Jayawon, J. Y. (2015). Project 350.1 reducing the prevalence of home deliveries in Toboso, Negros Occidental: A quasi experimental study (Unpublished master's thesis). Graduate School of Public and Development Management, Development Academy of the Philippines.

Graduate School of Public and Development Management Health Systems and Development Batch 5 Thesis (MPM-HSD)--Development Academy of the Philippines.

The Maternal Mortality rate in the Philippines is higher than most other Southeast Asian counties, and home deliveries attended by traditional birth attendants is a major contributing factor. This is a problem common to many localities throughout the Philippines especially those in the rural areas. The town of Toboso, Negros Occidental is a 3rd class municipality with a persistently high prevalence of home deliveries. Recognizing the interest risk associated with home delivery, this paper sought to determine the gaps on the maternal health care program of the municipality in terms of facility based delivery, evaluate the impact of Project 350.1, a combined regulation and persuasion intervention, on the problem; and to describe measures that can be done to ensure the sustainability of the project. Using quasi experimental single group design and deductive approach to research, this study evaluated through prepost analysis the impact of Project 350.1 in reducing the prevalence of home delivery Tobos. Qualitative descriptive method was used in determining the gaps the in municipalitys Maternal Health Care Program using non structured key informant interview with the midwives, and separate non structured focused group discussions with the traditional birth attendants and parturient women. The study was conducted in the entire municipality of Toboso and included all parturient women for the month of July and August 2015 identified through purposive sampling. In terms of facility based delivery, service utilization and service delivery gaps in the maternal health care program of Toboso were identified in the study Financial and geographical barriers coupled with the availability of TBAs were most significant contributors to the service utilization gap. Also identified were sociocultural barriers, including womens preference for the convenience of home birth, privacy issues, availability of TBAs, and lack of family and spouse support; quality care barriers were also identified, including womens previous unpleasant experiences in other facilities, lack of privacy, fear of reprimand, and poor referrals by TBAs barangay health workers (BHW). Gaps service delivery were contributed by inadequate local health financing leading to inadequate and poorly distributed birthing infrastructure, inadequately staffed and overloaded health workforce, and insufficient maternal medicines and supplies. Community based Womens Health Team was lacking in all barangays. Referral was poor and no referral incentive scheme exist. There was no local policy that prohibits home deliveries and TBAs. And the overloaded health workforce has low incentives despite their circumstance. Implementation of Project 350.1 resulted to an immediate significant 65% reduction in the prevalence of home delivery. To ensure the sustainability of the project and its effect, its core component strategies and activities are incorporated institutionalized into municipal Safe Motherhood ordinance. The project was also incorporated onto the Gender and Development Plan of the municipality. The results of the study revealed that the prevalence of home delivery is multifactorial and a result of several gaps in the maternal health program. One conclusion was that an intervention that targets more than one gap, like Project 350.1, is more likely to produce a favorable outcome. It was also found that to sustain the intervention and its effects, it must be institutionalized into local policies and reforms.