Professional Documents
Culture Documents
CHILDREN:
The Provincial Nutrition
Situation Facts and Figures
(Based on the Provincial Nutrition data from 2009-2014)
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
INTRODUCTION
Malnutrition is attracting attention both in international and local regions. The damage
it does in the past has only recently begun to sink in. The damage malnutrition does in
infancy and childhood is irreversible. It also attracts attention because of its puzzling
failures more than in the grass roots level. The provincial government of Quezon in
lieu, shares the conviction that hunger, malnutrition and poverty can be overcome in
the near future. Through the scaled up effort of the Provincial Nutrition Action Office,
there is indeed an assurance that malnutrition in the province can be countered.
Nutrition problems in the province are the results of numerous factors such as poverty,
political will, food shortage and its unavailability. Another concern is the geographical
issue among the mainland and island municipalities, unequal distribution of wealth,
Barangay Nutrition Scholars competency and prevailing micronutrient deficiency adds
more to the perceived problems. According to FAO (2010) other factors of
malnutrition includes:
Presence of incongruent ideologies and policies that govern the sector;
Problems in collaboration and coordination in nutrition among different
agencies involved
Limited evaluation of the effectiveness of nutrition intervention programs
Lack of timely nutrition data for use in planning effective programs.
1
World Health Organization Children: reducing mortality. Accessed from www. Who.org ON June 22,
2015.
2
2
The Economist (2008).Thestarvelings.Accessed from on June 23, 2015.
Page
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
In connection, this document theprovincial nutrition situation 2015 will give the
overall picture of Quezon Province in terms of nutrition. Compared to the last six
years, the nutrition situation in the province has been improving, lessening the
numbers of malnourished children. However, there are deviations with regards on the
data presented. For instance, while the provincial prevalence rate on malnutrition of
pre-school children drops, the prevalence on school-children increases. This factor
affects not only the education sector but the whole province as well. The data
presented herein are obtained from the collated reports from the:
Operation Timbang Plus in 2014 and the collected data from the
Department of education Division of Quezon.
3
Page
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
Some salient findings of the most recent OPT+ campaign conducted by the
Municipalities and compiled by the Provincial Nutrition Action Office includes the
following:
11.14 percent is the provincial prevalence rate for 2014 a minimal decrease of
0.2% from the previous year.
77 percent OPT coverage where identified all over the province lower than the
expected 88% turn out.
218, 595 out of 284,304 children were weighed during the OPT+ campaign
Stunting among pre-school children
The interpretations of data are based from the author’s perspective in managing
nutrition programs of the province. The data are presented in a format that is likely
easy to understood and interpreted. Relationships of data to identified literatures are
solely from the author without using statistical correlation. This cans serve as a useful
reference especially in determining provincial nutrition programs.
Approved:
ROBERTO D. GAJO
Contributors: Provincial Nutrition Officer
Allan B. Valencia RN
Nigel Imperial RN
District Nutrition Program Coordinators
4
Page
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
20
18 17.92
16
14
12.9 12.87
12 12.3
11.34 11.14
10
8
6
4
2
0
2009 2010 2011 2012 2013 2014
Figure 5SIX YEAR TREND OF PROVINCIAL PREVALENCE RATE ON UNDERNUTRITION OF PRE SCHOOL CHILDREN
The figure presented herein is the six year trend on the prevalence of under nutrition of
pre-school children ages 0-71 months. The last prevalence data in Quezon province
suggests that there have been a decrease since 2009. A decrease of 6.78% prevalence
have been seen or a fall of 37% from the baseline data. While progress has been made,
it is still insufficient leaving thousands of underweight children in the province.
Nonetheless, the decline in the prevalence rate is a substantial number compared to
other provinces in the Philippines. However, in the regional (CALABARZON) level,
Quezon has the highest prevalence rate among the 5 provinces. According to the FNRI
8th National Nutrition survey (2013), there is one in every 5 (19.9%) Filipino pre-
school children (ages 0-5) which are underweight for their age. In CALABARZON
the prevalence rate is 18.1% and in Quezon province its 25.4% topping the national
and regional levels.
