Health Problem: Poor Nutritional Status among Children Under Five Years Old
"We are guilty of many errors and many faults, but our worst crime is abandoning the children, neglecting the foundation of life. Many of the things we need can wait. The child cannot. Right now is the time his bones are being formed, his blood is being made and his senses are being developed.
To him we cannot answer "Tomorrow". His name is "Today"."
-Gabriela Mistral, 1948
Our country’s future relies on the children of today. Good health is widely affected by how we value proper nutrition of children and considering it as an important priority, an issue that cannot be overlooked. Proper nutrition is a powerful determinant that affects society as a whole: people who are well nourished are more productive and able to learn. Good nutrition benefits families, their communities and the world. Undernutrition is, by the same logic, devastating. It blunts the intellect, saps the productivity of everyone it touches and perpetuates poverty. (UNICEF)
Malnutrition, defined as underweight, is a serious public-health problem that has been linked to a substantial increase in the risk of mortality and morbidity. Women and young children bear the brunt of the disease burden associated with malnutrition. In Barangay Delusom, a remote barangay located in Zamboanga peninsula, data shows that 24.49% of the children residing the area are malnourished. And knowing that malnutrition affects not only the personal, but also the social circumstances of the person affected, the data findings are indeed strikingly alarming.
Efforts to improve nutrition are some of the most effective forms of development aid. Breastfeeding can reduce rates of malnutrition and death in children. In young children, providing complementary food (in addition to breastmilk) between six months and two years of age improves outcomes. There is also good evidence supporting the supplementation of a number of micronutrients to women during pregnancy and among young children in the developing world. To get food to people who need it most, both delivering food and providing money so people can buy food within local markets are effective based on evidences. Simply feeding students at schools is insufficient. Management of severe malnutrition within the person's home with ready-to-use therapeutic foods is possible much of the time. Longer-term measures include: improving agricultural practices, reducing poverty, improving health literacy, improving sanitation, and the empowerment of women. These principles are our foundation for our comprehensive plan to combat malnutrition.
Combating malnutrition is never easy. But we are glad that, through the years, we were able to achieve an enormous decline in the number of underweight children – from 24.49% to 9.68%. And as we end our four-year community exposure, we hope that the people of barangay Delusom will continue to be empowered and self-reliant.
Malnutrition is a difficult endeavor. It affects the whole world; but it is most prominently seen in third-world countries; unsurprisingly, Philippines is vulnerable to this social catastrophe.
In 2013, based on the joint UNICEF-WHO-World Bank Database on Child Malnutrition, approximately 33.6% of the Filipino children aged 0-5 years old are stunted, 20.2% are underweight, while 6.9% are considered wasted. Within the Philippines, Bicol Region (Region V) tops the list with the most underweight children with 33.8%. The Zamboanga Peninsula (Region IX) and MIMAROPA Region (Region IV-B), on the other hand, come in as second and third with 33.3% and 33.1%, respectively.
In addition, according to the 7th National Nutrition Survey conducted by the FNRI last 2008, the Zamboanga Peninsula, which is composed of Zamboanga del Norte, Zamboanga Sibugay, and Zamboanga del Sur, was noted to have an underweight percentage of 35.5%, 41%, and 28.6% respectively.
Within the region, Barangay Delusom, which is situated in the municipality of Mahayag Zamboanga del Sur, is just one of the barangays afflicted with a rising number of malnourished children. Through our surveys held last September 2013, it was noted that the malnourished children present within the barangay was at 42%. And during one of our barangay assemblies, where in the residents of Delusom presented a number of perceived problems within the community, malnutrition was one of the problems that notably needed an action. Thus a community health plan was created.
The first action of the team, prior to starting any implementation, is of course to present the problem and the strategies to alleviate such problem to the Barangay Council and the Community Health Team, during the monthly Barangay session at the Barangay Hall. Through this, we were not only able to inform the Council of our plans, but was also able to gather aid, may it be monetary, supplies, or manpower.
Our team believes that change comes through education. People are enthusiastic to do things when they have a background on it, rather than acting out alone. Thus, we focused on educating the people who can greatly influence the status of the malnourished children – mothers of the malnourished children, pregnant women, and the community health team.
