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Health Indicators
The Philippine Health Situation
Tables 1 and 2 give important health status indicators in the Philippines and the leadingcauses of morbidity and mortality in the country.
| Table 1: Ten leading causes of morbidity 2003 (Rate per 100,000) |
|
Causes |
Number |
Rate |
| 1. Acute Lower Respiratory Tract Infection and Pneumonia |
674,386 |
861.2 |
| 2. Diarrhea |
615,692 |
786.2 |
| 3. Bronchitis |
604,107 |
771.4 |
| 4. Influenza |
431,216 |
550.6 |
| 5. Hypertension |
325,390 |
415.5 |
| 6. TB Respiratory |
92,079 |
117.6 |
| 7. Disease of the Heart |
30,398 |
38.8 |
| 8. Malaria |
28,549 |
36.5 |
| 9. Chicken |
26,137 |
33.4 |
| 10. Measles |
25,535 |
32.6 |
|
| Table 2: Ten leading causes of mortality 2000 (Rate per 100,000) |
|
Causes |
Number |
Rate |
| 1.Heart Disease |
60,417 |
79.1 |
| 2. Disease of the vascular sytem |
48,271 |
63.2 |
| 3. Malignant neoplasm |
36,414 |
47.7 |
| 4. Pneumonia |
32,637 |
42.7 |
| 5. Accidents |
32,355 |
42.4 |
| 6. Tuberculosis (all forms) |
27,557 |
36.1 |
| 7. Chronic obstructive pulmonary disease and allied conditions |
15,904 |
20.8 |
| 8. Certain conditions originating in the perinatal region |
15,098 |
19.8 |
| 9. Diabetes mellitus |
10,747 |
14.1 |
| 10.Nephritis, nephritis syndrome and nephrosis |
7,963 |
10.4 |
|
While many of the indicators show steady improvements over the years, progress has
generally been slow. To illustrate, even though the infant mortality rate (per 1,000
livebirths) declined from 34 in 1993 to 26 in 2003, our current rate is still high compared
to many of our neighbors.
| Table 3. Infant and maternal mortality rates in Southern Asia and China |
|
|
Infant Mortality
Rate (per 1000 live births) |
Maternal Mortality Rate
(per 100,000 live births) |
| China |
33 |
56 |
| Cambodia |
91 |
450 |
| Indonesia |
38 |
230 |
| Lao PDR |
84 |
650 |
| Malaysia |
10 |
41 |
| Myanmar |
71 |
360 |
| Philippines |
26 |
200 |
| Singapore |
3 |
30 |
| Thailand |
18 |
44 |
| Vietnam |
28 |
130 |
|
The poor performance of the Philippine health sector is partly due to our limited resources.
The national government, saddled with chronic deficits, has not been able to allocate
enough funds for social services, including health.
| Table 4.National Health Expenditure on Health: The Philippines (Peso) |
|
Selected Indicators Health Expe |
1998 |
1999 |
2000 |
2001 |
2002 |
| Total expenditure on health as % of Gross Domestic Product |
3.5 |
3.5 |
3.4 |
3.2 |
2.9 |
| Government expenditure on health as % of Total expenditure on health |
42.5 |
43.7 |
47.1 |
43.1 |
39.1 |
| Private sector ecpenditure on health as % of Total expenditure on health |
57.5 |
56.3 |
52.9 |
56.4 |
60.9 |
| Government expenditure on health as % of Total government expenditure |
6.5 |
6.5 |
7.0 |
5.8 |
4.7 |
| Social Security funds as % of Government expenditure on health |
8.9 |
11.5 |
14.9 |
18.2 |
23.4 |
| Prepaid and risk-pooling plans as % of Private sector expenditure on health |
15.5 |
18.0 |
18.0 |
17.0 |
17.9 |
| Private household's out-of-pocket payment as % of Private sector expenditure On health |
80.6 |
77.0 |
76.6 |
77.8 |
77.9 |
| External resources on health as % of Total expenditure on health |
2.8 |
3.7 |
3.5 |
3.7 |
2.8 |
| Total expenditure on health per capita at exchange rate |
32 |
36 |
34 |
30 |
28 |
| Total expenditure on health per capita at dollar |
163 |
164 |
169 |
163 |
153 |
| General government expenditure on health per capita at exchange rate |
13 |
16 |
16 |
13 |
11 |
| General government expenditure on health per capita at international dollar rate |
69 |
72 |
80 |
71 |
60 |
|
A significant proportion of health expenditures in the country comes out of family savings
(out-of-pocket expenses), as shown in Table 9. In times of emergencies and catastrophic
illnesses (including HIV and AIDS), not only are household savings wiped out, families
also often go into debt.
Many problems on economic and political equity are reflected in the health care system;
for example, there are more private hospitals than public hospitals in the Philippines. Of
the 1,738 hospitals in the country, 1,077 are privately owned and only 661 are public
hospitals. Moreover, hospitals are also unevenly distributed across the regions. While
there are 178 hospitals in Metro Manila, the ARMM has only 14 hospitals.
In addition to hospitals, there are around 1,879 rural health units (RHUs) and 15,343
barangay health stations (BHS) in the country as of 2002. RHUs are usually staffed by a
doctor, a nurse and a few midwifes. On the other hand, BHSs should have at least one
midwife.
