Exploring High Rate Malnutrition among Children in a Selected Barangay in Silang, Cavite

by 6ISC Web Administrator | Oct 20, 2018 | Allied Health |

Jay Ann M. Gamelong
Adventist University of the Philippines
Jay Ann Morales-Gamelong is a nurse married to an architect with a 3-year-old son. She is a
fulltime mom and a student from Bacolod city, currently pursuing DrPH at the Adventist
University of the Philippines.
Abstract
Malnutrition remains a serious problem in the Philippines. The death rate of children below five
years old remains highest in the poorest sector of families in populated urban settings. Literature
has identified factors that influence malnutrition quantitatively in other countries; however, this
dilemma has not been identified in the Philippines qualitatively. This study explored the reasons
for malnutrition among children below five years old in Barangay Inchican, Silang, Cavite
anchored on the ecological approach and health belief model. This qualitative case study used
purposive sampling. Data were gathered through semi-structured interviews of three mothers
and three health workers. For triangulation, observation and document analysis were done.
Findings showed that factors influencing malnutrition in Barangay Inchican include children’s
poor health condition, poor access to affordable healthcare services, bigger family size and rising
population, lack of knowledge and education of mothers, negative behavior of mothers and weak
financial support from the government. Because of the need for appropriate intervention to curb
malnutrition, these findings may merit future sustainable programs to improve children’s
nutritional status in Barangay Inchican, Silang, Cavite. Further studies are needed to evaluate
malnutrition reduction programs implemented in the barangays of the Philippines.

http://web1.aup.edu.ph/6isc/exploring-high-rate-malnutrition-among-children-in-a-selected-barangay-
in-silang-cavite/
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Vital Health Indices and Nutrition Health

Service delivery in Cavite has evolved into dual delivery systems of public and private provision,
covering the entire range of health interventions with varying degrees of emphasis at different
health care levels. Hospitals are mainly classified as general or as DOH hospitals which provide
services for al l kinds of illnesses, diseases, injuries or deformities. It has emergency and
outpatient, services primary care services, family medicine, pediatrics, internal medicine,
obstetrics- gynecology, surgery including diagnostic and laboratory services, imaging facility and
pharmacy. These hospitals are further classified into the following: Level-1, Level-2, and Level-3
general services. Table 5.14 shows that the province of Cavite has 60 hospitals providing various
health services. About 78.33% (or 47) are privately owned and the rest 21.67% (or 13 hospitals)
are government-owned operated hospitals. These hospitals are also classified as Level 1, Level 2
and Level 3 hospitals. There are 44 Level -1 hospitals operating in the province. These Level-1
hospitals are those emergency hospitals that provide initial clinical care and management to
patients requiring immediate treatment as well as primary care on prevalent diseases in the
locality, which includes: isolation facilities, maternity, dental clinics, 1st level x-ray, secondary
clinical laboratory with consulting pathologist, blood station, and pharmacy. Fourteen (14)
hospitals are classified as Level-2 general hospitals. Health services in Level 2 category, include
Level-1 services and departmentalized clinical services, respiratory units, ICU, NICU and HRPU,
high risk pregnancy unit, tertiary clinical laboratory, and 2nd level x-ray. There are two (2) are
level-3 general hospitals in the province, the De La Salle University Medical Center in the City of
Dasmariñas and General Emilio Aguinaldo Memorial Hospital, a provincial-government hospital
which is located in Trece Martires City. Level-3 general hospitals include level 2 services and
teaching/training, physical medicine and rehabilitation, ambulatory surgery, dialysis, tertiary
laboratory, blood bank, and 3rd level x-ray. The government hospitals are funded out of the
provincial government’s budget while municipal/city hospitals are financed by the municipal/city
budgets. Management and financial parameters are determined primarily by the local chief
executive and, in varying level of influence and technical leadership of the respective
provincial/city/ municipal health officer or chief of hospital.

Vital Health Indices Vital health indices are the indicators that measure the total health condition
in a certain locality or area (Table 5.18). Crude birth rate is the ratio of live births per 1,000
population during a given period. For the year 2016, the crude birth rate in the province is 11.07
births per 1,000 total populations, compared to 12.03 per 1,000 total populations in 2015, which
recorded a decrease of 0.96 (7.98%) live birth rate level. Crude death rate (CDR) is the number of
deaths per 1,000 population during a given period. CDR slightly increased by 0.8% in 2016 (3.44%)
from 3.41% in 2015. This is the ratio of the number of deaths occurring within one year to the
mid-year population expressed per 1,000 populations. It is “crude” in the sense that all ages are
represented in the rate and does not take into account the variations in risks of dying at particular
ages. Infant Mortality Rate refers to the number of deaths among infants (below one-year) per
1,000 live births. The province’s infant mortality rate for the year 2016 increased by 1.2% from
the previous year’s rate of 10.94%. Maternal mortality rate includes deaths of women during
pregnancy, at childbirth or in the period after childbirth related to pregnancy and giving birth per
1,000 live births. There was an increase in the maternal mortality rate from 52.00 in 2015 to 54.91
in 2016. Having a physician, nurse or midwife who has formal training present during the birth
decreases the maternal mortality rate.
Operation Timbang Plus Operation Timbang Plus or OPT Plus is the annual weighing of pre-
schoolers below six years old (or 0 to 17 months) in all barangays in the province. The program,
spearheaded by the National Nutrition Council (NNC), aims to identify and locate malnourished
children for local nutritional planning. It also provides important information on the nutrition
situation of the population useful for nutrition program and policy formulation and important
nutrition information about a child for prevention or management of nutrition. It is done on every
first quarter of the year on the barangay level to identify and to make summary of master list of
priority beneficiaries for nutrition and nutrition-related services. This allows the barangay to
determine the magnitude and prevalence of malnutrition. Mostly done in the barangay health
centers, the weighing of the children is conducted by the Barangay Nutrition Scholars (BNS)
assisted by the barangay health workers and barangay officials. During the first quarter of 2016,
about 873,277 children ages 0-71 months old are targeted for OPT Plus, of which 63.03% or
550,466 have been subjected to weighing. From the 550,466 children weighed, 506,091 children
are categorized normal that results to a normal prevalence rate of 91.94%. Of the total 27,357
underweight children, 18,638 are considered as underweight while 8,719 are severely
underweight. In terms of underweight and severely underweight prevalence rate, the City of
Bacoor got the highest prevalence of 10.7% and 7.48%, respectively. The municipality of Tagaytay
City has the lowest rate of 0.94% and 0.03%, correspondingly.

