Philippines' multisector approach to break the cycle of stunting

Teachers serve students with meals during a supplemental feeding program at a daycare center in Manila. Photo by: REUTERS / Cheryl Ravelo

MANILA — The Philippines is looking at improving cross-government collaboration and the regulatory framework to address poor nutrition outcomes in the country. While wasting prevalence among children under 5 years old is improving, much remains to be done on stunting, and overweight and obesity.

Wasting prevalence among children under 5 years old decreased to 5.6% from 7.1% between 2015 and 2018, according to the country’s “2018 Expanded National Nutrition Survey,” said Azucena Dayanghirang, executive director of the Philippines National Nutrition Council, during last week’s launch of UNICEF’s “State of the World’s Children” report in Manila.

The current rate shows the country is getting closer to its target of reducing wasting prevalence to 5% by 2022. A planned insurance benefit package for malnutrition in the country could further that reduction, although it’s currently unclear when and how that will be implemented.

But a bigger challenge is reducing the chronic problem of stunting, which was at 30.3% in 2018. While data shows stunting rates have improved from 33.4% in 2015, the current rate is similar to 2013 figures and is far from the Philippines’ 2022 target of reducing stunting among children under 5 years old to 21.4%.

The intergenerational problem of stunting makes the task more challenging.

“If you have an adolescent female who might probably get pregnant, and this girl was also stunted when she was a child, probably the offspring may also [be] stunted. So unless we stop [the] cycle and we make sure that those children will no longer be stunted, then that’s where the acceleration comes in,” said Anthony Cabilo, OIC division chief of the Philippines Department of Health Disease Prevention and Control Bureau.

To break the cycle, the country needs to ensure that the infants and children are no longer stunted by the time they reach their fifth birthday, he said.

Rates of overweight and obesity among children between 5 and 10 years of age slightly dipped in 2015 to 8.6%, but increased again to 11.7% in 2018 — the highest since 2003. Meanwhile, the overweight and obesity rate among adults 20 years old and above was 37.2% in 2018, moving further away from the 2022 target of 28%.

The proportion of food-secure households increased to 46.1% in 2018 from 33.9% in 2015, although that may not always ensure better nutrition or a well-balanced diet among families.

Some families receiving conditional cash transfers from the government, for example, often buy more rice — the country’s staple food — as opposed to food rich in proteins and vegetables, said the National Nutrition Council’s Dayanghirang.

About 44% of children aged 6 to 23 months old are not being fed fruits and vegetables, and 59% are not receiving proteins such as eggs, dairy products, fish, and meat, according to a press release issued during the event.

In addition, parents or caregivers often lack knowledge of proper feeding practices, and may at times adopt “quick-fix solutions,” serving easily made food on the go, such as canned goods or instant foods, Calibo said.

The government has several programs in place, such as a “mother’s class” at barangay level teaching parents how to prepare different nutritious recipes, as well as school-based feeding programs. The Department of Health and the Department of Social Welfare and Development are currently exploring the possibility of expanding the scope of these feeding programs to include children aged between 6 months and 3 years old.

Both Dayanghirang and Calibo, however, underscored the need for a “convergence” or cross-collaboration between government agencies to address malnutrition in the country. For example, working with the government’s Food and Drug Administration to address harmful food marketing that may be having an impact on the nutrition of both children and adults.

Dayanghirang also floated the idea of discussing, with the Department of Public Works and Highways, the creation of guidelines for contractors bidding on the government’s infrastructure projects to provide employment to parents with malnourished children.

One issue affecting hunger and stunting in the country is families not having sufficient income to buy food, Dayanghirang said.

This focus area, powered by DSM, is exploring innovative solutions to improve nutrition, tackle malnutrition, and influence policies and funding. Visit the Focus on: Improving Nutrition page for more.

About the author

  • Jenny Lei Ravelo

    Jenny Lei Ravelo is a Devex Senior Reporter based in Manila. She covers global health, with a particular focus on the World Health Organization, and other development and humanitarian aid trends in Asia Pacific. Prior to Devex, she wrote for ABS-CBN, one of the largest broadcasting networks in the Philippines, and was a copy editor for various international scientific journals. She received her journalism degree from the University of Santo Tomas.