Historically, the principal duty of women has been viewed as bearing children and serving as the foundations of families.

Health is a basic need of a human being and therefore, denying women their health needs has affected seriously their productive and reproductive roles. Women play an enormous part in maintaining the health care system through their caring work at home, in the family, in the neighborhood and in the nation. At present, more than ever, the health services depend on the caring work of women and their skills and capabilities.

 Antenatal care coverage is an indicator of access and use of health care during pregnancy. It constitutes screening for health and socioeconomic conditions likely to increase the possibility of specific adverse pregnancy outcomes, providing therapeutic interventions known to be effective; and educating pregnant women about planning for safe birth, emergencies during pregnancy and how to deal with them (WHO; Indicator definitions and metadata 2008).

Maternal, Newborn, and Child Health and Nutrition Situation in the Country The Department of Health (DOH) is committed to achieve the Millennium Development Goals (MDGs) of reducing child mortality and improving maternal health by 2015. Although significant gains in maternal and child mortality have been realized in the past four decades, pregnancy and childbirth still pose the greatest risk to Filipino women of reproductive age, with 1:120 lifetime risk of dying from maternal causes.1 Maternal deaths account for 14percent of deaths among women of reproductive age. The Maternal Mortality Ratio (MMR) in the country remains high and decreased very slowly at 162/100,000 live births (LB) in 2006 from 209/100,000 LB in 1990.2

Majority of maternal deaths directly result from pregnancy complications occurring during labor, delivery and the postpartum period. These complications include hypertension, post-partum hemorrhage, severe infections, and other medical problems arising from poor birth spacing, maternal malnutrition, unsafe abortions and presence of concurrent infections like TB, malaria and sexually transmitted infections as well as lifestyle diseases like diabetes and hypertension.

emphasis on the importance of access to emergency obstetrics and newborn care (EmONC) services is due to the shift from the risk approach to pregnancy management to that which considers all pregnancies to be at risk. Under the risk approach pregnant women are screened for risk factors and only those diagnosed with pregnancy complications are referred to facilities capable of providing EmONC services. The approach that considers all pregnancies to be at risk recommends that all pregnant women should deliver with assistance from skilled health professionals and have access to EmONC services since most maternal deaths occur during labor, delivery or the first 24 hours post-partum and most complications cannot be predicted or prevented. The best intra-partum care strategy is likely to be one in which women routinely choose to deliver in health centers with midwives as the main providers but with other attendants

MATERNAL MORTALITY: BY MAIN CAUSE Number, Rate/1000 Livebirths & Percent Distribution Philippines, 2009 CAUSE Number Rate Percent* TOTAL 1,599 0.9 100.0 1. Complications related to pregnancy occuring in the course of labor, 655 0.4 41.0 delivery and puerperium 2. Hypertension complicating pregnancy, 513 0.3 32.1 childbirth and puerperium 3. Postpartum 286 0.2 17.9 hemorrhage 4. Pregnancy with 142 0.1 8.9 abortive outcome 5. Hemorrhage in early 3 0.0 0.2 pregnancy *Percent share to total number of maternal deaths

Prenatal Care Ideally, prenatal care functions to identify and monitor women at risk of future complications, to detect and treat pre-existing and concurrent illnesses of pregnancy, to provide preventive care and information to women and their families, and to establish a relationship between providers and women early in pregnancy. Prenatal care services are part of primary health care services or pregnant women which include regular medical checkups, medical advice regarding health, hygiene, nutrition, etc. related to pregnancy and child bearing. Pregnant women who were registered for prenatal care and who visit on a regular basis usually receive iron and folic acid tablets and they are vaccinated against tetanus. Results of the logistic regression reinforce the importance of womens education as the most important determinant of prenatal care. With women having tertiary level of education is six times more likely to access prenatal care than women with primary education and twice more likely than women who reached secondary level of education. The logistic regression identified a number of variables, including urbanity, parity, age of the woman and work status, as significant and independent predictors for the use of prenatal care services in the Philippines. In terms of urbanity, women in urban areas are 0.88 times more likely to avail prenatal care services that their rural counterpart. Regarding parity, the study revealed that there is little difference in the likelihood of use of prenatal services among women. The odds of having prenatal care decreases as the number of children increases. On the other hand, women who are 15 to 19 years old are twice as likely to access maternal care as the 45-49 years old women FACTORS AFFECTING MATERNAL HEALTH UTILIZATION IN THE PHILIPPINES1 by Shanna Elaine B. Rogan2 and Ma. Virginia R. Olvea3