Lectures on the importance and benefits of prenatal, immunization, and breastfeeding were given to expectant mothers during the monthly prenatal and immunization schedule at the barangay health station. Through this, we were able to educate expectant mothers that malnutrition does not begin after birth. Instead, it begins during the formative months of the child – that is, during the perinatal period. Eating right, taking supplements, having immunizations, and advocating breastfeeding was the highlight of this lecture. This is to ensure that both the mother and the child are healthy throughout the duration of pregnancy and after delivery.
Moreover, we also held a seminar, headed by Ms. Maria Dolores Paredes, a registered nutritionist, who is currently working at Zamboanga City Medical Medical Center (ZCMC). This seminar was attended by the Community Health Team, which was headed by the Barangay Health Nutritionist. Through this program, we were able to equip the members of the team, the basic knowledge on what malnutrition is, its effects, and how they can combat it. With these knowledge, they can impart information that is vital in reducing the incidence of malnutrition within the barangay. Also, during this program, it was emphasized that meals don’t need to be extravagant for it to be nutritious. Several recipes with readily available ingredients were given to the members, which was used during their lectures and subsequent feeding programs.
“Even with the simple vegetables found in our own backyards, if used well, a meal could be nutritious enough.”-Ma. Dolores Paredes.
Malnutrition is an umbrella term, and it has many types. Being thin or short is not the only measure of malnutrition. And when a child is malnourished, it does not mean that it is already a hopeless case. There is always something that we can do. This is what we wanted mothers to understand. Thus, to further extend our information dissemination, we held a Purok-to-Purok Lecture Campaign using the DOH flipchart on macro- and micronutrient deficiency, breastfeeding, and NNC flyers on Pinggang Pinoy and 10 Kumain-ments. This program is particularly made for mothers of children aged 0-12 years old.
Aside from these, daycare, pre-school, and elementary school children were also educated through a puppet show, which focused on proper hygiene, most especially hand washing and oral hygiene. Having good hygiene is the simplest way to combat diseases leading to a decreased risk of acquiring infection. In addition, to promote its practice and make it a habit, we incorporated the DOH jingle on hand washing during the demonstration of the steps in proper hand washing; and we also distributed hygiene kits to the kids.
The Philippines has many programs to help alleviate the problem on malnutrition, and one of these is the school-based deworming and vitamin A supplementation. As shown in the national news, a number of students allegedly got sick after receiving deworming tablets. This then led a number of mothers to prohibit their children from receiving any medications. To provide assistance to the school and Rural Health Unit (RHU), we started an extensive campaign on deworming and vitamin A supplementation. Parents were gathered during a PTA meeting, and lectures with open forum were conducted. This was aimed to give them an avenue to voice out their concerns, worries, and clear out any misconceptions or misunderstanding regarding the medications of the program.
Aside from education, feeding is also vital in resolving malnutrition. Promotion of healthy food is of utmost importance in order to maintain a healthy community. Thus, to support this endeavor against malnutrition, feeding programs were conducted in coordination with the BNS. First, feeding sessions were done during FDS. All mothers, together with their malnourished children, were encouraged to attend. However, only a few were able to attend. Thus, the group decided to do house-to-house feeding, where in the undernourished children were tracked down, and were given healthy meals in the span of 3 days.
Though feeding is important, it is a very costly program, because, to remove the child from his or her malnourished status, feeding must be done every day for at least 3 months. And due to the limited budget allotted by the barangay, feedings are then rarely done. Thus, communal gardens were established. The crops from these gardens were used in feeding programs and were given to families with malnourished children. With the assistance of Mr. Antipas Colcol, Agricultural Municipal Officer, seedlings for the crops on the communal gardens were distributed. Through this program, we will not only lessen the cost of feeding, but we will also empower the community and the families with malnourished children to use the resources available in the community. These enabled them to become innovative and self-reliant.
Lastly, PABASA, a program from the National Nutritional Council, wherein using a nutritional and educational approach, incorporated with fun learning activities, is promoted. Through this, better comprehension of the topics being discussed is enhanced. Furthermore, it also aims to empower the caregivers so that they can reduce their family’s vulnerability to malnutrition.
This was done to, again, educate mothers, and this time assess their understanding. The lecture was conducted by the BNS, followed by a series of games, which was headed by the other members of the Community Health Team. Fortunately, all mothers were present during the event.
Malnutrition is indeed a tough problem, but it is not impossible to solve. With proper education, and proper attitude and practices towards it, the dream of having health children is not too far ahead.
