April 2018 — Throughout Estela Tudio’s first pregnancy in 2013, she worried about medical expenses. Estela, a homemaker in Bayambang — a town in the Philippines’ northern region of Luzon — and her husband, Almar, who earned $6 (300 Philippine pesos) per day as a tricycle driver, could not afford birth at a hospital. So Estela gave birth at home.

Giving birth at a facility with a skilled attendant greatly increases the chances of survival for both mother and baby. The Philippine Government has been seeking ways for low-income families to access this critical health care, including by subsidizing the cost of joining PhilHealth — the national health insurance program.

USAID helped build the foundation for PhilHealth in the 1990s.

Families insured by PhilHealth can receive affordable treatment at any accredited hospital or health clinic, which are reimbursed by the insurance program. Reimbursement funds are used to maintain daily operations, pay workers’ salaries, and make improvements to buildings. But many clinics in the region lack the workforce and services needed for accreditation.

In response, USAID’s LuzonHealth project partnered with the Department of Health in 2013 to build health workers’ skills and improve operations of over 350 hospitals and clinics. In the Bayambang health clinic, USAID helped train midwives in emergency obstetric and newborn care. The midwives also learned to counsel parents seeking family planning services and safely administer or dispense their chosen method.

Meanwhile, USAID helped the clinic identify and resolve the gaps in administrative requirements that were holding them back from getting accredited. For example, the project standardized the clinic’s hiring practices to boost efficiency and transparency. As a result of the Bayambang health clinic’s diligent work, it is now accredited with PhilHealth.

Today, women in Bayambang can safely and affordably give birth at the clinic. Couples can receive family planning and counseling services, too. When Estela became pregnant with her second child in 2017, she received regular prenatal care and delivered her baby with a skilled birth attendant.

“I was happy that I could give birth here and afford all of this care!” she said.

Meanwhile, the facility claimed reimbursements from PhilHealth amounting to $30,000 (1.5 million Philippine pesos) last year. This additional income helps the clinic expand and sustain its work.

“We are continually improving our services and providing for more people’s health needs,” said Dr. Paz Vallo, Bayambang’s municipal health officer.

Since 2013, USAID’s five-year LuzonHealth project, in partnership with the Research Triangle Institute, has been working with the Philippine Government to reduce maternal and infant deaths and help couples access quality family planning services. Of the 364 public birthing facilities that USAID has partnered with in Luzon, 80 percent are now accredited and receive reimbursements from the Philippine Government.

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,“We are continually improving our services and providing for more people’s health needs.”

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Advancing Maternal Health Care in the Philippines
Estela Tudio gave birth to her first baby at home because she could not afford hospital expenses. USAID and local partners made a way for Estela and all other low-income families in her community to finally access affordable and quality health care.
LuzonHealth