Similarly, the reduction trend may be co-related to the outstanding nutrition programs
of the provincial government. One can see that a major dip in the trend have been
5
Page
identified between the years 2009 and 2010. As such, the administration of the recent
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
Overall, the prevalence of malnutrition declines significantly over the years. However
the rates remains in a high level compared to the national and regional levels.
3
Operation Timbang Plus results 2014
Page
4
2003 City and municipal level poverty estimates. National Statistics Coordination Board.
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
body size, low levels of energy and reductions in mental functioning, hunger can
Page
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
lead to even greatest poverty by reducing people’s ability to work and learn, thus
leading to even greater hunger5.
5
VictorIa CG, Adair L, Fall C, et al (2208) Maternal and child under nutrition: consequences for adult
health and human capital.Elesevier ltd. Accessed at ncbi.nlm.nih.gov on june 27, 2015.
6
National Statistics Coordination Board (2009).2003 City and municipal level poverty estimates. The
World Bank. Makati
8
7
Cadeline (2011).Quezon Province a Human Development Data accessed at nelcadelina.blogspot on
Page
are more likely to predispose to poor nutrition and health related problems than
children from food secure households8. Both date presented excludes the cities of
Lucena and Tayabas.
8
World Bank (2006).Repositioning Nutrition as central to development: A strategy for large Scale
9
The detailed table above present’s two different rankings of the municipalities
(excluding Cities of Lucena and Tayabas) from the Operation Timbang Plus results in
2014. The thirty-nine municipalities were ranked based on; (a) Highest number of
underweight and severely underweight pre-school children weighed and (b)
Municipalities with highest number of OPT coverage.
(A) The municipalities of San Francisco,Catanuan, Lopez, Sariaya and Calauag have
the highest number of underweight and severely underweight children with 1,602,
1,423, 1,364, 1,339 and 1,311 numbers respectively. On the contrary, the
municipality of Dolores with 233, Plaridel with 165, Sampaloc with 137,
Agdangan with 127 and Alabat with 76 got the lowest numbers of underweight
and severely underweight children. In total, there are 24,346pre-school children
across the province identified as underweight (UW) and severely underweight
(SUW).Moreover, for the three years, Quezon province have been keen in
10
addressing malnutrition problems thus as seen in the table below there have been a
Page
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
30,000
27,303
25,000 24,346
22,419
20,000
15,000
10,000
5,000
0
2012 2013 2014
Figure 6 TREND DATA ON NUMBER OF UNDERWEIGHT AND SEVERELY UNDERWEIGHT PRESCHOOL CHILDREN IN
QUEZON PROVINCE FROM 2012-2014
(B) The municipalities of San Francisco, Candelaria, Tiaong, Jomalig, Lopez are the
top fivemunicipalities with highest operation timbang plus (OPT) coverage with
103 percent, 102 percent, 98 percent and 93 percent. 16 out of 39 municipalities
achieved the required 80 percent needed coverage of the operation timbang plus.
23 municipalities fall short to the required percentage lead by General Nakar with
only 42% coverage. To our knowledge, the undersized coverage were based on
factors identified by the municipal nutrition action officers themselves during the
first quarter meeting of 2015 and these are as follows: 1. High expected coverage
from the Department of Health, 2. Low or no manpower (Barangay Nutrition
Scholars) to conduct the operation timbang plus campaign, 3. Old BNSs to
conduct and complete the task and 4. Geographically isolated areas that cannot be
easily reached. In addition, the province of Quezon has been consistent in not
11
achieving the required OPT+ coverage for the last years. As indicated in the
Page
following table:
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
100
89
80 79 78
73 73
66
60
40
20
0
2009 2010 2011 2012 2013 2014
Figure 7 TREND DATA ON THE OPT COVERAGE OF QUEZON PROVINCE FROM 2009-2014
300000
272877 279444
250000
236185
222544 218595
200000 198759
TOTAL PRE-SCHOOL
150000 POPULATION
TOTAL PRESCHOOL
WEIGHED
100000
50000
0
2012 2013 2014
Figure 8 COMPARATIVE DATA ON TOTAL PRESCHOOL POPULATION VS. PRE SCHOOL WEIGHED FROM 2012-
2014
The above data presents the comparative data on total pre-school population vs. the
12
weighed pre-school in the province in the three year period. In 2012 OPT campaign,
Page
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
there are 236, 185 children in the province in relation to 222,544 children weighed. As
such, there has been an identified gap between the target children to be weighed and
the actual children weighed. On the course of the next two years this has been
increasing as seen on the figure above.
