A call for action on malnutrition

As National Nutrition Month drew to a close, it’s essential to reflect on the ongoing issue of malnutrition in the country. Proclaiming July as Nutrition Month in 1974 through Presidential Decree No. 491 marked a significant milestone in raising awareness about the vital role of nutrition in the lives of Filipinos. But after 50 years, where do we stand?

Malnutrition presents in various forms, encompassing undernutrition (wasting, stunting, being underweight), and the prevalence of obesity, both of which lead to diet-related illnesses. Alarmingly, global data from 2022 revealed that 890 million adults are suffering from obesity, while 390 million are classified as underweight. Children are equally impacted, with an estimated 149 million children under five experiencing stunting, 45 million dealing with wasting, and 37 million being either overweight or obese. It is troubling that almost half of child deaths under five are attributed to undernutrition, particularly in low- and middle-income countries.

The landscape of child malnutrition in the Philippines, detailed in the Philippine Plan of Action for Nutrition (PPAN) 2023-2028, is disturbing. A significant 26.6 percent of Filipino children under five are stunted, while 5.5 percent suffer from wasting. Geographically, all regions in the Visayas and Mindanao report high stunting rates, with the Bangsamoro Autonomous Region in Muslim Mindanao registering the highest at 45.2 percent. As children grow older, issues persist, with children aged 10-12 experiencing iodine deficiency at a rate of 12.4 percent, rising to 22 percent among lactating women.

The consequences of malnutrition are far-reaching, impeding development, straining economies, destabilizing societies, and burdening health-care systems. Stunting, especially, is a predominantly irreversible outcome of poor nutrition and recurrent infections during a child’s critical first 1,000 days of life. Stunted children often face adversity, struggle academically, and earn lower incomes as adults. This early setback affects individual futures and hampers economic progress, perpetuating cycles of poverty and inequity.

Stunting remains a significant public health challenge as the Philippines aspires to become an upper-middle-income country by 2025. Despite commendable economic growth, our stunting prevalence remains double that of the average in upper-middle-income nations. While the country saw steady per capita income growth from 2000 to 2015, the reduction in stunting prevalence was minimal, in contrast to advancements in other low- and middle-income countries facing similar obstacles.

The Philippine government has taken a comprehensive approach to address stunting and malnutrition nationwide. The PPAN highlights the importance of nutrition-sensitive agricultural practices and targeted interventions in childcare and food intake. A pivotal initiative within this plan is the First 1,000 Days program, which concentrates on maternal and child health during the critical early years.

In addition, the government has secured a multibillion peso loan from the World Bank for the Philippine Multisectoral Nutrition Project. Spearheaded by the Department of Health and Department of Social Welfare and Development, this four-year project aims to implement a robust multisectoral strategy to deliver nutrition-specific and nutrition-sensitive interventions across various local government units (LGUs).

While showing promise, progress is gradual in these endeavors and falls short of the significant scale needed to cover 90 to 95 percent of our vulnerable population. A rapid upscale of existing initiatives is essential to effectively reach more people, with collaboration with LGUs and the private sector being crucial for successful implementation.

Province-based initiatives, like the Zuellig Family Foundation’s Provincial Nutrition Governance Program (PNGP), have effectively addressed systemic nutritional challenges, focusing on the health of pregnant women and children within specific age groups. By enhancing the leadership and governance capacity of LGUs, the PNGP has been instrumental in advancing nutrition indicators in provinces such as Samar, Northern Samar, Saranggani, and Zamboanga del Norte. This has resulted in significant reductions in stunting and wasting rates among children, and has mitigated the prevalence of at-risk pregnant women.

By leveraging government initiatives and the active involvement of nongovernment organizations, civil society, and the private sector, significant progress can be made in addressing malnutrition. Let this be a call to action for collective efforts and collaborative endeavors toward aligning our nutrition indicators with those of an upper-middle-income country by 2025.

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Dr. Anthony Rosendo “Tonyboy” Faraon is deputy executive director of Zuellig Family Foundation and chair of the Philippine Society of Public Health Physicians.