Pregnant women wait at the CSV Maternity and Lying-in Clinic in Quezon City, Oct 2, 2018. Jonathan Cellona, ABS-CBN News/File
MANILA — As extreme heat, flooding and changing weather patterns become more common, health experts are stressing the need to strengthen prenatal care, particularly for pregnant women who may face greater risks from infectious diseases and other climate-related health threats.
At a recent roundtable discussion on antenatal care, infectious disease specialists and maternal health stakeholders called for improvements in prenatal services to ensure pregnant women receive the medical care, screening and vaccines they need throughout pregnancy.
Doctors say vaccination is particularly important as climate change complicates the risk and transmission of some infectious diseases.
“It’s very important to prevent infections. We would like to cover them for the most common infections. For example, tag-ulan ngayon, our dream is to cover pregnant women with flu vaccines to avoid them getting sick,” said Dr. Analyn Fallarme, vice president of the Philippine Infectious Diseases Society for Obstetrics and Gynecology (PIDSOG).
Vaccination is already included in PhilHealth's Maternity Care Package under Circular 2026-0004. However, Fallarme said maternal immunization should not be limited to tetanus vaccination.
Depending on a woman's health condition, vaccination history and stage of pregnancy, doctors may recommend protection against other infections.
Fallarme said the tetanus, diphtheria and pertussis (Tdap) vaccine could be administered at around 27 weeks of pregnancy, while influenza vaccination could be given at any time during pregnancy.
She also cited other vaccines that may be considered for pregnant women in specific circumstances.
“Ang Respiratory Syncytial Virus (RSV), ang recommendation ay 28-36 weeks. We can also give Hepa B vaccines, but these are for sexually active women or for high risk behavior. Pneumococcal vaccines especially for those with asthma and cardiac problems. Rabies vaccines can be given during pregnancy and meningococcal vaccines,” she said.
Health experts emphasize, however, that vaccination during pregnancy should be based on medical recommendations and an individual woman's health risks.
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GAPS IN PRENATAL CARE
At a workshop earlier in September, Fallarme and other stakeholders revisited PhilHealth's maternity care policies, calling for improvements in patient access to prenatal services, financing and service delivery, as well as wider access to maternal vaccination.
The proposed changes are part of broader efforts to reduce maternal deaths in the Philippines and bring the country closer to the United Nations Sustainable Development Goal of reducing the global maternal mortality ratio to fewer than 70 deaths per 100,000 live births by 2030.
The Philippines recorded an estimated 119 maternal deaths per 100,000 live births in 2024, still above the SDG target.
Experts say improving access to prenatal care is critical because regular checkups allow health workers to monitor the mother's health, identify complications early and provide preventive interventions, including appropriate vaccination.
But access remains a challenge for some women.
Fallarme cited poverty, lack of awareness and health education, distance from health facilities and cultural preferences as some of the reasons pregnant women may delay or avoid seeking prenatal care.
“Kahirapan, kulang sa awareness at edukasyon, malayo ang bahay sa site of service. Yung cultural preference either gusto lang talaga nila sa lying-in or local health units, o kaya hilot lang ang gusto even if may referral to other institutions,” she said.
Speaking to ABS-CBN News, a PhilHealth official said the agency acknowledges the recommendations raised by PIDSOG.
However, the official noted that some proposed interventions might first require evaluation by the Health Technology Assessment Council (HTAC) before they could be incorporated into PhilHealth's benefit packages.
Under existing PhilHealth policies, pregnant women may avail themselves of various diagnostic services through accredited health facilities. They may also receive antenatal and postpartum care through qualified YAKAP providers, which can provide up to eight antenatal visits and three postpartum care visits.
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Health experts say the challenge is ensuring that these benefits translate into actual access, particularly for women who face barriers in terms of finance, location or information.
PIDSOG is set to submit a policy brief to relevant government agencies recommending updates to clinical guidelines on maternal immunization.
The group also wants to establish a clearer pathway for pregnant women to receive vaccines that are recommended during pregnancy.
Fallarme said the goal is for vaccines that receive the necessary approval and recommendations from medical societies and HTAC to eventually be reflected in national health guidelines and PhilHealth benefit packages.
“Kapag approved na ang isang vaccine, recommended by the medical societies, HTAC of DOST, we hope ito ay matranslate into the omnibus health guideline at maipasok sa PhilHealth benefit package. Kasi ang dulo nito, ang pasyente ang makikinabang,” Fallarme said.
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