100%
90% 65,708
80%
70%
60% Number of Unweighed
Preschool Children
50%
Number of Weighed Preschool
40% 218,595 Children
30%
20%
10%
0%
Based on the OPT result 2014 out of the 284,303 projected population to be weighed,
seventy-seven percent or 218,595 were actually weighed 65,708 were either
unweighed or no child have been weighed. Similarly, the reasons for this problem are
identified in the justification on table 2 section B.
13
Page
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
OVERWEIGHT, SEVERELY
UNDERWEIGHT,
4138 UNDERWEIGHT,
18354
5992
NORMAL , 190,111
The figure above represents the classification of 218,595 pre-school children ages 0-
71 months old which are actually weighed in 2014. 190, 111 or eighty-seven percent
are normal for their age, 18,354 or eight percent are underweight, 5,992 or three
percent are severely underweight and 4,138 or two percentage are overweight.
14
Page
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
Figure 7 DISTRIBUTIONS OF UNDERWEIGHT PRESCHOOL CHILDREN BY AGE GROUP AND GENDER IN 2014
The figure represents the distribution of underweight preschool children by age group
and gender in 2014. The variables used to determine the age group is based on the age
grouping in the Operation Timbang Plus form 2A (revised in February2012). It was
observed that under nutrition is high in the male gender than the female gender.
Moreover, the age group 60-71 months has the largest number of undernourished
children with 3,850. The age group with the least number is the age group 0-5 months
old with only 569 recorded children. According to the World Bank in 2012, globally,
girls are less likely to attend school, have secure jobs, or hold public office. But by
most measures, they have an advantage in one area: malnutrition.9 Better-nourished
girls are more likely to stay in school and to learn more. They will miss fewer days to
illness and be more attentive when in class. They will grow up to become more
15
9
The World Bank (2012).Child malnutrition: how did boys and girls fare in the past decade. Accessed at
Page
productive economically and more aware of the various livelihood options10. Thus as
seen in the figure above, more boys in the province of Quezon are underweight for
their age. Over all, there are 9,542 underweight boys fifteen percent larger compared
to 7,890 in girls.
Figure 8 DISTRIBUTIONS OF SEVERELY UNDERWEIGHT PRESCHOOL CHILDREN BY AGE GROUP AND GENDER FOR
2014
As indicated in the figure, there are more severely underweight male children than in
females. In total there are 3,205 severely underweight boys and 2,924 girls. However
in this case, the province of Quezon posed to have more severely underweight boys by
4.6 percent than girls. As reported, the age group 36-47 months has the highest
number of severely underweight children across the province this is due to the fact that
boys have slightly higher nutritional requirements related to their slightly higher
16
10
Ruth Oniang’o and Edith Mukudi (2002), "Nutrition and Gender.” In Nutrition: A Foundation for
Page
Development, Geneva:ACC/SCN.
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
average height and weight. If boys and girls were fed equally, more boys than girls
would become underweight because of their higher nutritional requirement (Ananta,
201311). However, based on other researches there is no disparity on gender as
evidence by various researches.
