The grave problem of malnutrition in the country

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The Philippines is a middle-income country but we are as worst compared to poor African countries in terms of nutrition numbers.

Consider these facts: In 1989 children under 5 were 27.3 percent underweight, 44.5 percent stunted and 6.2 percent wasted. By 2005, we only managed to reduce these challenges to 20 percent, 32.9 percent and 5.8 percent, respectively. Ten years later in 2015, the Food and Nutrition Research Institute has reported increases in the prevalence of underweight children under 5 to 21.5 percent, stunting to 33.4 percent and wasting to 7.1 percent. As a result, Filipino males and females were reported to be an inch shorter than the average Asean heights, and are 4 inches shorter than the tallest-in-the-region Singaporeans. The impact of stunting alone is something worth contemplating. It often starts in the first two years of life and is mostly irreversible. It results to delayed motor development, impaired mental development and poor school performance. What started as a simple nutritional challenge has become bigger present and future policy problem, as it is now seen having grave repercussions to the country’s present and future labor force.

The government agency at the center on nutrition policy is the National Nutrition Council (NNC). The Philippine Plan of Action for Nutrition, the country’s blueprint of actions for nutrition, has just been launched in May. The NNC formulates policies and coordinates nutrition programs, but direct implementation is delegated to the line agencies, such as the Department of Health (DOH) and the local government units (LGUs). In 2014 I made a study on malnutrition trends in the country. I estimated determinants of malnutrition at the regional (sub-national) and national levels. Specifically, the study looked to identify factors that strongly influenced the malnutrition trends that were being observed. Constrained by data availability, I managed to test the effects of some variables, such as food price inflation, income per capita, number of subsistence children, underemployment and unemployment to the prevalence of malnutrition of children. These variables did not include those that provide comparable health and governance indicators disaggregated at the regional level.

I found that food price inflation has significant and adverse effects on all three malnutrition indicators at the regional level and consequently at the country level. A 1-percent change in food price inflation means 0.036 percent change in the prevalence of underweight children under 5 years, 0.878 percent change in prevalence of stunting and 0.169 percent in wasting. Food prices, excluding rice, have stronger effect on stunting on children under 5 as a 1-percent increase in food price inflation (minus rice) means 1.854-percent increase in stunting. The largest effect is reserved for underemployment since a 1-percent change in underemployment means a 3.5-percent increase in stunting of children. Among children age 6 to 10, my estimates resulted to a 1-percent change in food price inflation (including rice) means 0.054-percent change in underweight, 0.17-percent change in wasting of children 6 to 10 years old, and no effect on stunting.

While the results of the study are not necessarily conclusive, they are consistent to behavioral expectations on the impact of said variables to malnutrition measures. For instance, no one will dispute that food prices affect prevalence of malnutrition. Going deeper into the data led me to the hidden nature of the malnutrition problem of children. I found that regional data on mean per capita income and children in subsistence families do not affect malnutrition prevalence. The regions’ mean per capita incomes must have masked the inequality and very low per capita income of the subsistence poor families relative to middle- and high-income families. However, the indicator on children in subsistence families is quite puzzling. The results show that poverty or subsistence condition does not automatically lead to malnutrition. Children’s malnutrition must have cut across among families in subsistence, poverty, transient poverty and even to nonpoor but vulnerable families above the poverty line. What the data is saying is that the challenge is so prevalent, we cannot pinpoint exactly where the problem is coming from.

Hence, the policy and program implication is that we must have blanket interventions to children under 5, starting from their conception, to prevent malnutrition. This is because it is difficult to bring down food price inflation and underemployment immediately and at low levels at that. Thus, the approach then is to consider the challenge of malnutrition as a public good and for government to intervene directly. For instance, a plausible policy is a nationwide feeding program for all public elementary schools. This suggestion comes from my latest study in one public school in National Capital Region where almost 10 percent of normal children are becoming underweight and wasted every year. Considering that we are aware of the negative impact of malnutrition to human capital now and in the future, we need the same or even better zeal as the one being waged on the war on drugs. Because the war on malnutrition will bring us better benefits in the future far more than the current war on drugs.



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