Tackling undernutrition among Filipino children

Despite commendable progress over the last few decades, undernutrition among children under 5 years of age in the Philippines remains high.

Stunting, a measure of chronic malnutrition indicated by low height for age, still stands at 26.7 percent, and 15 percent of children are born with a low birth weight—a known precursor for future malnutrition.

These figures are higher than many regional peers and low- and middle-income countries with comparable GDP per capita, indicating a need to strengthen nutrition efforts in the Philippines in terms of program targeting, coverage, and implementation.

Earlier this year, the Second Congressional Commission on Education (EdCom II) released a comprehensive policy brief outlining the existing challenges around undernutrition in the Philippines. In this article, we summarize four key investments that can improve the country’s nutrition outcomes.

Prioritizing the first 1,000 days of life, from pregnancy through age 2. The critical window for ensuring adequate child nutrition starts before a child is even born and continues to age 2, a crucial period for physical and cognitive development. After birth, exclusive breastfeeding for up to six months, followed by a transition to solid foods (complementary feeding) up to age 2, coupled with micronutrient supplementation, is required.

However, based on the 2021 Expanded National Nutrition Survey, only 13.3 percent of children aged 6 to 23 months received a minimum acceptable diet (i.e., a varied and adequate diet to support healthy growth and development).

Addressing gaps in coverage and implementation of Republic Act No. 11148, or the first 1,000 days law, such as providing nutrition counseling, micronutrient supplements including iron, folic acid, vitamin A, and other necessary micronutrients, and dietary supplementation of age-appropriate and nutrient-dense quality complementary food for nutritionally at-risk mothers and infants, can promote the Filipino child’s complete developmental potential and ultimately cultivate a robust workforce for the Philippines.

Ensuring coverage for severely malnourished children. For children facing acute malnutrition, providing immediate care is essential to prevent long-term health issues. However, existing data reveal that only 4.4 percent of children with severe acute malnutrition (SAM) between six and 59 months receive treatment through outpatient therapeutic care. This highlights critical gaps in malnutrition management, indicating that the most in-need and at-risk children are not receiving care when they need it the most. A notable inadequacy in local government unit (LGU) allocations for managing SAM is evident, and to effectively address this issue, a boost in local funding and broader program coverage are paramount.

Strengthening nutrition-sensitive interventions that complement nutrition outcomes. Nutrition-sensitive interventions are those that indirectly address nutrition to promote broader health and nutrition outcomes, such as improving food security, education, and sanitation.

They create a supportive environment that can magnify the impact of nutrition interventions and contribute to overall health and well-being. For example, in 2016, Kandpal et al. found that participation in the “Pantawid Pamilyang Pilipino Program” (4Ps), a nutrition-sensitive intervention, led to a 10-percent reduction in severe stunting. However, in a more recent evaluation of the 4Ps in 2021, Orbeta et al. noted that outdated beneficiary records and stagnation in new registrations since 2009 have hampered the program’s impact on the nutrition of pregnant women and children aged 0 to 5 years.

Greater resourcing, prioritization, and monitoring at the LGU level. The LGUs, which rely on barangay health workers (BHWs), nutrition scholars, and child development workers, face challenges in staffing, finances, advocacy, and monitoring, hindering effective program implementation.

In 2019, Jean Annette Ibo observed that in certain municipalities in Albay, BHWs were found to cover around 100 households, despite the recommended ratio of at least one BHW per 20 households. The Department of the Interior and Local Government Memorandum Circular No. 2018-42 urges LGUs to prioritize local funding for nutrition programs, but lack of funds and issues with supply chain management and essential equipment, especially in poorer regions, impede their effective execution and coordination.

To decisively break the cycle of undernutrition in the Philippines, it is essential to turn these challenges into stepping stones for impactful change, focusing on the critical 1,000 days, targeted malnutrition interventions, bolstered nutrition-sensitive programs, and reinforced LGU engagement. Strengthening execution at the LGU level, securing adequate resources, and utilizing data for agile monitoring are the strategic actions needed to pave the way toward a resilient future where Filipino children grow up nourished and thriving. As one promising step in the right direction, the Department of Health, through the efforts of EdCom II, was recently allocated P300 million for a comprehensive care package for nutritionally at-risk mothers and children. With concerted efforts from local governments, communities, and health workers, harnessing the power of local commitment and improved logistics, we can transform our aspirations into tangible health outcomes, ensuring that reducing stunting is not just a goal but a reality for every Filipino child.

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Steven Walker and Akshita Sharma are from IDinsight; Gayl Porter-Laurel and Mavreen Yapchiongco are from EdCom II.