Title: A Cross-Sectional Analytic Study of Postpartum Health Care Service Utilization in the

Philippines
Authors: Tadashi Yamashita, Sherri Ann Suplido, Cecilia Ladines-Llave, Yuko Tanaka, Naomi Senba,
Hiroya Matuso
Summary:
When weve had our case findings for our home visit, we interviewed one pregnant mother in
the community for our case. Weve spent minutes getting all the information from the mother. As we
observed her answers about her knowledge on pregnancy, most of it was wrong. That is why when I
was looking for an article for our biblio sharing, I saw this article and it came into my mind that maybe
the lack of knowledge of most pregnant mothers has something to do with the health care service
utilization.
One of the projects of the WHO is to reduce the morbidity and mortality rate of maternal and
child through the Millennium Development Goals. In the Philippines MMR has dropped from 170 per
100,000 live births in 1990 to 99 in 2010, but the rate of annual change is slowing down. If the MMR
remains high it will be difficult to achieve the MDGs5 by 2015.

77 postpartum women from 3 hours to 6 weeks post-delivery with no complications were

enrolled in the study that was conducted from January to march 2013. Knowledge test were distributed
who received postpartum checkups at Philippine General Hospital and those who participated in a
postpartum health education seminar at Muntinlupa City Hall. Mothers were recruited using 2 stage
stratified random sampling method. Self-report questionnaire comprised 3 sections. 1st section is about
the demographic information. 2nd section assessed their utilization of health care services during
pregnancy and the third assessed their utilization of postpartum health care services. Postpartum
health concerns test was developed to evaluate postpartum womens knowledge of postpartum health.
The test consisted of 11 questions on six areas of possible postpartum physical and mental health
concerns. Postpartum utilization of health care services was significantly correlated with delivery
location. Women who delivered at home had a lower rate of postpartum health care service utilization
than women than women who delivered at medical facilities. The majority of participants scored low on
the knowledge test.

Participants did not received postpartum health care services at the appropriate time, those who
delivered at home utilized fewer health care services after delivery compared to those who delivered at
medical facilities and they had poor overall understanding of postpartum. In the Philippines, postpartum

health care guidance may be inadequate due to the large number of deliveries, few skilled birth
attendants, and short post-delivery stays at perinatal medical facilities. As a result, postpartum women
may have less knowledge of postpartum issues and receive fewer postpartum health services. The
survey revealed that 47.4% of postpartum women attended their first post checkups in 41 days after
delivery which is very late. The researchers concluded that inadequate postpartum health care service
utilization, especially for women who delivered at home. In the Philippines Barangay Health workers
may play a role in educating postpartum women regarding health care service utilization to improve
their knowledge of possible concerns and their overall utilization of health care services.
Reflection/Recommendation:
I believed that the factors that affect the poor utilization of health care services for postpartum
that was said here are all true. And I would like to add based on my observations. I guess that some of
postpartum was not able to utilized it is because most of them are lazy, or some of them is busy with
their livelihood, or some of them maybe have so many children and they are get used to what will
happen to them and also maybe some of them is far away from the local health unit and health
agencies failed to reach their health needs. It is for the BHW or the Public health nurse to visit the
mothers at their home and inspect their homes.

Nursing Education this will help nursing students to further know why maternal and child health is
important and how they will be able to care for the community with all of their abilities in the future.
Nursing Research this article will help the government or the health care professionals on how they
will expand their hands and mind on why there are still high maternal mortality and morbidity rate. This
will probably help researchers to also study in a big population.
Nursing Practice this will aware nurses that health teaching is very important and can save a life. This
will help them that there is a need to give a complete but simple health education to their client not only
in maternal side but also in all aspects of nursing care.