The Maternal and Child Health (MCH) Handbook was created in Japan about 76 years ago, when Japan was a poor country with high infant and maternal mortality, with the aim of promoting health and well-being for mothers, newborns, and children. Today, MCH Handbook programs have been introduced in more than 50 countries and regions in Asia, Africa, America, and Europe. The MCH Handbook is an indispensable tool in our efforts to crystallize the idea of leaving no one behind. Each country in Asia and Oceania has its own culture and customs of pregnancy, delivery, and child-rearing. Each culture should be respected as worthy, and good practices and lessons should be learned and shared. We hope that the MCH Handbook will promote health and well-being for mothers, newborns, children, and families, while celebrating many elements of their traditional culture.

Aim: This study co-developed a Maternal and Child Health (MCH) Handbook among Tagbanua mothers in Coron, Palawan, and assessed its effectiveness in improving maternal and child health outcomes within the indigenous community and ensuring Universal Health Care (UHC) coverage for marginalized populations.

Methods: An action research approach was used with Tagbanua mothers to tailor an MCH Handbook to their cultural context. Its effect on maternal and child health knowledge, attitudes, and practices pre- and post-introduction was analyzed, alongside the handbook’s effectiveness in improving UHC access among the rural and indigenous population of Tagbanua. Data were collected through field surveys, key informant interviews, focused group discussions, and observations during field activities.

Results: The Tagbanua-specific MCH Handbook significantly improved mothers’ knowledge and attitudes toward MCH, except for breastfeeding aspects, and led to enhanced maternal and child health practices, with some exceptions in antenatal and delivery care. This collaborative effort resulted in improved maternal and child health outcomes, showcasing the potential of community-specific MCH Handbooks in promoting UHC among marginalized populations.

Conclusion: The community-specific MCH Handbook was effective in improving MCH outcomes among the Tagbanua, supporting UHC. This underscores the importance of tailored interventions in public health and advocates for developing population-specific MCH Handbooks.

This retrospective cohort study aimed to determine a better management strategy for patients with preterm preeclampsia/superimposed preeclampsia (PE/SPE). Thirty-six women with PE/SPE and their neonates managed from January 2018 to March 2019 (Period 1: P1), and 53 women with PE/SPE and their neonates managed from October 2019 to March 2021 (Period 2: P2), were enrolled. Antihypertensive therapy was initiated when blood pressure increased to ≥160/110 mmHg and ≥140/90 mmHg in P1 and P2, respectively. During P1, pregnancies beyond 34 weeks of gestation with severe features were terminated without exception. During P2, pregnancies were maintained to 37 weeks of gestation. Maternal and neonatal outcomes were compared between the two groups, with the main outcome measures being the incidences of composite adverse maternal outcomes and composite adverse neonatal outcomes. Gestational weeks of delivery were significantly prolonged in P2 than in P1. The incidence of composite adverse maternal outcomes was comparable between the two groups. The incidence of composite adverse neonatal outcomes was significantly lower, and the duration of NICU stay significantly shorter, in P2 than in P1. In conclusion, aggressive antihypertensive therapy with cautious observation can prolong pregnancy and may benefit neonates born to mothers with PE/SPE.

Recommended treatment for patients at high risk for recurrent preeclampsia is low-dose aspirin before 16 weeks’ gestation. Cases in which preeclampsia is suspected in the absence of hypertension, proteinuria, or organ damage, and cases of suspected preeclampsia before 20 weeks’ gestation are reported as atypical preeclampsia. We treated a patient with a history of early-onset preeclampsia in two previous pregnancies. Despite treatment with low-dose aspirin and low-molecular-weight heparin initiated in the first trimester, intrauterine fetal death occurred at 24 weeks’ gestation. Hypertension or proteinuria was not present, but the soluble Fms-like tyrosine kinase-1/placental growth factor ratio was high; considering her medical history, a diagnosis of atypical preeclampsia was rendered. Diagnosis and treatment at an early stage in patients at high risk for atypical preeclampsia must be considered. Additionally, for aspirin non-responders such as our patient, the establishment of treatments other than low-dose aspirin for effective preeclampsia prophylaxis is required.