The country has seen a decline in the number of health personnel as many of them
choose to work overseas where demand and pay is high. Those who remain, on
the other hand, often choose to stay in the cities. Health professionals are unevenly
distributed in the country, with a majority of government doctors and nurses practicing in
urban areas, particularly in Metro Manila. Of the 3,021 government doctors, 658 work
in NCR; in contrast, ARMM and CARAGA have to make do with only 69 and 79 doctors,
respectively.
| Table 5: Health Status Indicators |
|
Indicators |
|
Year |
| Life expectancy at birth (years) |
|
2003 |
| Female |
72.5 |
|
| Male |
62.7 |
|
| Crude death rate (per 100,000 population) |
4.8 |
2000 |
| Infant mortality rate (per 100,000 population) |
29 |
2003 |
| Under-five mortality rate (per 1,000 live births) |
40 |
2003 |
| Maternal mortality rate (per 100,000 live births) |
172 |
1997 |
| Births attended by health professional (%) |
60 |
2003 |
| Births delivered in health facility (%) |
38 |
2003 |
| Pre-natal care coverage (%) |
94.1 |
2003 |
| Malnutrition rate (% children under 5) |
27.6 |
2003 |
|
| Table 6. Health Care Indicators |
|
Indicators |
|
Year |
| Number of hospitals |
1,738 |
2002 |
| Private |
1,077 |
|
| Public |
661 |
|
| Number of barangay health stations |
15,343 |
2002 |
| Number of rural health units |
1,879 |
2001 |
| Hospital beds (per 1,000 people) |
1.1 |
2002 |
| Doctors (per 100,000 population) |
11.5 |
2002 |
| Nurses (per 100,000 population) |
43.69 |
2002 |
| Hospitals (per 100,000 population) |
2.24 |
2000 |
|
Reproductive Health
The Philippine MDGs include a target that reads: "Increase access to reproductive
health (RH) services to 60 percent by 2005, 80 percent by 2010 and 100 percent
by 2015". The target associates reproductive health services mainly with antenatal
check-ups, attendance by health professionals at delivery, and family planning.
| Table 7 Reproductive Health Indicators 2003 |
|
Indicators |
|
| Percentage of deliveries attended by health professionals |
88 |
| Percentage of pregnant women receiving post-partum check-ups (PPC) |
72 |
| Total fertility rate (wanted) |
2.5 |
| Total fertility rate (actual) |
3.5 |
| Contraceptive prevalence rate |
49 |
| Unmet need for FP of currently married women |
17 |
|
The Department of Health recommends that all pregnant women should have at
least four antenatal check-ups (ANCs); however, the 2003 NDHS found that only
70 percent of women had four ANCs. To put it another way, around 30 percent of
pregnant women have less than four ANCs, with some having none at all.
Family planning is a complex problem in the Philippines as some groups and sectors
are aggressive in opposing family planning services. The 2003 NDHS found that
the total fertility rate (TFR)-the average number of children a woman has in her
lifetime-minutely decreased from 3.7 in 1996-1998 to 3.5 in 2001-2003.
Access to reproductive health services should not be limited to family planning; in
particular, young people also need access to sex education, family planning and
other reproductive health services. In discussions regarding young people, too much
emphasis has been given to premarital sex (PMS) as a risk factor, often citing figures
from the 3rd Young Adult Fertility and Sexuality Study (YAFS-3) showing that about
23 percent of unmarried young adults (aged 15 to 24) have had sex. Actually, the
health risk is not so much of "PMS" per se than of unprotected sexual activity that
could lead to early pregnancies and marriages, or sexually transmitted infections
including HIV.
The 2003 NDHS reports that by the age of 19, 23.5 percent of Filipino women have
already borne a child. This figure is rarely used as an indicator of the risks faced
by young Filipinos. In fact, the number of young people having sex is actually quite
low compared to many other countries; yet, many of the young women seem to get
pregnant, indicating a lack of protection during sex. If HIV prevalence rates were
higher in the country, young girls could also be expected to come down with the
disease.
The focus on "PMS" as a risk factor also tends to suggest that sex within marriage
is safe-an assumption far from reality. There is increasing concern that when HIV
becomes more prevalent, many of those infected will be monogamous wives; that
is, women who are sexually faithful to their husbands, but whose husbands have
unprotected sex with multiple partners. The figures from YAFS are very clear in
showing how males engage in far more risky sexual behavior than females.
| Table 8: Commercial and extramarital sex behavior among sexually active youth |
|
|
Male
(in percent) |
Female
(in percent) |
Both
(in percent) |
| Ever paid for sex |
19.1 |
(.05) |
10.4 |
| Ever been paid for sex |
11.3 |
(0.7) |
6.4 |
| Used condom when receiving payment for sex |
53.3 |
(88.9) |
53.8 |
| Used condom when paying for sex |
56.1 |
(84.6) |
56.9 |
| Used condom with extramarital sex |
8.0 |
3.2 |
4.4 |
|
| *figures in parenthesis less than 30 cases |
Source: Philippines 2005 HIV AIDS Country Profile HAIN PNAC UNAIDS Philippines
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