"We are guilty of many errors and many faults, but our worst crime is abandoning the children, neglecting the foundation of life. Many of the things we need can wait. The child cannot. Right now is the time his bones are being formed, his blood is being made and his senses are being developed.
To him we cannot answer "Tomorrow". His name is "Today"."
-Gabriela Mistral, 1948
Our country’s future relies on the children of today. Good health is widely affected by how we value proper nutrition of children and considering it as an important priority, an issue that cannot be overlooked. Proper nutrition is a powerful determinant that affects society as a whole: people who are well nourished are more productive and able to learn. Good nutrition benefits families, their communities and the world. Undernutrition is, by the same logic, devastating. It blunts the intellect, saps the productivity of everyone it touches and perpetuates poverty. (UNICEF)
Malnutrition, defined as underweight, is a serious public-health problem that has been linked to a substantial increase in the risk of mortality and morbidity. Women and young children bear the brunt of the disease burden associated with malnutrition. In Barangay Delusom, a remote barangay located in Zamboanga peninsula, data shows that 24.49% of the children residing the area are malnourished. And knowing that malnutrition affects not only the personal, but also the social circumstances of the person affected, the data findings are indeed strikingly alarming.
Efforts to improve nutrition are some of the most effective forms of development aid. Breastfeeding can reduce rates of malnutrition and death in children. In young children, providing complementary food (in addition to breastmilk) between six months and two years of age improves outcomes. There is also good evidence supporting the supplementation of a number of micronutrients to women during pregnancy and among young children in the developing world. To get food to people who need it most, both delivering food and providing money so people can buy food within local markets are effective based on evidences. Simply feeding students at schools is insufficient. Management of severe malnutrition within the person's home with ready-to-use therapeutic foods is possible much of the time. Longer-term measures include: improving agricultural practices, reducing poverty, improving health literacy, improving sanitation, and the empowerment of women. These principles are our foundation for our comprehensive plan to combat malnutrition.
Combating malnutrition is never easy. But we are glad that, through the years, we were able to achieve an enormous decline in the number of underweight children – from 24.49% to 9.68%. And as we end our four-year community exposure, we hope that the people of barangay Delusom will continue to be empowered and self-reliant.
Malnutrition is a difficult endeavor. It affects the whole world; but it is most prominently seen in third-world countries; unsurprisingly, Philippines is vulnerable to this social catastrophe.
In 2013, based on the joint UNICEF-WHO-World Bank Database on Child Malnutrition, approximately 33.6% of the Filipino children aged 0-5 years old are stunted, 20.2% are underweight, while 6.9% are considered wasted. Within the Philippines, Bicol Region (Region V) tops the list with the most underweight children with 33.8%. The Zamboanga Peninsula (Region IX) and MIMAROPA Region (Region IV-B), on the other hand, come in as second and third with 33.3% and 33.1%, respectively.
In addition, according to the 7th National Nutrition Survey conducted by the FNRI last 2008, the Zamboanga Peninsula, which is composed of Zamboanga del Norte, Zamboanga Sibugay, and Zamboanga del Sur, was noted to have an underweight percentage of 35.5%, 41%, and 28.6% respectively.
Within the region, Barangay Delusom, which is situated in the municipality of Mahayag Zamboanga del Sur, is just one of the barangays afflicted with a rising number of malnourished children. Through our surveys held last September 2013, it was noted that the malnourished children present within the barangay was at 42%. And during one of our barangay assemblies, where in the residents of Delusom presented a number of perceived problems within the community, malnutrition was one of the problems that notably needed an action. Thus a community health plan was created.
The first action of the team, prior to starting any implementation, is of course to present the problem and the strategies to alleviate such problem to the Barangay Council and the Community Health Team, during the monthly Barangay session at the Barangay Hall. Through this, we were not only able to inform the Council of our plans, but was also able to gather aid, may it be monetary, supplies, or manpower.
Our team believes that change comes through education. People are enthusiastic to do things when they have a background on it, rather than acting out alone. Thus, we focused on educating the people who can greatly influence the status of the malnourished children – mothers of the malnourished children, pregnant women, and the community health team.
