Maternal nutrition and health get a boost in hard-to-reach Sindangan, Zamboanga del Norte
Strengthening health services for every mother and newborn

Anccita Badia-on, 42, proudly shows off 3-month-old Robin as she joins UNICEF for a chat at the barangay (village) health station in Dapaon, Sindangan Municipality.
“He almost never cries,” she says. “He’s a well-behaved baby.” Little Robin was born in a breech position which resulted in prolonged labour of two days. Anccita notes that although she was initially told it was going to be a caesarean delivery, her doctor pushed for a normal one. It was a good thing that she gave birth at the regional hospital or things could have gone worse, her 46-year-old husband, Robinson, says.
The couple has four older children who were all born at home with the assistance of a traditional birth attendant. Ma. Theresa Conte, 32, a registered nurse serving in the health station, says this practice used to be widespread – pushing the municipality to pass an ordinance prohibiting home birth in 2014. Still, she says, Dapaon has been slow in fully adopting the ordinance. In the first quarter of 2022, the barangay hasn’t recorded any home births so far. There are 13 pregnant women currently under its care who are receiving close monitoring – all have signified their intention to give birth in a facility.

“I have to mobilize the barangay health workers to reach the mothers,” Theresa says shaking her head. “Many still do not come here for prenatal [check-up] during the first trimester, but I always advise those who do come about the importance of giving birth in the facility.”
But access to health care facilities is not easy. Dapaon is one of the 596 barangays classified as geographically isolated and disadvantaged areas in the province of Zamboanga del Norte – places that are difficult to reach with services and are separated from the rest due to several factors such as poor transportation networks and high poverty rates, to name a few.

Improving the skills of local health workers
Given the challenges in service delivery, Sindangan was selected to participate in the First 1,000 Days programme rolled out by UNICEF and local partners with the support of the Government of Korea through the Korean International Cooperation Agency. The programme aims to strengthen the delivery of nutrition and health services for the first 1,000 days of a child’s life (from conception to the child’s second birthday) in 19 local government units in the provinces of Zamboanga del Norte in Mindanao, and Samar and Northern Samar in Visayas.
A very important part of strengthening service delivery is skills training for the barangay health workers and nutrition scholars who support mothers and babies in assessing nutritional status, providing nutrition counselling, infant and young child feeding, micronutrient supplementation, and maternal, newborn and child health. Theresa adds that she is planning to set up a mothers’ class in the health station to make information dissemination to mothers more effective. Although this will not replace one-on-one counselling, a classroom setup will encourage mothers to share their experiences and learn from each other.

While Anccita tells us about her pregnancy journey, another mother sitting next to her listens intently. Sixteen-year-old Jecel Lismis, four months pregnant with her first child, is on her second prenatal consultation. Her mother, 37-year-old Angel, brings her daughter to the health station to have her monthly check-up and receive micronutrient supplements. She was told during counselling that Jecel’s pregnancy is automatically classified as high-risk because of her very young age.
“I was worried when I found out that she was pregnant,” Angel says when asked how she felt. “But it has already happened and all I can do is support her and her baby.” She adds that the counselling they receive from Theresa and her team helps a lot in their understanding of good nutrition for both Jecel and her baby.
At present, mothers and mothers-to-be in Dapaon can also seek comprehensive services from the Sindangan Rural Health Unit and the nearby birthing facilities in Siari and Upper Inuman. Because there are more options for mothers now, Theresa is optimistic that her barangay will see more improvement in maternal health and nutrition in the coming years.