Agustero, J. G. (2016). Integration of cultural birthing practices among kalibugans as basis for strengthening facilitybased delivery in Sirawai, Zamboanga del Norte (Unpublished master's thesis).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 6 Thesis (MPM-HSD)--Development Academy of the Philippines.

Global initiatives to improve maternal health status remain a challrnge as women around the world are still dying from pregnancy-related causes. These strategies on improving maternal health status are mainly focused on increasing antenatal care coverage, facility-based delivery, and family planning advocacy. This study aimed to establish the integration of cultural birthing practices among Kalibugans as basis for strengthening facility-based delivery in Sirawai, Zamboanga del Norte. Specifically, it determined the perception of indigenous Kalibugans on the problem on maternal health care services provision by the rural health unit, identified the common cultural practices surrounding pregnancy and childbirth, which hindered facility-based deliveries; and developed a culture-sensitive action plan project to strengthen facility-based delivery among Kalibugan pregnant women. The study employed a descriptive design utilizing document analysis, focus group discussion among Kalibugan community and key informant interviews on traditional birth attendants to build the right perspective and rationale in designing the action plan project to strengthen facility-based delivery among Kalibugan mothers. The findings showed that the community perceived poor access to health facility and mother's preference to home delivery over facility-based delivery as the main causes of low facility-based delivery among Kalibugan mothers. Furthermore, there were 14 identified common cultural birth practices surrounding birth; five are done pre-birth, four during birth and five are done post-birth. During the implementation of the action plan and project, eight of these practices were fully integrated into the maternal health care services, four were modified and two were banned. There was a 78% increase in facility-based delivery after 5 months of project implementation. In conclusion, by integrating cultural birthing practices into the maternal health services of Sirawai Rural Health Unit, empowered Kalibugans are able to strengthen the facility-based delivery utilization of their community.