TOTAL NO. OF
TOTAL NO. OF
STUNTED & PREVALENCE
MUNICIPALITY CHILDREN
SEVERELY RATE
MEASURED
STUNTED
1 PATNANUNGAN 2272 1113 48.99%
2 BURDEOS 3481 1564 44.93%
3 SAN NARCISO 6405 2669 41.67%
4 PANUKULAN 1621 674 41.58%
5 PITOGO 2527 1041 41.20%
6 GEN. LUNA 2779 1136 40.88%
7 PLARIDEL 1165 445 38.20%
8 MACALELON 3025 1142 37.75%
9 QUEZON 1634 588 35.99%
10 JOMALIG 1114 400 35.91%
11 SAN ANDRES 4598 1608 34.97%
12 GUINAYANGAN 5037 1758 34.90%
13 GEN. NAKAR 1847 613 33.19%
14 PADRE BURGOS 2344 772 32.94%
15 POLILLO 3995 1277 31.96%
16 SAMPALOC 1236 388 31.39%
17 CALAUAG 9448 2960 31.33%
18 PEREZ 1766 551 31.20%
19 MAUBAN 7837 2401 30.64%
20 TAGKAWAYAN 5443 1652 30.35%
21 REAL 4660 1384 29.70%
22 LOPEZ 10734 3178 29.61%
23 UNISAN 2657 725 27.29%
24 LUCBAN 4571 1136 24.85%
25 ATIMONAN 6675 1599 23.96%
26 GUMACA 8252 1966 23.82%
27 PAGBILAO 8989 1906 21.20%
28 DOLORES 2711 542 19.99%
17
11
Ananta, Aris (2013) the Indonesian crisis: A human development perspective. Institute of south East
Page
The table presents the overall ranking of municipalities based on the stunting data of
Quezon province in 2014 from the OPT results conducted. The province posed at
24.68 percent of stunting which is highest in the region. 2 out of 10 pre-school
children measured are short for their age. As indicated in the FNRI data in 2013, 3 in
every Filipino 0-5 years old were short for their age. The national prevalence on
stunting is 30.3 percent while the CALABARZON region has 25.3 percent. Quezon
has the highest prevalence in the region lower than the national and regional stunting
rate. Moreover, as reported in the FNRI, 44.8% of stunted children belong to the
poorest quintile of society. Children with low height for age are stunted. This
condition is usually associated with long term chronic malnutrition and long term
factors such as frequent infection and poor feeding practices12 (UNICEF, 2000).
Moreover, Africa and Asia has more stunting rates in comparison to other regions of
the world and more than 90% of the worlds stunted children live in these continents
(UNICEF, 2009). As indicated in a study done in the Philippines by Rohner et al in
2013, among children from urban and predominantly poor and very poor households,
26% were stunted, 18% were underweight, and 5% were wasted. Forty-two percent
were anemic, 28% were iron deficient, and 3% were vitamin A deficient. Of the
18
12
United Nations International Children's Education Fund (UNICEF), Nutritional assessment in
Page
factors investigated, low socioeconomic status, use of cheaper cooking fuel, and
nonuse of multivitamins were all independently associated with stunting. The
prevalence of anemia, iron deficiency, and vitamin A deficiency were independently
associated with the same factors and poorer sanitation facilities, lower maternal
education, current unemployment, and inflation13.
SEVERELY
STUNTED, 16,667 TALL , 5,501
STUNTED, 27,627
NORMAL, 129,659
The figure represents the classification of all measured children ages 0-5 years old.
Out of 179, 454 measured children there are 129,659 or 72 percent children with
normal height for their age while 27,627 or 16 percent are stunted, 16,667 or 9 percent
are severely stunted while the remaining 5,501 or three percent are tall for their age.
