Among the Southeast Asian nations, the Philippines has the third highest rate of stunting among children.
According to recent data, 28.8 percent to 31 percent of children under 5 in the Philippines are stunted. In Southeast Asia, Indonesia has the highest rate of childhood stunting at 45.1 percent, followed by Timor-Leste at 28 percent.
These data are from a 2023 report issued by the Food and Agriculture Organization of the United Nations. Similar data are available from the United Nations Children’s Fund and the World Food Programme.
A decade ago, the rate hit 45 percent in BARMM – Bangsamoro Autonomous Region in Muslim Mindanao – due to conflict and limited healthcare, according to Save the Children, a global nongovernmental organization with offices in Quezon City.
The data and the rankings vary slightly depending on the source and the year of the data.
The Philippine government has implemented several programs to combat stunting, some with outside support from the World Bank, UNICEF and others. (See, for example, the Catanduanes Tribune, Sept. 23, 2024.)
A case in point is the Philippine Plan of Action for Nutrition, which aims to reduce stunting to 21 percent by the end of this year.
The word “stunted” is not merely another word for “short”. Stunting, the noun, is a medical term with a sound basis in child development research.
The technical definition of stunting is a child’s “height-for-age” being two standard deviations below the median of the World Health Organization’s Child Growth Standards.
It is reasonable to ask how the WHO arrived at these child growth standards. Is it possible, for example, that the standards are based on measurements of children from countries such as The Netherlands, where the average male height is nearly 184 centimeters?
Actually, the WHO draws its standards from a small but representative sample of nations – Brazil, Ghana, India, Norway, Oman, and the United States – to account for diverse ethnic backgrounds and reduce the influence of genetic factors.
Stunting is dreadful for two reasons: It is largely irreversible if it occurs within the first 1,000 days of life, from conception to the age of 2; and it is correlated with poor cognitive development.
Poor cognitive development can result in reduced school performance, lower economic productivity, and increased risk of chronic diseases later in life due to metabolic changes that occurred during childhood.
While stunted children may experience some catch-up growth later in life, full recovery is unlikely. Stunting, particularly during the first 1,000 days from conception to age 2, is basically irreversible.
However, childhood stunting can be attributed practically to a single cause – poor nutrition uptake – and that cause is easily remedied.
Admittedly, there are a few afflictions such as tapeworm that interfere with nutrition – but it is still the lack of nutrition that causes the stunting.
To prevent this problem, the first step a newly pregnant woman should take is to visit the local barangay nutrition scholar, or BNS. The BNS has specific training to advise expectant mothers on nutrition needs.
Presidential Decree 1569 mandates that there be a BNS in every barangay. According to the Philippine National Volunteer Service, there are 49,779 BNS volunteers deployed in 39,942 of the nation’s 42,046 barangays.
And Republic Act 11148, the Kalusugan at Nutrisyon ng Mag-Nanay Act, approved by both the House and the Senate in 2018, calls for maternal, neonatal and child health and nutrition interventions from conception to a child’s second birthday, especially in isolated and disadvantaged areas such as the BARMM.
Another measure, Senate Bill 2397, seeks to make the BNS role a mandatory professional post, but that bill has been languishing in the senate for more than a decade.
In the absence of a BNS, barangays are also mandated by law to provide barangay health workers, or BHWs, who also are qualified to provide nutrition advice to expectant mothers.
Nutritional interventions, especially high-protein diets and micronutrient supplementation, can accelerate growth during this critical period. Nutrition supplements are safe and inexpensive, and they may be provided free of charge by the local barangay health office.
Measurement of infants should be done lying down on a so-called “recumbent length board”, or recumbancy board. The measure should be done three times and the average calculated. As for timing, the WHO recommends measuring at birth, 6 weeks, and again at 3, 6, 9 and 12 months.
The WHO publishes standardized growth charts for children aged 0-5 years, available on their websites. There are separate charts for boys and girls, and they are available in several different formats.
Bryce McIntyre, PhD, resides in San Andres. He holds a doctoral degree from Stanford University, Palo Alto, California, USA.