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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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    2. Raoul Bermejo III & Sonja Firth & Andrew Hodge & Eliana Jimenez-Soto & Willibald Zeck, 2015. "Overcoming Stagnation in the Levels and Distribution of Child Mortality: The Case of the Philippines," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-13, October.
    3. Paqueo, Vicente B. & Abrigo, Michael Ralph M., 2017. "Social Protection and Access to Health Care among Children in the Philippines," Discussion Papers DP 2017-36, Philippine Institute for Development Studies.
    4. Tadashi Yamashita & Sherri Ann Suplido & Cecilia Ladines-Llave & Yuko Tanaka & Naomi Senba & Hiroya Matsuo, 2014. "A Cross-Sectional Analytic Study of Postpartum Health Care Service Utilization in the Philippines," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-6, January.

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