Ph ranks 9th among countries with most stunted children file photo file photo

A study by the Save the Children said the country had dropped to “sub-Saharan levels” of malnutrition.

SIDEBAR: Malnutrition will stay as long as there is poverty, study says


MANILA – Three-year-old Abdul is born with cerebral palsy, a condition that affects movement and motor skills. Unlike other kids his age, Abdul is unable to run around and play with other children. He is also severely malnourished, weighing only 3.6 kilograms – almost the weight of an infant.

A study by the non-government organization, Save the Children in the Philippines, says malnutrition among children is still prevalent in the country, most especially in impoverished communities. Abdul is among the children featured in the report.

At least one in every three Filipino children suffers from stunted growth, an indicator of chronic malnutrition, said Save the Children. The Philippines ranked ninth worldwide among countries with the highest number of stunted children, and 10th among countries with highest number of wasting, followed by countries in Africa such as United Republic of Tanzania, Egypt, Kenya, Uganda and Sudan.

Ned Olney, Save the Children’s country director, noted a drop to “sub-Saharan African levels of malnutrition” in the Philippines, despite reported improving poverty level. The number of malnourished children did not significantly go down along with the level of poverty.

“In order for stunting to go down, poverty has to go down as well,” he said during the launch on Sept. 3 of the report of their study, entitled “Sizing up: the stunting and child malnutrition problem in the Philippines.”

Prevalence of stunting and wasting

Dr. Armando Parawan, health and nutrition adviser of Save the Children, said that Filipinos’ shortness is not just a genetic trait. He said it is attributed to generations of stunted children who are too small for their age due to chronic malnutrition.

Infographic by Save the Children
Infographic by Save the Children
He cited the three forms of undernutrition: underweight, stunting which affects the height, and wasting, which affects weight and height. Stunting and wasting, said Parawan, are serious forms of malnutrition.

A child is stunted when he does not reach the Child Growth Standards set by the World Health Organization (WHO). Parawan said stunting is a result of prolonged hunger or chronic malnutrition. He said a child’s growth is affected if there is insufficient intake of particular nutrients.

Frequent infection, such as pneumonia, diarrhea, and measles are also factors that slow growth and may lead to stunting, said Parawan. He said stunting is very serious because it has short term and long term effects, such as impaired mental development.

A more serious form of malnutrition is wasting. Parawan said a wasted child may have the same height as children of the same age, but the weight is less. “When you have a severely wasted child, his or her internal organs are impaired. They are prone to infections because the immune system is also affected.” He added that deaths among malnourished children are due to severe wasting.

In 2013, eight percent or 769,000 Filipino children suffered from either moderate to severe wasting. According to WHO, wasting prevalence that exceeds five percent is “alarming given a parallel increase in mortality that soon becomes apparent.”

“Provided there is no severe food shortage, the prevalence of wasting is usually below five percent, even in poor countries,” the WHO website read.

The report said the provinces of the Autonomous Region of Muslim Mindanao (ARMM), the poorest region in the country consistently exhibited critical levels of stunting and wasting as they registered the highest prevalence of food insecurity with 64 percent.

This was followed by South Cotabato, Cotabato, Sultan Kudarat, Saranggani and General Santos (SOCCSKSARGEN) with wasting prevalence of 36 percent. The report attributed the high level of food insecurity in Mindanao, to the recurrent armed conflict which often results to displacement and dislocation of families.

Infographic by Save the Children
Infographic by Save the Children
The report also said that even with government programs to address both the problems of poverty and malnutrition and its commitment to achieve Millennium Development Goals, trends over the past 20 years show only moderate improvement in nutrition status of children.

“The national nutrition surveys show that prevalence of stunting among children under five years old declined gradually, from 39 percent in 1993 to 30 percent in 2013.” It also added that the percentage of underweight children in the same age group was reduced from 24 percent to 20 percent over the same 20-year period.

Undernourished mother more likely to have undernourished baby

The report said, as high as 20 million babies around the world are born with low birth weight every year. “This is either because they are born too early, or they are born full term but are small because of poor growth of the baby in the womb.”

It said that the low nutritional status of most mothers in developing countries is the result of “cumulative and synergistic effects” of many factors such as limited access to food and health care, power relation in the household, traditions and customs relegate women’s demands of early and frequent pregnancies and breastfeeding and the heavy demand of physical labor, among others.

“In most cases, undernourished mothers are more likely to give birth to undernourished children,” the report said.

In the Philippines, the 2011 Updating Nutritional Survey of the Food and Nutrition Research Institute and Department of Science and Technology said that one in every four pregnant women is at risk of delivering low birth weight babies and face pregnancy complications, because she is underweight, or is not the getting required gestational weight relative to her age.

The report said teenage mothers have a higher risk of delivering low birth weight babies. The same survey also showed that 36 percent of those identified as nutritionally at risk are less than 20 years old, compared to 24 percent among older age group. A similar percentage of nutritionally at-risk pregnant women are in their first trimester when the fetus is developing.

Inforgraphic by Save the Children
Inforgraphic by Save the Children
The report said that nutrition during the first 1,000 days of a child’s life is crucial in preventing stunting. This starts from the mother’s pregnancy up to the child’s second birthday.

“Studies have shown that children who were not able to achieve optimum growth within their first 1,000-day window is at higher risk of impaired cognitive development, which has adverse effects on their schooling performance, labor force participation, and productivity in later life.”

The report also put emphasis on the importance of breastfeeding noting empirical evidences that identified childcare and feeding practices as contributory factors in ensuring optimal growth and development of children.

“The World Health Organization recommends that babies should be exclusively breastfed in the first six months and from six months on, they should be given a diverse range of food as supplement to breastfeeding,” the report said.

It also added that child mortality is reduced with early initiation of breastfeeding, exclusive breastfeeding for six months, appropriate and right timing of complementary feeding and sustained breastfeeding for up to two years.

The report said the higher prevalence of stunting is found among children who have never been breastfed, had been breastfed for less than a year, or had been fed with semi-solid food of poor quality. (Read also: Children’s health at risk with low breastfeeding practice)

‘Make nutrition a top development priority’

“Malnutrition, in all its forms, continues to affect millions of children particularly in the developing countries,” the report said. The Philippines, which is a developing country, has in fact been identified as one of the countries that account for most of the global burden of malnutrition.

In its conclusion, the report said, “There is a need to make nutrition a top development priority, alongside issues such as poverty, climate change, and national security.”

Olney said that malnutrition is undermining children’s development, economic growth and people’s capacity to get their way out of poverty.

“By tackling child malnutrition alongside poverty and food security, we are helping save and tap full potential of millions of Filipino children.

Save the Children also launched their campaign against malnutrition dubbed “Lahat Dapat” (No child left behind) to call the government, civil society and the public to step up efforts to reduce malnutrition, especially in the first 1,000 days of the child’s life. (

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