The provinces under study are grouped into the 13 regional administrative regions discussed earlier as shown in Table 2-8 (see Figure 2-1 for the geographical locations of such provinces). The composition of the NCR, the most developed region and seat of the national government, is distinct from the other regions as its components are cities and municipalities while the other regions’ components are provinces.
Table 2-8: Classification of provinces according to 1980 regional administrative regions
Region Component provinces
NCR Caloocan City, Manila City, Pasay City, Quezon City, the municipalities of Las Pinas, Makati, Malabon, Mandaluyong, Marikina, Muntinlupa, Navotas, Paranaque, Pasig, Pateros, San Juan, Taguig in Rizal and Valenzuela in Bulacan Ilocos Abra, Benguet, Ilocos Norte, Ilocos Sur,
La Union, M t . Province, Pangasinan Cagayan Valley Batanes, Cagayan, Ifugao, Isabela,
Kalinga-Apayao, Nueva Vizcaya, Quirino Central Luzon Bataan, Bulacan, Nueva Ecija, Pampanga,
Tarlac, Zambales
Southern Tagalog Aurora, Batangas, Cavite, Laguna, Marinduque, Occidental Mindoro, Oriental Mindoro, Palawan, Quezon, Rizal, Romblon
Bicol Albay, Camarines Norte, Camarines Sur Catanduanes, Masbate, Sorsogon
Western Visayas Aklan, Antique, Capiz, Iloilo, Negros Occidental Central Visayas Bohol, Cebu, Negros Oriental, Siquijor
Eastern Visayas Leyte, Southern Leyte, Eastern Samar, Northern Samar, Western Samar
Western Mindanao Basilan, Sulu, Tawi-Tawi, Zamboanga del Norte, Zamboanga del Sur
Northern Mindanao Agusan del Norte, Aguaan del Sur, Bukidnon, Camiguin, Miaamia Occidental, Mi aami a Oriental, Surigao del Norte
Southern Mindanao South Cotabato, Davao del Norte, Davao del Sur,
Central Mindanao
Davao Oriental, Surigao del Sur
Lanao del Norte, Lanao del Sur, Maguindanao, North Cotabato, Sultan Kudarat
The availability o f comparable data over time for Manila City allows its inclusion in the present analysis as well as in Chapter 6 to represent NCR. It is regarded as an individual unit like each o f the 73 provinces.
Figure 2-3 illustrates the classification o f Manila City and the 73 provinces according to the 1980 measures, composite index o f development (ID) and road density (ROAD). Classifying the first 25 top ranking areal units as high, those ranking 26th to 50th as middle, and those 51st to 74th as low, provides a clear picture o f the large gap in economic standing among the provinces.
Being the centre o f trade, commerce, industry, education, communications and health services, Manila city ranks high and first in both measures under consideration.
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Out of the seven provinces composing the Ilocos Region which is situated in the northern part of the country (Figure 2-1), Bcnguct (which includes Baguio City, the summer capital of the country), Ilocos Norte, Ilocos Sur, La Union, and Pangasinan join the high ranking provinces in the index of development. When it comes to road density, only Benguet goes down to the middle ranking status group; this is due to its mountainous nature. Abra falls in the middle group and Mountain Province in the lowest group for both indicators.
Of the seven provinces constituting the adjacent region called Cagayan Valley, Batanes, Isabela and Nueva Vizcaya are high in the ID scale. However, in terms of road density, Isabela and Nueva Vizcaya go down to the low and middle status, respectively, resulting from their mountainous nature which makes road expansion extremely costly and difficult. Batanes maintains its status as one of the most advantaged provinces. This finding may be quite surprising as it is an isolated province. However, it is possible that development concerns may have been intensive in this province around 1980 to make up for its isolation. Before 1980, this province was all rural but in 1980,25 per cent of its population were already classified as living in urban areas. This may be one of the explanations of its high economic status in 1980. Cagayan and Quirino fall in the middle ID scale but are low in road density, again owing to their mountainous nature. Ifugao and Kalinga-Apayao emerge as the poorest, ranking 73rd and 64th, respectively, in the composite ID scale. Their mountainous nature makes them fall in the low group with the road density measure.
