PART I: RESPONDING TO THE BASIC NEEDS

 

     Chapter 2. Nutrition

I. Summary

 

   Malnutrition among preschoolers and schoolchildren is prevalent in Bicol.  Food and dietary patterns as well as changing lifestyles result to certain nutritional problems.  In the Updated Bicol Development Plan 2008-2010, the objectives for nutrition are: (1) reduce hunger incidence and promote good nutrition in food-poor areas; (2) mitigate protein energy malnutrition, micronutrient deficiencies and over nutrition; (3) contribute to the incidence of low birth weight; and (4) contribute to the reduction by 30 percent the prevalence rate of lifestyle- related non-communicable diseases by 2010. 

 

   The strategic framework for nutrition addresses hunger at the supply side or the sufficiency of food and at the demand side or the ability to buy food.  On the supply side, measures are along producing more food and ensure efficient logistics and food delivery to whom and where it is needed.  On the demand side, measures are geared towards putting more money in poor people’s pocket, diversifying their diet and managing population levels.

 

   In 2008, progress in nutrition programs were made through the Accelerated Hunger Mitigation Program (AHMP) focused on addressing hunger to ensure good nutrition. Malnutrition among preschoolers and schoolchildren went down during the period 2007-2008. 

 

   However, the prevalence of malnutrition and micronutrient deficiencies is still alarming. Attention should be more focused on growing children because the state of nutrition is highly associated with cognitive development and schooling performance.  Adequate calorie intake should be provided as well as measures to prevent diseases such as diarrhea, measles, respiratory infections, intestinal parasitism and HIV infection.

II. Assessment

   In 2008, the protein and energy nutrition improved as the percentage of malnourished preschoolers declined from 19.71 percent in 2007 to 19.45 percent in 2008 (Table 2.1).  Among the provinces, the highest improvement was noted in Albay and lowest in Camarines Sur. Among the cities, Naga posted the highest improvement. 

   The highest percentages of malnourished preschoolers in 2008 were in Camarines Sur and Catanduanes. The lowest percentages were in Sorsogon  and Camarines Norte (Table 2.1).

   The adverse effects of the strong typhoons in 2006 on the economic activities and the high cost of living in 2008 exerted much pressure especially on food poor families. 

Table 2.1 1 Prevalence of Malnutrition Among Preschoolers,
Bicol Region, 2007-2008

                 Sources: :DOH-CHD 5

   There was little improvement in the nutritional status of schoolchildren from 30.6 percent malnourished in SY 2007-2008 to 30.3 percent in SY 2008-2009.  It was highest among the pre-elementary level students with boys being more malnourished than the girls.  Stunting was high, majority in the pre-elementary level, at 27.8 percent in SY 2007-2008 and 26.6 percent in SY 2008-2009. 

 

   No surveys were done for the region for micronutrient deficiency in 2008.  High prevalence though of anemia, Vitamin A deficiency and iron deficiency disorder in 2005 based on the Food and Nutrition Research Institute (FNRI) survey may still be dominant until 2008 in far-flung areas and in urban areas.

 

   The National Nutrition Council (NNC) and the local government units jointly implemented programs for nutrition under the Philippine Plan of Action for Nutrition (PPAN). The PPAN underscores the involvement of health, agriculture, food production, food processing and manufacturing sectors to ensure adequate supply of safe, nutritious and quality food products to the people.  The programs for nutrition were:  (1) home, school, and community food production; (2) livelihood assistance; (3) micronutrient supplementation; (4) food fortification; (5) nutrition education; (6) food assistance; (7) nutrition in essential maternal, and child health services; and (8) enabling mechanism.

 

   Home, school and community production.  Planting materials for food crops were distributed to 9,214 Grades 4 to 6 schoolchildren, 285,658 families with malnourished preschoolers and 6,044 families with malnourished schoolchildren.  Fruit and vegetable nurseries were also established. Twenty eight barangays were provided with water impounding projects.  Poultry and livestock were distributed to 1,372 families with malnourished children.

 

   Livelihood assistance. Financial assistance for livelihood were provided to 10,851 families with malnourished preschoolers and schoolchildren, 1,050 other families, 183 nutritionally depressed barangays and 1,681 rural improvement clubs.  Livelihood trainings were likewise provided to 256 families and 141 women’s groups/ farmers.

