An Attempt to Reduce Infant and Child Mortality in Bohol, Philippines

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Abstract
Development agencies are increasingly interested in how primary health care can best be provided to rural populations in developing countries. This paper describes a maternal and child health/family planning project that attempted to improve health and reduce mortality and fertility in a large rural population in Bohol, Philippines. Although health services clearly improved and fertility declined, infant mortality remained around 70/thousand. It became evident that easier to control diseases like neonatal tetanus were no longer of major demographic significance. Respiratory infections, possibly interacting with inadequate nutrition were important causes of infant and child death. Also, living conditions in Bohol had stagnated, and a more conprehensive primary health care approach, which would also tackle environmental conditions, was prohibitively expensive. As more countries attain moderate levels of infant mortality and have difficulty improving living conditions, they may encounter similar difficulties.