All of the six provinces composing the rice granary region of the country, which is Central Luzon, are highly developed. This is expected as they are contiguous to Metro Manila, the centre of development activities. They have vast tracts of rice lands, which make them both industrially and agriculturally more progressive than the other provinces. In terms of road density, Bataan, Bulacan, Pampanga, and Tarlac retain their high-ranking status while Nueva Ecija falls down to the middle-ranking group and Zambales to the low-ranking group, as some of their portions are mountainous.
Four of the 11 provinces making up Southern Tagalog - Batangas, Cavite, Laguna, and Rizal - are in the most privileged group in both indicators of modernization. Their closeness to Metro Manila favours their economic status, which is higher than other provinces within and outside the region. Occidental Mindoro and Quezon belong to the middle economically developed group with the index of development. Aurora, Marinduque, Oriental Mindoro, Palawan, and Romblon are in the least developed group. According to road density, Romblon goes up to the high status rank. Marinduque follows but only until the middle status group. Perhaps improvement of road networks took place in these provinces but such improvement did not help in their economic advancement, so the index of development is taken as the better economic development indicator.
Camarines Norte, Camarines Sur and Catanduanes fall in the medium category while Masbate and Sorsogon belong to the poorest section. In terms of road density, Camarines Norte and Masbate are the least privileged and the other provinces occupy the middle position. Again, with such inconsistencies between the index of development and road density, the former is taken as the better indicator, as all socioeconomic and health-related indicators are accounted for in its construction. It is worth mentioning that some of the provinces in the Bicol region are centres of the New People’s Army, a leftist organization aiming to overthrow the democratic form of government in the Philippines and to establish instead a socialist or communist form of government which, according to the organization, is the best solution to the growing inequality between the rich and the poor.
Among the five provinces of Western Visayas, not one shows a high-ranking score in ID. Aklan, Iloilo and Negros Occidental join the middle- ranking group. Antique and Capiz join the poorest group. Only Iloilo falls in the most advantaged section in road density but again the index of development is the better differentiating variable.
It appears that among the Visayas regions, Central Visayas, consisting of four provinces, is the most developed with Cebu falling in the high scales of index of development and road density. It contains Metro Cebu, next in rank to Metro Manila, economically speaking. It is joined by Bohol and Siquijor in road density measure. Negros Oriental is the least advantaged province in this region in both indicators under consideration.
The five provinces of Eastern Visayas are on a par with the provinces of Western Visayas in that not one scores high in the ID scale. Being in the middle group, Leyte, Southern Leyte and Eastern Samar are better off than the other Samar provinces which are in the poorest group. As to road density, Leyte and Southern Leyte belong to the high-ranking group but again index of development is the better measure of economic status.
Out of the seven provinces of Northern Mindanao region, Camiguin, Misamis Occidental and Misamis Oriental fall in the high index of development and road density status groups. Agusan del Norte, Agusan del Sur and Surigao del Norte are in the middle group while Bukidnon joins the poorest group in terms of index of development. As to road density, while Agusan del Norte and Surigao del Norte remains in the middle group, Agusan del Sur and Bukidnon change position, the former being demoted to the lowest group.
All of the five provinces of Western Mindanao are the poorest in terms of index of development. As to road density, all except Tawi-Tawi fall in the middle-ranking group.
index of development Davao del Norte and Surigao del Sur join the middle ranking group and Davao Oriental falls in the most underdeveloped group. As to road density, South Cotabato and Davao Oriental are in the middle group and the remaining three are in the lowest group.
