For Mangyans, an indigenous group living in remote and mountainous areas in Oriental Mindoro, maternal and child mortality was a pressing problem until an innovative ADB project changed their lives. Mangyan tradition calls for women to give birth at home, assisted by their husbands and untrained birth attendants - a practice that usually leads to pregnancy-related problems and complications.
To make maternal and newborn health care accessible to Mangyans while acknowledging their culture and traditions, ADB supported the development of a culturally sensitive maternal and newborn care program. This includes the establishment of traditional birthing facilities called Balay Mangyan (home of Mangyans) in the community.
The Family Medicine Research Group (FMRG), a nongovernment organization, developed the program based on an ethnographic study of the Mangyans. The study made Mangyan practices and beliefs more easily understood and helped craft Mangyan-friendly health facilities and personnel.
Pregnant Mangyan women and their family members are admitted to Balay Mangyan on the week they are due to deliver, and can stay there until they give birth and recover. This ensures that they have access to the services of skilled health staff who are respectful of their culture and tradition.
The childbirths are documented in the Department of Health's official registry, allowing the Mangyan mothers to avail of the government's social services including the Pantawid Pamilya Program or conditional cash transfer program, which was also supported by ADB.
ADB's approach to maternal and child care is responsive to the Mangyan culture. "In the past, Mangyan women were made to adapt to the health system rather than the health services being responsive to the needs of the population. With the project, health services become accessible to the Mangyans by taking into account their culture and traditions," says Emiko Masaki, Social Sector Economist of Southeast Asia Department.
The project also supports the hiring of Mangyan nurses by rural health units and local government units as part of their regular health force. Health workers were trained to use the Listen-Explain-Acknowledge-Recommend-Negotiate (LEARN) method to convince pregnant Mangyans to avail of health services in the facility. In addition, calendars and health materials are distributed to help expectant mothers remember their birth month.
A good indication of the impact of the program is the strong acceptance of the Balay Mangyan concept among community members. Recent surveys reveal that 95% of Mangyan women believe that giving birth in the health center is good for both mother and child. To ensure that the benefits of the program are felt by other women, the provincial health office allocated funding for the construction of additional 11 Balay Mangyan in Oriental Mindoro. They will also maintain the operating costs of the existing Balay Mangyan and the training of health workers.