June 25th, 2010

The People’s Lifeline: Midwives in the Philippines

From Katsura Tsuno, Director Corporate Contributions, Asia-Pacific, Johnson & Johnson

I still remember the sights and sounds that filled the maternity hospital in Manila when I visited in 2005. It was my first trip to the Philippines after taking a position in Corporate Contributions at Johnson & Johnson. Although the public hospital had been described as the largest for mothers and babies, to me, it looked more like an old train station. There was an emergency room inside with simple bedding, and a separate family waiting room with a ceiling, yet no walls – providing no refuge from the hot and humid weather. As I approached the delivery room, I noticed two pregnant women sprawled out on one bed. Newborn babies were the same – two babies shared each basket.  

When I finally reached the hospital room, I saw an overwhelming number of mothers and babies. Three to four pairs of mothers and babies lay horizontally on two beds connected to each other, also known as a tandem bed. As I surveyed the room, I could see that there were obviously not enough doctors and nurses. “The average income of a doctor working in the public sector is not better than the salary of a call center operator,” one doctor revealed. The crowded and under-funded hospital was daunting to me, yet the women with access to it were considered fortunate. I felt dizzy over the reality of it all.

The Philippines, with a population of almost 100 million, is growing nearly 2 percent annually with a fertility rate of more than three babies per woman. A third of the population is living below the poverty line. The country depends on almost 10 percent of its Gross Domestic Product from people working overseas. One of the country’s major exports is health care workers, mostly nurses. The majority of new nursing graduates in the Philippines decide to work abroad for better income. Even doctors – 80 percent in the public sector, opt to work overseas by converting their profession to nurses. This results in a significant shortage of health care workers in the country.

With such high birth rates, midwives are very important in the Philippines. Although midwives traditionally specialize in health for mothers and babies, in the Philippines their roles are much broader. The shortage of doctors and nurses makes it critical for midwives to expand their roles in community health, especially in rural areas of the country. For many people, midwives are the only health care workers they can access; therefore, midwives must play multiple roles. The working conditions for midwives are tough and their wages are not sufficient for the many hats they wear.

Despite their situations, many midwives are motivated to stay in their job in the country and play leadership roles in community health. Their dedication is critical for people’s health because midwives are often the lifelines for people in the Philippines, which is why we believe it’s extremely important to train and strengthen the skills of health care workers who decide to stay. One program in the Philippines – The Midwives Leadership Development Program – is doing just that. You can learn more about this program here.


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