`Indigenous women’s health Creating a healthy community

ARCELIE Cawag, from the Arumanen tribe, is one of the 12 members of the community health team providing maternal health care services in 374 households in sitio Gawasan, Brgy. Bentangan, Carmen town, North Cotabato.

Before 2012, Arcelie said mothers give birth at home, some of them dying due to complications from childbirth.

For indigenous peoples like the Arumanen, access to health services remains to be a problem. Arcelie, the only woman in the sitio who has finished a college degree, said it takes time and a lot of patience to explain and make mothers understand the value of family management. IP women are not very comfortable talking about their bodies, much less discussing reproductive health, so programs relating to health has to be culturally sensitive and adaptable.

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The Indigenous Women’s Summit held last November 4 to 6, at the Ritz Hotel in the city, was able to gather a hundred women to share their experiences and triumphs in maternal and child health.

The Indigenous Peoples Maternal, Neonatal and Child Health and Nutrition (IP MNCHN) Project – Mindanao, implented by the Department of Health, National Commission on Indigenous Peoples, UNFPA and funded by the European Union, seeks to “contribute sustainable improvement in maternal and child health towards meeting the Millennium Development Goals 4 and 5 (Reduce Child Mortality, Improve Maternal Health) in targeted IP and other disadvantaged communities in Mindanao.”

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In sitio Gawasan, Arcelie said this started in 2012 and three years into the project, she is seeing changes in the health seeking habits of Arumanen mothers. Immunization of young children is acceptable now and mothers are seeking ante-natal care. An IP nurse, Jowena Bangkas, is also assigned at the health center in Brgy. Bentangan, 6 kilomenters away from sitio Gawasan. She comes every second Wednesday of the month. Otherwise, the health center has barangay health workers to provide basic health services.

“Before, mothers fear bringing their children to the health center for immunization because they get sick after the treatment but we are educating them on this and why children below 5 years have to be immunized from childhood diseases,” Arcelie said.

Family planning methods may be a subject that the Arumanen women are quite heistant to explore but Aracelie said more young mothers are now thinking of having two children as opposed to the previous practice of having 12 to 13 children per family with little or no spacing in between births.

The practice of going to the hilot or traditional birthing attendants still remains not only because health centers and birthing facilities are far and transportation is difficult, money is also a problem.

The IP MNCHN project brief on the State of Maternal and Child Health Care has this to say: “Delivery at home by a hilot costs the IPs P500 for the first delivery and P200 for the second delivery. The cost decreases fore the succeeding deliveries. In contrast, deliveru at the health center costs P1,500 and delivery by a doctor costs P3000. In additon to these low costs (of delivery by hilot), the preferences to home delivery is reinforced by the need to perform rituals attendant to childbirths.”

One of the Millennium Development Goals is to reduce maternal deaths by 75 percent in the country by 2015, but this may not be achieved. The 2013 National Demographic Health Survey results showed that there still has to be continuous and intensive improvement in the maternal health care services to reduce the high rates of death and disability caused by complications of pregnancy and delivery.

Improvement of maternal health care services will happen if other factors in the community are also addressed. Strengthening education, good governance, presence of health centers with equipment and medicines, better road infrastuctures need to be considered.

IP MNCHN Project is serving the Matigsalug-Manobo community, Dibabawon and Mangguangan of Montevista, Compostela Valley; Subanen in Dumingag, Zamboanga del Sur and the Arumanen-Manobo in Carmen, North Cotabato.

Providing additional support to the community are the Pamulaan Center and the Institute of Primary Health Care of the Davao Medical School Foundation.