The determinants of use of maternal and child health services in Metro Cebu, the Philippines
Becker, S.; Peters, D.H.; Gray, R.H.; Gultiano, C.; Black, R.E.
Health Transition Review the Cultural Social and Behavioural Determinants of Health 3(1): 77-89
1993
ISSN/ISBN: 1036-4005 PMID: 10148799 DOI: 10.2307/40652001Document Number: 325981
Between July 1988 and January 1989, local interviewers surveyed 8330 currently married nonpregnant mothers of 9586 children less than 30 months old (age range, 15-52 years) to gather baseline data with which to evaluate the effect of health services on child health in Metro Cebu on one of the central Visayan islands of the Philippines. This analysis of the data describes the patterns and determinants of use of maternal and child health services by mothers and children. The mother's education was the most significant and uniform predictor of use of maternal and child health services (except for use of prenatal care among urban women). The estimated odds of full immunization rose by 15% and 10% for every year of education in urban and rural women, respectively. The researchers could not define the mechanisms for the maternal education effect, however, Socioeconomic factors were significant predictors of contraceptive use, adequate immunizations, and knowledge and use of oral rehydration salts (ORS). Such factors had no effect on prenatal care use in rural areas, however, and only a minimal effect in urban areas. Any paid work at all by mothers increased the likelihood of contraceptive use. Some categories of employed mothers and fathers reduced the odds of immunization, possible because immunization clinics were closed after working hours. Owning a radio and/or television had a greater effect on use of contraception, immunization, and prenatal care in urban areas than it did in rural areas. Since other economic indicators had a less significant effect on use, possession of a radio and/or television may actually represent access to information rather than wealth. Distance to a health facility was significant for all uses in rural areas, except prenatal care. It was not important in urban areas. These results showed a need for short term health programs to attract less educated women.