Pneumonia and other Acute Respiratory Infections

Pneumonia remains in the list of the leading causes of morbidity and mortality in the
Philippines. It ranked third among the causes of morbidity and fourth among the causes
of death in 2000.

There was an increase in the morbidity trend

Figure 4.4 Trends in Pneumonia Morbidity and Mortality
Philippines, 1980-2000 for pneumonia from 1990 to 1996. This may
1200
be due to improved case finding and reporting
Rate per 100,000 population

1000
with the intensification of the program to
800
control acute respiratory infections during
600
this period. The morbidity trend decreased
400 Morbidity
slightly from 1997 to 2000 but the number of
Mortality
200
cases remained high at 829 cases per 100,000
0
population in 2000. On the other hand, there is
1989

1999
1983

1993
1984

1994
1988

1998
1980

1990

2000
1982

1985

1992
1986

1995
1996
1981

1991
1987

1997

a decreasing trend of mortality from

Year
Source: Philippine Health Statistics, 2000 pneumonia in the general population from
1990 to 2000 despite the high number of cases
Figure 4.5 Pneumonia Mortality Rate by Region per year. The mortality rate from pneumonia
Philippines, 2000
decreased from 64.7 deaths per 100,000
NCR
CAR population in 1990 to 42.7 deaths per 100,000
Ilocos
Cagayan Valley
in 2000 (PHS). This reflects improvement in
Central Luzon the diagnosis and treatment of cases.
Southern Tagalog
Bicol The region with the highest reported
Region

Western Visayas
Central Visayas mortality rate from pneumonia is Western
Eastern Visayas
Western Mindanao
Visayas (74.6 deaths per 100,000 population)
Northern Mindanao followed closely by Ilocos (73.7 per 100,000)
Southern Mindanao
Central Mindanao
and Cagayan Valley (59.2 per 100,000) with
Caraga ARMM having the lowest reported death
ARMM
PHILIPPINES from pneumonia at 2.5 deaths per 100,000
0 10 20 30 40 50 60 70 80 followed by Central Mindanao (15.6 per
Rate per 100,000 population 100,000) and Western Mindanao (21.3 per
Source: Philippine Health Statistics, 2000 100,000) (PHS 2000).

Death rate from pneumonia among children under-five years of age followed a
downward trend since the 1980s. The death rate from pneumonia decreased by around
83.6 percent during a twenty-year period, from 401.93 per 100,000 under five years old

138 Chapter 4 Reducing the Burden of Disease

children in 1980 to 66.11 per 100,000 in 2000 Figure 4.6 Pneumonia Mortality Rate Among the
Under-Five-Years-Old Children

Rate per 100,000 under 5 years old children

(PHS). On the other hand, morbidity rate Philippines, 1980-2000
450
among under-five years old children went up 400
from 4,899.23 per 100,000 in 1999 to 350
300
5,076.17 per 100,000 in 2002 (FHSIS). 250
200
The 2003 NDHS revealed that only 46 150

percent of children below five years of age 100

50
who had the symptoms of acute respiratory 0

1989

1999
1983

1993
1984

1994
1988

1998
1980

1990

2000
1982

1985

1992
1986

1995
1996
1981

1991
1987

1997
infection were taken to a health facility or
health care provider for treatment. This is a 12 Year
Source: Philippine Health Statistics, 1980-2000
percentage point reduction from the 58
percent reported in the 1998 NDHS. This may imply that the reduction in deaths from
pneumonia among young children may have been due to improved knowledge and skills
in managing the fewer pneumonia cases that have been brought to the health facility.

Management of pneumonia and other childhood infections has improved in 16 of the 17

regions that applied the Integrated Management of Childhood Illness (IMCI). IMCI is a
strategy used in providing holistic health care services among the under five-year-old
children ranging from detailed history taking, physical examination, diagnosis and
treatment of diseases and conditions. The promotion of IMCI through regular in-service
and pre-service training of frontline health personnel is supported by international and
local funding agencies. The IMCI strategy requires that appropriate drugs for
pneumonia are available at the health service outlets at any given time. DOH and
PhilHealth-accredited clinics, health centers and hospitals generally provide patients
with the necessary drugs at low cost. However, not all health facilities are able to carry
out IMCI appropriately and consistently due to shortage of drugs. This is due to the
limited local sources of drugs or to failures in the drug distribution system at the regional
and local levels.

Although the drugs necessary to treat pneumonia are available over the counter, general
consultations and treatment services for older children, adults and older persons with
pneumonia needs improvement to multiply the gains that have been achieved in
pneumonia control among the younger age groups.

National Objectives for Health Philippines 2005-2010 139

 Goal: Mortality from pneumonia and other acute respiratory infections is reduced.

National Objectives for 2005 - 2010

Objective Indicator Target Baseline Data and Source

Mortality from pneumonia Mortality rate from pneumonia 33 per 100,000 under five-year- 66.11 per 100,000 under five-
among children under 5 years among under five-year-old old children year-old children
old is reduced. children
Philippine Health Statistics,

Percentage of under five-year- 90 percent 46.3 percent

old children with symptoms of
National Demographic and
ARI who sought treatment from
Health Survey, 2003
a health facility or health
provider

Mortality from pneumonia
among older persons is
reduced.
Mortality rate from pneumonia
among 60-year-old persons and
older
400 per 100,000 older persons 453 per 100,000 older persons
Philippine Health Statistics,
2000

Mortality from pneumonia
among the general population is
reduced.
Mortality rate from pneumonia 21 per 100,000 population 42.7 per 100,000 population
among all age groups
Philippine Health Statistics,
2000

Strategic Thrusts for 2005-2010

Improve the quality and reliability of implementation of the Integrated Management of Childhood Illness (IMCI) in all health
care units through training, supervision and monitoring.

Continue medical, nursing and midwifery education on pneumonia diagnosis and management.

Promote timely and appropriate management for pneumonia and acute respiratory illness among the general population to avoid
further complications of the disease.

Ensure availability of affordable drugs for pneumonia patients, especially for young children and older persons, at the local level.

140 Chapter 4 Reducing the Burden of Disease