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The population-level impacts of a national health insurance program and franchise midwife clinics on achievement of prenatal and delivery care standards in the Philippines

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  • Kozhimannil, Katy Backes
  • Valera, Madeleine R.
  • Adams, Alyce S.
  • Ross-Degnan, Dennis

Abstract

Objectives Adequate prenatal and delivery care are vital components of successful maternal health care provision. Starting in 1998, two programs were widely expanded in the Philippines: a national health insurance program (PhilHealth); and a donor-funded franchise of midwife clinics (Well Family Midwife Clinics). This paper examines population-level impacts of these interventions on achievement of minimum standards for prenatal and delivery care.Methods Data from two waves of the Demographic and Health Surveys, conducted before (1998) and after (2003) scale-up of the interventions, are employed in a pre/post-study design, using longitudinal multivariate logistic and linear regression models.Results After controlling for demographic and socioeconomic characteristics, the PhilHealth insurance program scale-up was associated with increased odds of receiving at least four prenatal visits (OR 1.04 [95% CI 1.01-1.06]) and receiving a visit during the first trimester of pregnancy (OR 1.03 [95% CI 1.01-1.06]). Exposure to midwife clinics was not associated with significant changes in achievement of prenatal care standards. While both programs were associated with slight increases in the odds of delivery in a health facility, these increases were not statistically significant.Conclusions These results suggest that expansion of an insurance program with accreditation standards was associated with increases in achievement of minimal standards for prenatal care among women in the Philippines.

Suggested Citation

  • Kozhimannil, Katy Backes & Valera, Madeleine R. & Adams, Alyce S. & Ross-Degnan, Dennis, 2009. "The population-level impacts of a national health insurance program and franchise midwife clinics on achievement of prenatal and delivery care standards in the Philippines," Health Policy, Elsevier, vol. 92(1), pages 55-64, September.
  • Handle: RePEc:eee:hepoli:v:92:y:2009:i:1:p:55-64
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    References listed on IDEAS

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    1. Wong, Emelita L. & Popkin, Barry M. & Guilkey, David K. & Akin, John S., 1987. "Accessibility, quality of care and prenatal care use in the Philippines," Social Science & Medicine, Elsevier, vol. 24(11), pages 927-944, January.
    2. Navaneetham, K. & Dharmalingam, A., 2002. "Utilization of maternal health care services in Southern India," Social Science & Medicine, Elsevier, vol. 55(10), pages 1849-1869, November.
    3. Quimbo, Stella A. & Peabody, John W. & Shimkhada, Riti & Woo, Kimberly & Solon, Orville, 2008. "Should we have confidence if a physician is accredited? A study of the relative impacts of accreditation and insurance payments on quality of care in the Philippines," Social Science & Medicine, Elsevier, vol. 67(4), pages 505-510, August.
    4. Solita Collas-Monsod & Toby Monsod & Geoffrey Ducanes, 2004. "Philippines' Progress Towards the Millennium Development Goals: geographical and political correlates of subnational outcomes," Journal of Human Development and Capabilities, Taylor & Francis Journals, vol. 5(1), pages 121-149.
    5. Guilkey, David K. & Popkin, Barry M. & Akin, John S. & Wong, Emelita L., 1989. "Prenatal care and pregnancy outcome in Cebu, Philippines," Journal of Development Economics, Elsevier, vol. 30(2), pages 241-272, April.
    6. Cynthia K. Stanton, 2004. "Methodological Issues in the Measurement of Birth Preparedness in Support of Safe Motherhood," Evaluation Review, , vol. 28(3), pages 179-200, June.
    7. Elizabeth Frankenberg & Duncan Thomas, 2001. "Women’s health and pregnancy outcomes: Do services make a difference?," Demography, Springer;Population Association of America (PAA), vol. 38(2), pages 253-265, May.
    8. Obermann, Konrad & Jowett, Matthew R. & Alcantara, Maria Ofelia O. & Banzon, Eduardo P. & Bodart, Claude, 2006. "Social health insurance in a developing country: The case of the Philippines," Social Science & Medicine, Elsevier, vol. 62(12), pages 3177-3185, June.
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    Cited by:

    1. Abrigo, Michael R.M. & Paqueo, Vicente B., 2017. "Social Protection and Access to Health Care among Children in the Philippines," Discussion Papers DP 2017-36, Philippine Institute for Development Studies.

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