MANILA, Philippines – Is the Philippines lagging behind its Asian neighbors in the fight against malnutrition?
Childhood malnutrition in the Philippines slightly went down over the years, but its pace is still the slowest among all ASEAN countries, according to a 2015 study by the World Bank and the Food and Nutrition Research Institute of the Department of Science and Technology (FNRI-DOST).
Undernutrition interventions across ASEAN countries are pretty much the same, Dr Cecila Acuin of the FNRI-DOST observed. Perhaps the Philippines, however, is doing it differently since its results are not as good as its neighbors, Acuin said.
“We are not feeding our children right despite the resources,” Acuin said during the assessment forum on the country’s nutrition situation on Wednesday, November 4. “We should be doing better,” she added.
In fact, only one-third of Filipino households can be considered food secure, official statistics showed.
Only a small percentage of Filipino children are meeting the minimum acceptable diet, which means only a few are getting the right diet diversity and feeding frequency.
"They usually eat rice, maybe one or two viands at most. They do not reach the minimum of at least 4 food groups for the diet to be acceptable," Acuin explained. "This could explain why our stunting and underweight rates haven’t changed much.”
Stunted children are those who are too short for their age. Stunting may result from poor nutrition as early as pregnancy, but its physical and cognitive impacts may last into adulthood. This is why a child’s first 1,000 days of life is important.
Makes a difference
The study also compared areas with low and high prevalence of underweight children, revealing that the latter had less awareness and participation in health and nutrition programs.
Overall, however, awareness rates were lower than participation. “They did not know it, but they’re participating anyway. This can be improved,” said Acuin.
While most households from low prevalence areas went to healthcare workers for information on breastfeeding, those in high prevalence areas depended more on relatives.
But both areas reported the same kind of frequently consumed food groups.
| Frequently consumed food groups | |
| Cereals and cereal products | |
| Spices, condiments, and beverages | |
| Oats and fats | |
| Fish and seafood | |
| Sweets |
| Least consumed food groups |
| Meat and organ meat |
| Fruits |
| Eggs |
| Vitamin A-rich vegetables and tubers |
| Roots and tubers |
| Legumes, nuts, and seeds |
There is, however, not much difference between the two areas' food expenditure: around P304-330/week or P43-47/day.
When the family plants their own food, most of it is sold, said Acuin. They only eat the "rejects" or those which are not good enough to sell.
The biggest difference, however, is seen in terms of governance.
Surveyed areas with low prevalence of underweight children have supportive local governments, extensive nutrition planning and reviews, and effectively implemented programs. They also have designated nutrition action officers.
Meanwhile, the local governments of areas with high prevalence do not prioritize nutrition. Instead of focusing on particular duties, their nutrition officers have to multi-task.
The study also highlighted the small number of nutritionists the Philippines has compared to its fellow developing ASEAN nations Indonesia and Malaysia.
| Ratio of government nutritionist per population | |||
| Philippines | Indonesia | Malaysia | |
| Number of nutritionist/dietitians | 357 | 22,443 | 520 |
| Nutritionist Population Ratio | 269,424 | 11,133 | 57,148 |
Burdens
The study found that the most vulnerable to malnutrition are still the poor, those in rural or agricultural areas, those exposed to calamities, larger households, and younger mothers.
The Philippines, home to its many ironies, displays a double burden of malnutrition – obesity existing alongside undernutrition.
Undernutrition can interrupt the physical and brain development of children and infants. Meanwhile, obesity is linked to chronic diseases like cancer, cardiovascular disease and diabetes.
Both conditions are forms of malnutrition. "Malnutrition, in every form, presents significant threats to human health," according to the World Health Organization.
Although the Philippines has a national action plan on nutrition, the challenge lies with how local governments can implement and fund such programs. But at the same time, national governance needs to play a more direct role, the study suggested.
The Philippines currently has no direct nutrition budget; instead, it is embedded in the health budget. This budget is coursed through the National Nutrition Council.
Another problem is the lack of data. There are enough national surveys, but local data are lacking, advocates say. "If we have good data, I think we will have better solutions to our problems," said Dr Corazon Barba of the World Food Programme. – Rappler.com