the ten-year period preceding the survey by previous birth interval, Philippines 2003
Previous Birth Interval | Infant Mortality Rate | Under-five Mortality Rate |
Deaths per 1,000 Live Births | ||
<2 years | 39 | 58 |
2 years | 26 | 38 |
3 years | 19 | 30 |
4+ years | 25 | 31 |
Table 3. Percentage distribution of non-first births in the 5 years preceding the survey by number of months since preceding birth and wealth index quintile, Philippines 2003
Wealth index quintile | Months since preceding birth | ||||
7-17 | 18-23 | 24-35 | 36-47 | 48+ | |
Lowest | 15.1 | 18.2 | 34.2 | 15.4 | 17.2 |
Second | 16.3 | 16.8 | 28.5 | 14.2 | 24.3 |
Middle | 18.5
| 17.7
| 21.9 | 13.5
| 28.4
|
Fourth | 16.5 | 13.6 | 21.7 | 15.4 | 32.9 |
Highest | 15.9 | 13.1 | 22.7 | 13.7 | 34.7 |
Table 4. Percentage of live births in the 5 years preceding the survey by person providing assistance during delivery, Philippines 1993, 1998 & 2003
Assistance during delivery | 1993 | 1998 | 2003 |
Health professionals | 52.8 | 56.4 | 59.8 |
Doctor | 26.0 | 30.9 | 33.6 |
Nurse/midwife | 26.8 | 25.5 | 26.2 |
Traditional birth attendant | 45.3 | 41.3 | 37.1 |
Table 5. Percentage of live births in the 5 years preceding the survey by place of delivery, Philippines 1993, 1998 & 2003
Place of delivery | 1993 | 1998 | 2003 |
Health facility | 28.2 | 34.2 | 37.9 |
Home | 71.5 | 65.5 | 61.4 |
Table 6. Percentage of live births in the 5 years preceding the survey by education, wealth index quintile, and person providing assistance during delivery, Philippines 2003
Doctor | Nurse/midwife | Traditional birth attendant | |
Education | |||
No education | 2.1 | 8.8 | 74.1 |
Elementary | 12.6 | 22.2 | 59.7 |
High School | 30.2 | 32.8 | 35.0 |
College or higher | 64.8 | 21.1 | 12.6 |
Wealth index quintile | |||
Lowest | 8.6 | 16.5 | 68.9 |
Second | 21.0 | 30.4 | 45.4 |
Middle | 37.4 | 35.0 | 26.3 |
Fourth | 52.6 | 31.8 | 13.3 |
Highest | 73.2 | 19.2 | 7.0 |