Undernutrition a public health imperative

There’s a saying that “pain in one’s little finger is felt by the whole body,” which is true of undernutrition. Chronically undernourished children face an increased risk of poor performance in school, and eventually face difficulties in securing decent jobs. By undermining the human capital stock of the country, undernutrition also reduces its potential for long-term economic growth.

In 2021, nearly 27 percent of Filipino children under five were stunted, which means they had been undernourished for so long that their height was below what could be expected for their age. The 27 percent is a modest improvement from 2019, when stunting rate was around 30 percent. However, the Philippines is still among the top 10 countries with the largest number of children suffering from stunting.

In general, more affluent places have lower stunting rates, so national level averages mask deep inequalities across the country. In 2015, 45 percent of children below five in the Bangsamoro Autonomous Region in Muslim Mindanao were stunted; in Region IV-B (Mindoro, Marinduque, Romblon, and Palawan or Mimaropa), it was 41 percent, and in Bicol, Western Visayas, and in southern-central Mindanao (Cotabato, Sarangani, South Cotabato, Sultan Kudarat, and General Santos, or Soccsksargen), it was 40 percent.

On average, children in rural areas were more likely to be stunted (30 percent) than those in urban areas (26 percent). In the last two years, COVID-19-driven health system disruptions and high food inflation have likely exacerbated childhood undernutrition. As food prices rise, many low-income families reduce overall food intake and, significantly, the consumption of more costly but nutrient-dense foods such as animal source foods, pulses, and vegetables—leading to a rise in all forms of undernutrition.

The World Bank’s High Frequency Monitoring survey of a representative sample of households found that 70 percent were worried about not having enough food for the following week. The Philippine government however demonstrated its commitment to reduce childhood stunting through the Philippine Development Plan, which sets a target for reducing its prevalence to 17.9 percent by 2028. As part of this commitment, the Department of Health (DOH) and the Department of Social Welfare and Development have begun implementing the Philippine Multisectoral Nutrition Project.

With support from the World Bank, the Philippine government is rolling out a bold, multisectoral nutrition approach, which will deliver a comprehensive package of nutrition interventions across different sectors and various local government unit (LGU) platforms, as well as strengthen the primary care system to enable it to provide essential health and nutrition services. By targeting 235 municipalities and 5,936 barangays in 12 regions and 26 provinces, which have some of the highest levels of childhood malnutrition and incidence of poverty in the country, the project will help strengthen the preparation, implementation, and monitoring of nutrition action plans, and encourage LGUs to spend more and spend better on nutrition and related interventions.

United Nations agencies will also work with the DOH to support the project’s implementation on the ground. This strategy recognizes that achieving good nutrition is much more than just providing food to vulnerable households and children. It is also about access to quality medical/health care, clean water, and good sanitation facilities, knowledge of nutrition-related behavior and practices, education, attention to the needs of marginalized populations, community empowerment, and access to financial resources.

This means scaling up investments and coordinating partnerships at the national and local levels. It is a big task but one that must be taken on. Reducing childhood undernutrition and ending stunting is an investment in human capital that will provide long-term social and economic benefits for the whole country. Providing children with good nutrition gives them a healthy start in life, and prepares them for a bright and promising future.

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Ndiamé Diop is World Bank country director for the Philippines, Malaysia, Thailand, and Brunei. Nkosinathi Mbuya is World Bank senior nutrition specialist for East Asia and the Pacific Region. However, the Philippines is still among the top 10 countries with the largest number of children suffering from stunting