New Nutrition Survey Triggers Formation of Task Force to Review Findings Before Reviewing Them Again

MANILA, PHILIPPINES — A new national nutrition survey has revealed that one in four Filipino children aged five and below suffers from chronic malnutrition, a finding described by public health officials as “alarming” and by several government agencies as “a situation requiring comprehensive inter-agency coordination” and by pediatricians as “something we have been saying for years, please help.”

The Survey: Its Numbers

The survey, conducted by the Department of Science and Technology’s Food and Nutrition Research Institute, found stunting rates of 25.4 percent among children under five, a figure that places the Philippines below the thresholds recommended by the World Health Organization for “acceptable” child nutrition outcomes and well within the range that nutrition scientists classify as a “public health emergency.” The survey also found wasting rates, iron deficiency anemia prevalence, and micronutrient gaps that complete a picture of childhood nutritional deficit that is, in aggregate, distressing.

The findings were presented at a press conference attended by officials from six government agencies, all of whom expressed concern with varying degrees of specificity. The Department of Social Welfare and Development called for “immediate action.” The Department of Health called for “coordinated response.” The Department of Agriculture called for “food security interventions.” The Office of the President, asked for comment, issued a statement calling the survey findings “a priority concern for the administration.”

The children, who were not at the press conference, continued being 25.4 percent malnourished.

The Response: Institutional

Within 72 hours of the survey’s release, two task forces had been formed, one inter-agency committee had been convened, and a subcommittee of the inter-agency committee had been established to review the terms of reference for the inter-agency committee’s mandate. This is not a caricature of Philippine bureaucracy. This is a description of it.

The Presidential Nutrition Council, which exists and meets, issued a resolution calling for “urgent and sustained action” on child malnutrition. The resolution was adopted unanimously. Implementation timelines were described as “to be determined based on available appropriations,” which is government-speak for “pending budget,” which is government-speak for “ask us again in the next fiscal year.”

What Works: Evidence Available

Nutrition scientists at the University of the Philippines Manila’s College of Public Health, who have been studying this problem longer than some of the task force members have been in government, note that effective interventions for child malnutrition are well documented. Community-based feeding programs, iron and micronutrient supplementation, maternal nutrition education, and improved access to complementary foods have all demonstrated measurable impact in Philippine settings where they have been properly funded and sustained.

“We know what works,” said a nutritionist who asked not to be named because she has to present to some of the task forces and does not want to appear in the news expressing frustration before she does. “The question is never the evidence. The question is always the political will and the sustained funding.”

She then returned to preparing her presentation materials, which include a slide with a graph that has been going in the wrong direction for longer than she would like.

The Human Scale

In Payatas, a community in Quezon City, a public health worker named Ate Nora runs a supplementary feeding program out of a barangay hall that doubles as a multi-purpose center on Tuesdays. She has been running the program for nine years with funding that she describes as “irregular but we make it work.” She knows the names of every child in her program, their weights, their ages, and which ones have been absent for more than three days, which is when she calls the family.

“The survey is correct,” Ate Nora said, folding the laminated nutrition charts she uses to track her children. “We see it every day. The programs work when they are funded. When the funding stops, the children go back to how they were before. It is very simple. It is just not treated like it is simple.”

The Global Context: Philippines Not Alone

The Philippines’ 25.4 percent child stunting rate places it above regional neighbors Vietnam (at approximately 20 percent) and Thailand (at approximately 13 percent), but within the same order of magnitude as several South and Southeast Asian countries that are also wrestling with the gap between economic growth and nutritional outcomes for the youngest and most vulnerable. The World Health Organization’s global stunting targets call for a 50 percent reduction from 2012 levels by 2025. The Philippines, like most countries in its income category, has made progress but not enough. The survey’s release into a political environment where budgets are contested and bureaucratic attention is limited is, as the nutritionist who asked not to be named put it, “a familiar challenge in an unfamiliar media moment.” She is correct. The survey exists. The children exist. The task forces will meet. The question is always, and only, what happens after the meeting.

The Budget Question

The Philippine government allocates funds for nutrition programs through the Department of Health’s National Nutrition Service, the Department of Social Welfare’s social protection programs, and the Department of Agriculture’s food security initiatives. The combined nutrition-related budget across agencies amounts to several billion pesos annually — a significant sum in absolute terms and insufficient in per-capita terms relative to the scale of the problem. International development partners including UNICEF, WFP, and USAID supplement government funding with targeted programs, particularly in regions with the highest stunting rates. The challenge is not that nobody is trying. The challenge is the gap between what is being done and what the survey says needs to be done, which is a gap measured in children who are not growing at the rate they should be growing, which is ultimately the only measurement that matters.

For Philippine public health coverage, see Inquirer.net. For nutrition and health policy reporting, visit Manila Bulletin. For regional child health data and context, see World Health Organization.