Bringing down ‘bansot’
More than a year ago, I wrote about a silent crisis in our midst that is threatening to turn our much-vaunted “demographic sweet spot” into a demographic time bomb if we don’t act fast. I sounded the alarm about how a full one-third of all Filipino children aged 0-5 are already damaged for life due to stunting caused by chronic malnutrition. That is, they can no longer reach full brain and physical development potential as adults, once stunted by age five. The 2015 National Nutrition Survey showed that 3.8 million or 33.4 percent of all Filipino children 0-5 years old are biologically stunted (“bansot”), or much shorter than the average height for their age. An additional 7.1 percent, or nearly a million, are “wasted” or acutely undernourished, with body weight substantially below the average for their height. Wasting can still be corrected with supplementary feeding, but the ill effects of stunting are lifelong.
What’s alarming is that not only have these numbers hardly fallen since the 1990s, but have actually risen in recent years. Wasting averaged 7 percent of 0-5-year-olds in the 1990s, but averaged 7.5 percent in the last five. Stunting afflicted 38.8 percent of the same age group in the 1990s, and still averaged 32.5 percent in the last five years; it in fact climbed back to 33.4 percent in 2015 from 30.3 percent in 2013.
In contrast, Vietnam saw a steep drop from 61.4 percent in 1993 down to 23.3 percent in 2010. Thailand was already at 21.1 percent in 1993, dropping down to 16.3 percent by 2012. Malaysia had similar numbers, while Singapore was already at 4.4 percent back in 2000. With our numbers, we seem destined to be the shortest—and worse, possibly the least mentally capable—among Southeast Asians. If that’s where we’re headed, there would be little comfort in being known as the most artistically talented people in the region and beyond, as we are now.
There’s an interesting new publication from the World Bank titled “Standing Tall: Peru’s Success in Overcoming its Stunting Crisis.” It tells the story of how that Latin American country cut stunting in half in less than a decade, or from 28 to 13 percent from 2008 to 2016. Peru now aims to halve that further to 6 percent by 2021, and seems poised to do so. Its story ought to inspire us that we can do it, too, if we do things right.
How do we “do things right”? For Peruvians, it was a combination of three things: strong political commitment, cooperation and coordination; smarter policies based on evidence, incentives and results; and behavioral change. In 2006, when their crusade started, a strong civil society coalition pushed the issue into the national agenda in that year’s election. Four presidents later, it has remained there. The publication narrates: “A year later these were enshrined in the government’s budget planning… The Ministry of Economy and Finance … played a crucial role by creating incentives for a coordinated response across government to address malnutrition through Result-Based Budgeting” (calling Secretaries Dominguez, Pernia and Diokno!). The Peruvians called it the “5-by-5-in-5 Goal,” or the ambitious yet clear and feasible goal of reducing stunting in children under age five by 5 percentage points in five years, and translated it into specific regional targets. A conditional
cash transfer program known as “Juntos” (Together)—their version of our Pantawid Pamilyang Pilipino Program or 4Ps—is cited as a crucial part of the mix. Launched in 2005, mothers who were Juntos recipients were required to take their young children regularly to health, growth monitoring
and promotion checkups at the health centers, while making sure their older children attended school.
On our part, we can start by making our food staple, rice, much more affordable than it is to our poor and malnourished—by boosting productivity in our best-suited rice farms, helping marginal rice farmers shift to more lucrative crops, and opening rice trade to get our rice prices closer to (rather than twice) the regional norm. Add to that Peru’s 3-point formula, and we can bring “bansot” numbers down, and make our demographic sweet spot truly work for us in the decades to come.
