The Curious Case of CAR (Cordillera Administrative Region): Healthcare Workers are Key to Improving Maternal Health Outcomes

Abstract

Introduction. Understaffed and underfunded Rural Health Units (RHUs) in Luzon struggle to provide Basic Emergency Obstetric and Newborn Care (BEmONC) services, resulting in high rates of maternal morbidity and mortality. The Cordillera Administrative Region (CAR) is different. Despite limited BEmONC-capable facilities, the region has maintained excellent maternal health outcomes.Objectives. This study describes the status of BEmONC-capable RHUs in CAR and how these relate to the maternal and child health outcomes in the region.Methods. This study uses the BEmONC Survey Toolkit to determine facility functionality based on the three categories of institutional capacity, service capacity, and personnel capacity. Focused Group Discussions were conducted to gather insights from community members, health personnel, and local stakeholders.Results. The study evaluated 31 facilities; only one was adequately functional. The service capacity of BEmONCRHUs in CAR (7.19) was significantly lower than that of Luzon (14.16). The overall functionality score of CAR (58.10) was also slightly lower compared to that of Luzon (60.42). Yet CAR still had some of the best outcomes in terms of maternal and child health. Maternal mortality from 2000 (23 deaths) to 2018 (13 deaths) was consistently low.Conclusion. The case of CAR reiterates the importance of having health personnel on the ground, maintaining the trust of the populace for health promotion to increase health awareness, and timely intervention in difficult situations. These directly impact health service delivery and improve health outcomes.