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POGS 2019 report on obstetrical and gynecological indicators of healthcare

Annette M. Macayaon, MD, FPOGS1, Maria Antonia E. Habana, MD, FPOGS2, Helen R. Amorin, MD, FPOGS3,
1 Chair, POGS Committee on Nationwide Statistics; 2 Philippine General Hospital, University of the Philippines-Manila; 3 Vicente Sotto Memorial Medical Center; 4 Our Lady of the Pillar Medical Center; 5 Emilio Aguinaldo College Medical Center-Cavite; 6 Un

Background: To address the need to improve the collation of vital statistical data from POGS-accredited institutions, the POGS Committee on Nationwide Statistics developed a new electronic census platform (now called the POGS Nationwide Statistics System or PNSS), that replaced the Integrated Statistical Information System (ISIS) which was started in 2008.

Objectives: The aims of this paper are the following: (1) to present initial data gathered through the PNSS and compare it to the Department of Health (DOH) census; (2) to discuss obstetrical and gynecological indicators of healthcare and (3) to assess the limitations of the PNSS and recommend improvements.

Methodology: This is a cross-sectional study that shall report obstetrical and gynecologic data generated from submissions of POGS-accredited hospitals from January to December 2019, through the PNSS. Charts and tables illustrating frequencies of the different health indices are presented. Health indices include crude livebirth rate, age-specific birth rate, adolescent birth rate, cesarean section rate, stillbirth rate, neonatal mortality rate, perinatal mortality rate, maternal mortality ratio, frequency of gynecologic admissions and procedures, and death secondary to gynecologic diseases.

Results: The number of accredited hospitals that submitted their census with 100% compliance was 135, thus 91.8% of accredited hospitals had full compliance. A total of 365,947 cases were reported, 89% (326,026) of cases were obstetric cases and the remaining 11% (39,921) were gynecologic cases. For obstetrical health indicators: the livebirth rate is highest in the NCR 36%, with the highest age-specific birth rates in the 20-29 age groups; adolescent birth rate is 7.3%, overall CS rate is 32.8%, stillbirth rate is 14.3 per 1000 neonates, neonatal mortality rate is 3.65 per 1000 livebirths, perinatal mortality rate is 18.35 per 1000 total births and maternal mortality ratio is 81.72 per 100,000 livebirths. The most frequent indications for gynecologic admissions are leiomyoma uteri, Abnormal Uterine Bleeding-Polyp (AUB-P) and Abnormal Uterine Bleeding-Myoma (AUB-M), while endometrial biopsy/diagnostic curettage is the most frequent gynecologic procedure performed; There were 150 deaths (0.38%) reported among gynecologic cases and majority (96%) had gynecologic malignancies, with ovarian cancer being the highest (41%).

Conclusion: Nationwide statistics serve as strong evidence on which policies are created. It provides vital information that serves as a basis for decision-making, planning and implementation of health programs and basic services and can also be used for monitoring and evaluation. It is recommended that preparations be undertaken for an improved 2021 version with enhancing the mechanism of encoding and transmitting data, improving data quality and developing more health indicators. Regular coordination with the accredited hospitals is encouraged for a more accurate data outcome and compliance performance. Collaboration in identifying areas for research should be fostered.

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