According to Wolde (2014) the age of a child increase the likely hood of a child to be
stunted will be increased this might be due to the fact that stunting is a chronic
13
Rohner et al (2013) Infant and young child feeding practices in the urban Philippines and their
19
associations with stunting, anemia and deficiencies of iron and vitamin A. PubMed. Accessed on July
Page
Figure 10 DISTRIBUTIONS OF STUNTED PRESCHOOL CHILDREN BY AGE GROUP AND GENDER FOR 2014
The data presented in the figure is the stunting of pre-school children of the province
as distributed by age group and gender. There are more stunted boys than girls in this
data by 5.6 percent. The total number of stunted boys is 14,449 while the girls are
12,878. In total there are 27,327 stunted children ages 0-71 months in the province
14
Gavin, Mary (2012). Hunger and malnutrition accessed on July 25, 2015 at http:// kidshealth.org/
20
teen/food_fitness /nutrition/hunger.ht
Page
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
21
16
UNICEF. 2009. Tracking progress on child and maternal nutrition: A survival and development
Page
20.6
20.4 20.43
20.39
20.2
20
19.8
19.67
19.6
19.4
19.2
2012 -2013 2013-2014 2014-2015
Figure 11 THREE YEAR TREND OF PROVINCIAL PREVALENCE RATE ON WASTING OF SCHOOL CHILDREN
The above figure is the three year trend of wasting among school children in the
Division of Quezon. The captured information comes from the height-for-length data
of the Division of Quezon which excludes both the schools division of Lucena and
Tayabas. The prevalence of wasting and severely wasting in the identified school
children are high. Moreover, the data presented also comes from different school
levels from kinder to grade 6 with the inclusion of the SPED pupils. It is worth noting
that the data from the Department of Education has a variation from decreasing in
2012-2013 and major increase in wasting in 2014. From 20.43 percent in 2012 a
decrease of 0.76 percent has been noted. However a drastic increase in the prevalence
was seen at 0.72 percent in 2014. In addition, the figure indicates the number of
wasted and severely wasted children in the three year period. For 2012 there are
22
31,026 wasted and severely wasted identified school children, 50,767 in 2013 and
Page
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
37,931 in 2014. Moreover, it only suggests that the number of wasting are varies in a
three year period. The drastic increase calls for an extensive nutrition interventions in
school children. As indicated in a study in 2014, under-nutrition in the schoolchildren
has multiple factors; Low maternal education and household food insecurity status
were the independent factors for under-weight. Having large family size, inadequate
carbohydrate intake and household food insecurity status were independent predictors
for low BMI for age status. Having Trichuristrichura infection, living in a food
insecure household, poor maternal education and children aged 10-14 years were risk
factors for stunting.17 Moreover, it is imperative to know as indicate in the study of
Wolde, if severe malnutrition in infancy occurs in a context of a life history which is
generally favorable for intellectual development; an early acute episode of
malnutrition appears to have a negligible effect on intellectual function.
40000 36766
35000
30000
26375
25000 23190
20000
14001
15000
11556
10000 7836
4504
5000 2970 3152
0
2012-2013 2013-2014 2014-2015
17
Woldeet. Al (2014).Determinants of health, stunting and wasting among school children. Retrieved
23
Based on the figure above, a three year trend on nutritional status based on three
categories is presented. The academic year 2013-2014 has the highest number of
affected school children in all three categories in comparison to years 2012 and 2014
respectively. Although the prevalence rate on that particular year as seen in figure 12
has been low, the number of wasted and severely wasted children increased. The
possibility of this indifference may be determined as hidden hunger. As such, it is
related to Richardson’s (1976) study which indicates that hidden hunger malnutrition
is because of micronutrient deficiencies that contributes to poor growth and also
debilitates children’s immunity and cognitive development and predisposes them to
lower productivity and higher risk of degenerative diseases later in life18.
30000
27428
25000 23339
21052
20000
16825 16879
15000 14201
10000
5000
0
2012-2013 2013-2014 2014-2015
MALE FEMALE
Figure 13 COMPARATIVE DATA ON WASTING AND SEVERELY WASTING BY GENDER FROM 2012-2015
24
18
Ananta, Aris (2013) the Indonesian crisis: A human development perspective. Institute of South East
Page
The figure presented above is the comparison of wasting and severely wasting by
gender from 2012-2014. As presented in the figure there are more wasted and severely
wasted in boys than in girls in the three year period. The academic year 2013-2014
poses the highest number of wasting and severely wasting among the three
comparative years. Moreover, there have been no major implication on the gender and
wasting issues of school children as reviewed in the new literatures presented.
