CEDAW/C/PHI/5-6 443. In the late 1990s, 92 percent of mothers received pre-natal care from doctors, nurses or midwives or hilot (traditional birth attendant; NSO 1998). Hilot attended 41 percent of women at childbirth, while doctors, 31 percent, and nurses and midwives, 26 percent. About two-thirds of child deliveries took place at home. Medical assistance at delivery was more common among women with lower order births, who live in urban areas, who have higher education, and who have made four or more prenatal visits. In Metro Manila, professional health workers attended 92 percent of deliveries while in Autonomous Region for Muslim Mindanao the proportion was only 16 percent (DOH 1999). 444. The infant mortality rate per 1000 live births in the Philippines is very high: 45.3 in 1985, 36.8 in 1990 and 35.3 in 1995 (NSO 1998). It reportedly fell to 29 per 1000 live births since 2001 up to 2003 (NSO), still higher than in neighboring countries, particularly Singapore (7) and Malaysia (8). Incidence of infant deaths varies with socio-economic and demographic factors. Between 1985 and 1995, it was 30.9 in urban areas and 40.9 in rural areas. It was notably high among infants of mothers with no education, no antenatal and delivery care, and younger than 20 and older than 40 years. Infant mortality rate was also high among male infants (39.4 per 1000 male live births versus 32.3 among female infants; NSCB 2003). Respiratory conditions of the fetus and newborn and pneumonia were the two most common causes of infant deaths. 445. While remaining relatively high, maternal mortality has also been decreasing, from 209 deaths per 100,000 live births in 1990-1992 to 172 in 1995-1997 (NSO 1998), to 96.1 deaths per 100,000 live births in 2000 (NSO 2000). Maternal deaths made up less than one percent of the total deaths in the country, but they contribute 14 percent of all deaths in women aged 15-49 (NSO 1998). Maternal deaths were primarily due to complications related to pregnancy occurring in the course of labor, delivery and puerperium (40 percent), hypertension and complications (23 percent), postpartum hemorrhage (19 percent), pregnancy with abortive outcome (13 percent) and hemorrhages related to pregnancy (8 percent; NSO 1997). Failure to obtain pre-natal care and limited access to professional health care during pregnancy and childbirth also contributed to maternal deaths. For most births (77 percent), mothers made three or more prenatal visits, and for almost half of the births, the first pre-natal visit was made in the first 3 months of gestation. A high proportion (86 percent) had gone to professional health workers for pre-natal check-ups, but only 56 percent were assisted by these health workers during childbirth. 446. Promoting contraceptive practice among women remains a challenge. Location, religious beliefs, educational level and age tend to influence contraceptive use. In general, higher prevalence rates were noted among urban women, those with more than an elementary education, and among women 25 to 39 years old. In 1996, fewer than half (48.1 percent) of currently married women used at least one contraceptive method. Slightly more women used contraceptives in 2001 (49.8 percent) and 2002 (48.8 percent; NSO 2003e). Despite prohibition of the Catholic Church, the prevalence rate for any modern contraceptive method rose from 30.2 percent in 1996 to 35.1 percent in 2002. The significant increase in the use of pills outweighed the loss in popularity of traditional methods, which fell from 18 percent to 14 percent. In 2002, the most popular contraceptives were the pill (15 percent), calendar or rhythm and female sterilization (11 percent each; NSO 2003f). Condoms were used by less than 1 percent of couples (NSO 2003e). Surveys showed that men object to their spouses’ practice of family planning, and very few of them use condoms, or take the responsibility of contraception. 119