https://cavite.gov.ph/home/wp-content/uploads/2018/01/13_SEPP2016_Chapter5_Social_Health.pdf
In the year 2000, Region 4 had an annual per capita poverty threshold of 13,414 and family
poverty incidence of 20.8%. Table 2 below shows the poverty rank of the 10 provinces in the
region. Among the 10 provinces, Laguna occupies the highest position while Palawan ranks
poorest in the region. Region 4A had a teacher- student ratio of 1:41 for public elementary and
1:48 for public secondary while Region 4B had a teacher-elementary student and teacher-
secondary student ratios of 1:36 and 1:30, respectively. (Regional and Social Economic Trends
Report 2004, NSCB).
Region 4-A and Region 4-B have comparable crude birth rate (CBR), crude death rate (CDR) and
infant mortality rate (IMR). The region has reached the target of the Department of Health of
an IMR less than 17 infant deaths for every 1000 livebirths, with Region 4-A and Region 4-B
having an IMR of only 9.18 and 11.84, respectively. However, Region 4-B has not reached the
desired level for Maternal Mortality Rate (MMR) whereas Region 4-B has achieved the target.
Looking at the provincial data, Quezon, Occidental Mindoro and Palawan, have an MMR of
120.07, 89.43 and 104.81, respectively, exceeding the desired level of less than 86.

http://nnc.gov.ph/downloads/category/86-region-4a-facts-and-
figures?download=1175:calabarzon-nutrition-situation-as-of-2018.
Malnutrition in the Philippines.
Ravenholt A. Am Univ Field Staff Rep Asia. 1982.
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Abstract
PIP:

In the Philippines poverty and pervasive malnutrition are not limited to families of
deprived seasonal workers. Undernourishment is endemic and increasing throughout
most of this archipelago of some 7100 islands, and is compounded by the prevalence of
intestinal parasites and gastrointestinal diseases which health workers estimate deprive
youngsters of at least 5-10% of the nutritional value in food they do consume. This
problem is particularly prevalent in rural villages and city slums where many people eat
with their fingers. According to the Philippine Ministry of Health, nearly 1/2 of all
reported deaths are among infants and children through age 4, and about 1/2 of the
accelerated death rate among those age 5 and younger is related to malnutrition,
compounded by diarrhea, measles, and malaria which is returning to areas where it
once was almost eradicated. 3 factors critically affect a newborn's survival prospects:
the family size he or she is born into; the time or spacing between the mother's
pregnancies; and the child's birth order. Evidence indicates that, during the 1970s, as
US aid and other family planning assistance became available, they were used most
among families in the 2 highest income classes, where reduction of family size is under
way. Poverty is the most fundamental cause of malnutrition, although many other
factors contribute. Land reform has brought security of tenure and increasingly is
transferring ownership of fields to former tenants of rice and corn lands. For the former
tenants enhanced security brings greater income and better eating for the farm families
retain more of the crop. The undernourished and truly poor of the Philippines number
about 1/2 of the population. Although dispersed throughout most of the archipelago,
there are important regional differences. These related to marked geographic patterns
that affect fertility of the soil, length of the dry season, fortunes of predominant crops,
vulnerability to destructive typhoons, chronic warfare and other endemic lawlessness,
major debilitating diseases, and especially population pressure. Malnutrition is not a
hidden problem. The government, almost since the proclamation of 1972 martial law,
has campaigned against malnutrition. During the 1970s, the government developed a
major program of expanded production with the result that rice production expanded
substantially. Even this achievement leaves the average Filipino short by 300 calories of
food intake per day. It is not jiggering with food aid or government price incentives that
will assure that future Filipinos will have enough to eat. Only a productive revolution of
rural life that also educates mothers to know what makes for sound family nutrition will
be adequate.
https://www.ncbi.nlm.nih.gov/m/pubmed/12264685/
The main reason of malnutrition is poverty because they don't have money to afford things
or foods that would make them healthy. To have a solution if you are at the right age you
should be able to apply family planning for a better future because when you plan things
are getting better.