Secondary analysis of a national health survey on factors influencing women in the Philippines to deliver at home and unattended by a healthcare professional.
OBJECTIVE
To elucidate factors that influence Philippine women to deliver at home and not be attended by a healthcare professional.


METHODS
Analysis of hospital data that were collected through Global Positioning System technology uploaded into the WHO HealthMapper and data on 7380 women from the Philippines Demographic and Health Survey, 2003.


RESULTS
Most of the home deliveries that were not attended by healthcare professionals occurred within 15 km of a hospital. Women who had home deliveries and were not attended by a healthcare professional were more likely to be of low educational and economic status and to reside in rural houses without basic amenities (P<0.001). Obtaining money (83.0%), transport (48.1%), and a companion (35.0%) were identified as barriers to getting treatment. Death rates of neonates born to these women were not statistically different from those of neonates who were born in a healthcare facility (OR 1.0; 95% CI, 0.63-1.57; P<0.99).


CONCLUSIONS
Most deliveries that were not attended by a healthcare professional occurred near a hospital. Financial barriers will need to be addressed to increase the number of deliveries in a healthcare facility. The apparent failure of hospitals to reduce newborn mortality may be related to suboptimal newborn care practices.
Sobel
Howard L
HL
World Health Organization, Representative Office in the Philippines, Manila, Philippines. sobelh@wpro.who.int
Oliveros
Yolanda E
YE
Nyunt-U
Soe
S
D036861:Delivery, Obstetric / Q000191:economics / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006700:Home Childbirth / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D010679:Philippines; D011247:Pregnancy; D012424:Rural Population / Q000706:statistics & numerical data; D012923:Social Class