Lectures on the importance and benefits of prenatal, immunization, and breastfeeding were given to expectant mothers during the monthly prenatal and immunization schedule at the barangay health station. Through this, we were able to educate expectant mothers that malnutrition does not begin after birth. Instead, it begins during the formative months of the child – that is, during the perinatal period. Eating right, taking supplements, having immunizations, and advocating breastfeeding was the highlight of this lecture. This is to ensure that both the mother and the child are healthy throughout the duration of pregnancy and after delivery.
Moreover, we also held a seminar, headed by Ms. Maria Dolores Paredes, a registered nutritionist, who is currently working at Zamboanga City Medical Medical Center (ZCMC). This seminar was attended by the Community Health Team, which was headed by the Barangay Health Nutritionist. Through this program, we were able to equip the members of the team, the basic knowledge on what malnutrition is, its effects, and how they can combat it. With these knowledge, they can impart information that is vital in reducing the incidence of malnutrition within the barangay. Also, during this program, it was emphasized that meals don’t need to be extravagant for it to be nutritious. Several recipes with readily available ingredients were given to the members, which was used during their lectures and subsequent feeding programs.
“Even with the simple vegetables found in our own backyards, if used well, a meal could be nutritious enough.”-Ma. Dolores Paredes.
Malnutrition is an umbrella term, and it has many types. Being thin or short is not the only measure of malnutrition. And when a child is malnourished, it does not mean that it is already a hopeless case. There is always something that we can do. This is what we wanted mothers to understand. Thus, to further extend our information dissemination, we held a Purok-to-Purok Lecture Campaign using the DOH flipchart on macro- and micronutrient deficiency, breastfeeding, and NNC flyers on Pinggang Pinoy and 10 Kumain-ments. This program is particularly made for mothers of children aged 0-12 years old.
Aside from these, daycare, pre-school, and elementary school children were also educated through a puppet show, which focused on proper hygiene, most especially hand washing and oral hygiene. Having good hygiene is the simplest way to combat diseases leading to a decreased risk of acquiring infection. In addition, to promote its practice and make it a habit, we incorporated the DOH jingle on hand washing during the demonstration of the steps in proper hand washing; and we also distributed hygiene kits to the kids.
The Philippines has many programs to help alleviate the problem on malnutrition, and one of these is the school-based deworming and vitamin A supplementation. As shown in the national news, a number of students allegedly got sick after receiving deworming tablets. This then led a number of mothers to prohibit their children from receiving any medications. To provide assistance to the school and Rural Health Unit (RHU), we started an extensive campaign on deworming and vitamin A supplementation. Parents were gathered during a PTA meeting, and lectures with open forum were conducted. This was aimed to give them an avenue to voice out their concerns, worries, and clear out any misconceptions or misunderstanding regarding the medications of the program.
Aside from education, feeding is also vital in resolving malnutrition. Promotion of healthy food is of utmost importance in order to maintain a healthy community. Thus, to support this endeavor against malnutrition, feeding programs were conducted in coordination with the BNS. First, feeding sessions were done during FDS. All mothers, together with their malnourished children, were encouraged to attend. However, only a few were able to attend. Thus, the group decided to do house-to-house feeding, where in the undernourished children were tracked down, and were given healthy meals in the span of 3 days.
Though feeding is important, it is a very costly program, because, to remove the child from his or her malnourished status, feeding must be done every day for at least 3 months. And due to the limited budget allotted by the barangay, feedings are then rarely done. Thus, communal gardens were established. The crops from these gardens were used in feeding programs and were given to families with malnourished children. With the assistance of Mr. Antipas Colcol, Agricultural Municipal Officer, seedlings for the crops on the communal gardens were distributed. Through this program, we will not only lessen the cost of feeding, but we will also empower the community and the families with malnourished children to use the resources available in the community. These enabled them to become innovative and self-reliant.
Lastly, PABASA, a program from the National Nutritional Council, wherein using a nutritional and educational approach, incorporated with fun learning activities, is promoted. Through this, better comprehension of the topics being discussed is enhanced. Furthermore, it also aims to empower the caregivers so that they can reduce their family’s vulnerability to malnutrition.
This was done to, again, educate mothers, and this time assess their understanding. The lecture was conducted by the BNS, followed by a series of games, which was headed by the other members of the Community Health Team. Fortunately, all mothers were present during the event.
Malnutrition is indeed a tough problem, but it is not impossible to solve. With proper education, and proper attitude and practices towards it, the dream of having health children is not too far ahead.