Not one of the five provinces of Central Mindanao appears in the high index of development Only Lanao del Norte and Sultan Kudarat rank in the middle and the rest are very poor. As to road density, Lanao del Sur is in the high-ranking group; Lanao del Norte and Sultan Kudarat maintain their middle- status group; Maguindanao and North Cotabato remain in the lowest status group.
Variation in health-related indicators is shown in Figure 2-4, which illustrates the provincial differentials by index of accessibility to hospitals (IAH) and the level of child malnutrition (MAL). The provinces are similarly grouped into three categories; those ranking 1st to 25th as high; those in the 26th to 50th group as middle; and those occupying the 51st to 74th place as low. With respect to index of accessibility to hospitals, Manila City, the same provinces of the Ilocos region, most provinces of Central Luzon and Southern Tagalog and Cebu of Central Visayas maintain their high- ranking status. However, it becomes clear that majority of the provinces have very poor access to hospitals.
In terms of the level of child malnutrition, there are indications of overreporting in some provinces. For instance in the Central Luzon region, where one would expect the lowest level, as it is one of the most developed regions, the level of child malnutrition reported is equal to that in the underdeveloped regions. Nevertheless, the pattern observed in some provinces is in accordance with expectation. For example, Negros Occidental, known as the sugar bowl of the country, ranks very high (fourth) in the level of child malnutrition; the high level resulted from the collapse of the sugar industry. This economic fall worsened poverty among the sugar workers who had been dependent on this industry for a long time. It is also very evident that most provinces score high in the level of child malnutrition.
2.5. Summary
This chapter has screened available socioeconomic and health-related indicators at the provincial level in the Philippines. Problems of comparability owing to provincial compositional changes, differences in the estimation base of relevant census data, poor quality of collection, as exemplified by the level of child malnutrition, generally characterize these indicators. While all either closely correspond or indirectly related to WHO’s suggested health indicators, very few comply with all WHO’s criteria of ideal indicators. However, as WHO (1981b; 12) notes,
In real life there are very few indicators that comply with all these criteria. Their scientific respectability therefore has to be tempered with a certain humility ... are partial measures o f a complex situation.
Moreover, their observed distributions nearly normal, except index of accessibility to hospitals, the high intercorrelations with most if not all of the other variables and compliance with at least one of WHO’s criteria of evaluating indicators are sufficient bases of their usefulness in the present chapter and in several
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41chapters of this thesis. The compromises made between derived precision and the feasibility of attaining that precision for each of the indicators in question suggest the importance of strengthening statistical services at the national, regional, provincial and local levels in order to improve the quality of information sources.
Those variables that appear to be most useful are percentage of population living in urban areas, average family income, percentage of households using electricity for light, road density, number of registered motor vehicles per 10,000 population, percentage literate among persons 10 years old and over, percentage of persons with at least a high school education, percentage of households with safe drinking water supply and percentage of households with sanitary toilets. Since they are measured sequentially in 1960, 1970 and 1980, they can indicate direction and speed of change and serve to compare provinces at the same moment in time. Given that literacy rate and percentage of persons with at least a high school education are on a par as education indicators, the latter was taken for statistical consideration, together with the other seven indicators, in the construction of a composite index of development for 1980, which was also shown to be statistically internally consistent.
Those indicators that emerge as less useful include agricultural output per worker (in pesos) percentage of persons with at least an elementary education, population per hospital bed, population per rural health unit, population per physician, population per nurse, and population per midwife. The least useful are index of accessibility to hospitals and level of child malnutrition.
Although these indicators vary a great deal in quality and coverage, a careful assessment and critical appraisal of each of them have led to discerning that great variations in social and economic development, with health as an integral part, exist among the provinces. Whether these substantial differences play an important role in their mortality status is examined further in Chapter 7, considering these factors as mortality determinants or covariates. Moreover, it is then useful to take into account these interprovincial variations in socioeconomic and health conditions in the choice of the best level of death registration completeness, which is the subject of Chapter 3, and in the derivation of infant death rates, which is contained in Chapter 4.