Bobis, R. C. (2017). "Balay ni nanay": A culture sensitive birthing facility protocol for the Bag-o tribe of Gregorio Del Pilar, Ilocos Sur (Unpublished master's thesis).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 7 Thesis (MPM-HSD)--Development Academy of the Philippines.

Antenatal care and postnatal care are recognized as key maternal health services that can significantly reduce maternal mortality. Understanding the factors that can affect the service utilization and designing strategies in improving utilization of maternal health services greatly helps in reducing the occurrence of maternal mortality. In the Philippines, there is a disproportion of maternal healthcare service utilization between urban and rural areas with indigenous groups. Bag-o tribe, an indigenous group in Gregorio del Pilar, Ilocos Dur has a very low antenatal care and postnatal care utilization. The objective of this study was to identify the factors that affect the utilization of maternal health services in Bag-o Tribe and devise strategies in developing a culture sensitive birthing facility and protocol. A descriptive study design was conducted in Gregorio del Pilar, Ilocos Sur. Data from an expensive document review was used to describe the status of utilization of maternal healthcare service. A total of 220 randomly selected women from the Bag-o tribe were interviewed using a semi-structured questionnaire. Key informant interview and focused group discussion were also done. The antenatal care (42%) and postnatal care (28%) utilization in Bag-o community were very low. Demographic analysis showed that 42% of them have low educational background and 74% belong to the low financial status bracket. The study also revealed that awareness of mothers to maternal healthcare services, access to transportation and traditional beliefs were important issues in the utilization of antenatal care and postnatal care services by the Bag-o tribe. Maternal health service utilization in Bag-o Tribe is very low. Socio-demographic and accessibility related factors were considered determinants of service utilization. Majority of the Bag-o women were from a lower financial rank, have poor knowledge of maternal health service, have no access to transportation and have faith in some traditional beliefs that hinders them in utilizing maternal healthcare services. Thus, changes in maternal health programs need to address such socio-cultural barriers for effective health care utilization.