 

   Micronutrient supplementation.  Infants, schoolchildren, pregnant and lactating women and sick children were provided with Vitamin A, iodine, iron and other medicines and vitamins.  Vitamin A was given to1,642 infants, 22,660 preschoolers, 112,878 schoolchildren, and 8,315 pregnant and lactating mothers, among others. Iodine was provided to 400 schoolchildren and iron was given to 4,068 infants, 1,338 preschoolers, and 3,982 schoolchildren. Schoolchildren were given medicines and vitamins during emergencies.

 

   Food fortification. There were 2,222,477 households, 1,071 establishments, 173 schools and 246 eateries that used iodized salt.  The high number of utilization was due to the selling of iodized salt in sari-sari stores and markets. On the other hand, Sangkap Pinoy seal products were sold in 1,714 establishments and 171 schools and 2,251 sari-sari stores.

 

   Nutrition education. The activities on nutrition education were the conduct of nutrition classes for mothers, Pabasa sa Nutrisyon in 1,203 barangays, conduct of Buntis classes, and promotion of childrearing practices to 20,557 mothers/caregivers. Information campaign on breastfeeding, nutritional guidelines and nutrition messages were also intensified.

 

   Food assistance. Supplementary feeding was provided to preschoolers and schoolchildren, and 220 underweight malnourished pregnant and lactating mothers.  Emergency feeding operations were also undertaken for 23,178 families in crisis situations and 4,092 preschoolers.

 

   Nutrition in essential maternal and child health services.  Maternal and child health services in 2008 consisted of maternal pre-natal and post natal care, immunization of children, promotion of breastfeeding, deworming and provision of dental care and conduct or responsible parenting sessions.

 

   Enabling mechanism. To strengthen coordination and collaboration, various sectors provided trainings, meetings, and support to other nutrition programs.  Nutrition committees were reorganized, task forces for special projects were created.

 

   The special projects such as the AHMP had the following highlights of accomplishments in the region.

• Establishment of Gulayan sa Masa for 26,625 beneficiaries in Masbate, 37,061 in Camarines Norte and 53,400 in Camarines Sur

• Distribution of livestock to 2,070 clients in Camarines Norte, Masbate and Camarines Sur

• Rise subsidy to 10,443 beneficiaries  in Camarines Norte, 21,944 in Masbate and 61,402 in Camarines Sur\

• Operation of 749 Tindahan Natin outlets – Albay (101), Camarines Sur (175),Catanduanes (48),Masbate (300), and Sorsogon (125)

• Construction of 176.65 kms of road for 15,747 beneficiaries in Masbate,  Camarines Sur and Camarines Norte

• Provision of assistance to 222,251 clients released with P2.5M

• Jobs generation for micro finance and SEA-K totaled 118,405 with P2,448.97  million loan released

• Establishment of bagsakan centers in 6 barangays located in Iriga, Goa, and Camalig

• Distribution of rice bags to 44,621 schoolchildren in Masbate, 4,777 in Albay, 1,482 in Camarines Sur and 2,080 in Sorsogon

III. Prospects and Trends for 2009

 

   The Updated Philippine Plan of Action for Nutrition 2008-2010 has set the following directions: (1) contribute to reduction of disparities related to nutrition focused on population groups and areas; (2) increase investments in interventions that could impact more significantly on undernutrition through the promotion of breastfeeding, complementary feeding, supplementation of Vitamin A and zinc, and appropriate management of severe acute malnutrition; (3) revival, identification and adoption of good practices and models; and (4) scaling up in the implementation of  nutrition and related interventions.

 

   Priority actions shall be on the following:

1. Reduction of underweight preschoolers and schoolchildren through:

1. promotion of maternal care

2. infant and young child feeding

3. micronutrient supplementation

4. water supply and sanitation

5. deworming for children

2. Protection of nutritional status of women in disaster situations

3. Media watch on concerns of women and children

4. Reduction of proportion of households with inadequate caloric intake 

5. Reduction of micronutrient deficiencies

6. Promotion of healthy lifestyle to reduce health risk factors associated with non-communicable diseases

7. Strengthening of the AHMP with stronger link with nutrition

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