However, the wasting and severely wasting problem can be related to past
malnutrition experiences of an individual and the intelligence quotient as backed by
Richardson in 1976, he states that the difference in IQ between boys who did and did
not experience severe malnutrition in infancy varies under different conditions of
height and social background when those are held constant for both groups. Under the
most favorable conditions of being tall and having an advantageous social history the
average IQ of the malnourished boys is only 2 points lower than those not
malnourished. Under the most unfavorable conditions of short stature and a
disadvantageous social background the IQ of the malnourished boys is 9 points lower
than those not malnourished19.
19
Richardson (1976). The relation of severe malnutrition in infancy to the intelligence of School
25
children with differeing life histories.. International pediatrics research foundation inc. accessed on
Page
17426
45% Male
21516 Female
55%
Figure 14 DISTRIBUTION OF WASTED AND SEVERELY WASTED IN SCHOOL CHILDREN BY GENDER IN 2014
The figure above is the distribution of wasted and severely wasted school children by
gender in 2014. There were more wasted boys than girls. The figure shows that 55
percent or 21,516 of the total weighed children with wasting and severely wasting
incidence are male with while 45 percent or 17,426 are female. It is well documented
that boys are more likely to suffer from under nutrition than girls due to increased
nutritional needs in boys than in girls and/or influences of early childhood diseases in
boys20.
26
20
Sharma B, Mitra M, Chakrabarty S, Bharati P. Nutritional status of preschool children of Raj Gond―a
Page
SPED 25 14
As seen on both figures, there are more wasted and severely wasted in boys in both
categories. One can identify that there are more wasted and severely wasted in grades
1-3 or six to nine years old.
27
Page
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
SPED 56 37
200,000 186614
180,000
154,258 186009 TOTAL SCHOOL
160,000 152,316 CHILDREN POPULATION
140,000
151879 152410
120,000
TOTAL
100,000 SCHOOLCHILDREN
80,000 WEIGHED
60,000
40,000
20,000
0
2012 2013 2014
Figure 17 COMPARATIVE DATA ON TOTAL SCHOOL CHIDREN POPULATION VS. SCHOOL CHILDREN WEIGHED
FROM 2012-2014
28
Page
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
As seen on the comparative data above, there has been an increasing trend in the
number of school children enrolled for three years. Moreover, the total school children
weighed category has been consistent in not accomplishing weighing all the enrolled
school children. The average percentage population weighed is 99.71 percent
coverage in 2012, 98.80 percent coverage in 2013 and99.68 percent coverage in 2014.
unweighed , 605
actual weighed ,
186,009
Out of 186,614 total enrollees in 2014 there have been 186,009 school children
actually weighed. 605 of them were unweighed due to reasons such as: transferred to
other schools or dropped out.
29
Page
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
Wasted
27,169
Overweight
3,300
Normal
149,713
The figure presented above is the nutritional classification of school children weighed
in 2014. Out of 186,009 actual school children weighed, there are 78 percent or
149,713 normal for their weight and height, 14 percent or 27, 169 wasted, 6 percent
11,991 severely wasted and 2 percent or 3,300 overweight.
SUMMARY:
This document provides evidence that Quezon province is acute and nutritional
stressed based on the identified data. Overall, there is a high prevalence of wasting and
stunting across the province. Malnutrition is caused by different factors as presented
above. In Quezon province there is one threat that mainly affects the nutritional status
30
of our children – poverty. The present economic condition in the province further
Page
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures
aggravates the malnutrition problem with about 11% of Quezonian children. However
the declining trends in the presented data were noted for the past 5 years. Moreover,
there is a need to further enhance/ create researches that focuses on micronutrient
malnutrition. This will subsequently give us a complete picture on the micronutrient
deficiencies of Quezonian children.
31
Page