INCREASING FACILITY-BASED DELIVERIES

THROUGH INTEGRATION OF TRADITIONAL

BIRTH ATTENDANTS INTO HEALTH PROGRAMS
OF THE LOCAL GOVERNMENT UNIT
MELANIO RAMIR P. BELOSO, MD, FPCS, MHA
Master in Public Management Major in Health Systems and Development
October 21, 2018
Background of th Study

 first class municipality with 34 brgy

with 48,000 people
 mountainous and irregular terrain,
transportation in uplands thru
angkas system
 Birthing home as economic
enterprise was shut down due to
decrease facility delivery and
failure to earn
 Traditional birth attendant
proliferate
Problem Statement

1. What are the reasons why pregnant

mothers go to traditional birth attendants
(hilot)?
2. What are the reasons why pregnant
mothers do not go to the health facility for
childbirth?
3. What are the interventions that can be
suggested to increase facility-based
delivery?
Significance of the Study

The research aims to understand the reasons why

people go to hilot and the advantages of the
facility-based deliveries in order to provide
interventions.
Scope and Limitations

 includes data inputs from health practitioners, pregnant women and hilot
 discuss available services of BEmONC facility and its advantages
 cover proposed regulatory mechanisms to monitor TBA
 does not include planning efforts nor services offered by TBA
Definition of Terms

 Hilot or Comadrona
 Basic Emergency Obstetrics and Newborn Care (BEmONC) Provider
 Infant Mortality Rate
 Maternal Mortality Ratio (MMR)
Review of Related Literature

 Hilot: unlicensed and informally trained

comforting assurance and readily available
more affordable
families are not used to planning ahead
 Maternal Health: maintain good health, child care, normal delivery
decrease mortality and morbidity thru proper nutrition, regular check up and
delivery at the facility
 BEmONC and facility delivery: pre pregnancy, prenatal and birth packages
Synthesis and Gaps

 maternal mortality remains moderately high

 efforts failed to make hilots a part of the health system
 unable to address the health concerns of mothers
Conceptual Framework

HOME-BASED FACILITY-BASED
DELIVERY DELIVERY

HILOT OBGYN, MIDWIFE

RESULTS INTERVENTIONS ADVANTAGES

HBD
FBD
MONITORING
METHODOLOGY

 Research Design: Phenomenological, Ethnographic

 Locale of the Study: Mabini, Batangas
 Unit of Study: Rural Health Unit
 Data Collection Procedure: Interview, Questionnaires
 Tools of Analysis: Discourse Analysis
Framework of Analysis

INPUT OUTPUT
PROCESS
Interview • Enumerate the
Discourse Analysis
• KII reasons why patients
• Identify the reasons why patients go
• Focused Group go to hilot
to hilot
Discussion • Enumerate the
• Identify the perceived advantages
perceived advantages
and disadvantages of FBD
Document Analysis and disadvantages of
• DOH Circular and FBD
Guidelines

OUTCOME
Create interventions that
address the reasons why
they go to hilot; including
the perceived
disadvantages
 Action Plan and Project Matrix
objective major expected person time risk risk budget
activity results responsibl frame treatment
e
to identify the conduct recorded researcher November far location make P3,000.00
reasons why interview interview - and appointment
mothers go to December availability of with hilot,
hilot make input data 2018 hilot, ask
questionnai form hilot may be assistance
re questionnaires skeptical with from brgy,
the interview relatives ,
BHW

to ientify the records records researcher November unavailability search P 500.00

reasons why review at reviewed - of records computer
pregnant the local December data base
mothers do registrar 2018
not go to the
facility for
childbirth
 Action
majorPlanexpected
objective
activity
and
results
Project
person
responsible
Matrix
time frame risk risk
treatment
budget

key KII researcher November- unavailabil regular P 3000.00

informants conducted December ity of key follow up
interview with 2018 informants and
pregnant confirmation
mothers, of schedules
OB-GYNE,
midwives
focused family researcher November- unavailabil regular P3000.00
group members, December ity of key follow up
discussion husband, 2018 informants and
relatives confirmation
of schedule
to data review records researcher January- incomplet thorough P1000.00
identify from reviewed February e data analysis of
interventi interview 2019 data
ons to
increase
facility
delivery