CEDAW/C/PHI/4 English Page 56 IX. ARTICLE 12 Equality in the field of health care; access to health care services, including family planning; appropriate and free services pertaining to pregnancy, confinement and the post-natal period; adequate nutrition during pregnancy and lactation Background 226. Studies done by the Department of Health have revealed that the health situation in the Philippines is improving. Maternal mortality decreased from 10 per 10,000 live births in 1985 to 8 per 10,000 in 1990. Postpartum haemorrhage, hypertension-complicating pregnancy, childbirth and puerperium and pregnancies with abortive outcome have been the leading causes of deaths among pregnant women. The infant mortality rate likewise declined, from 59 to 57 per 10,000 live births from 1985 to 1990. Female infants (27 per 10,000) tend to survive better than male infants (30 per 10,000). Death among women in the reproductive age has been principally attributed to heart disease, tuberculosis, cancer and pregnancy-related diseases. 227. With regard to immunization, the Department reports that the percentage of immunized female children was almost equal to that of male children in 1993. As regards mothers, the majority received at least one tetanus toxoid injection during pregnancy. It is interesting to note that most of the beneficiaries who were injected had reached at least high school, which clearly indicates that women who have a higher level of education were more aware of the importance of the preventive aspects of medicine. 228. As regards maternity services, nearly 60 per cent of births in 1993 were medically attended. The rest were attended by traditional midwives or "hilots". 229. While the overall health status is improving, a continuing problem is rural women's poor access to health care and services. Thus, their health, reproductive and nutritional needs are still not adequately responded to. This problem was further aggravated by the implementation of the Local Government Code of 1992 by which health services were devolved to the local government units which were apparently not ready to assume the function. According to the Department of Health, the delivery of basic health services to the people, especially those in the rural areas, suffered owing to the following: (a) inadequate funds of the local government units for basic health services; and (b) incapability of the local health personnel to take full responsibility for the health needs of their constituents. 230. As of 1993, the number of females infected with HIV was fast increasing. Of the 206 reported cases, 146 were in the productive age (15-29). As regards the mode of transmission, sexual and heterosexual/homosexual are the most common. Department data further revealed that for the past nine years five offspring caught the virus from their mothers. /...