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On its continuous pursuit to address hunger and malnutrition in Central Luzon, the National Nutrition Council Region III (NNC-Region III) held the first of its webinar series which focuses on the WHY – reasons WHY there is a need to focus on addressing the malnutrition problem in Central Luzon – last 3 May 2021.

With the objective of providing the nutrition community and stakeholders in Central Luzon with the current information on the nutrition situation in the region while simultaneously intensifying and mobilizing integrated actions of regional line agencies, nongovernment agencies, local government units (LGUs), and communities to implement suitable assortment of programs under the Philippine Plan of Action for Nutrition (PPAN), 2017-2022.

With topics ranging from updates on the food security in the country and in the region up to analysis of childhood overweight and obesity, the 4-hour webinar was able to disseminate updates and provide reasons on why there is a need and focus on addressing hunger and malnutrition in the region. More than a hundred individuals coming from different LGUs of Central Luzon, members of the regional line agencies, stakeholders, nutrition federated groups, media partners, and various nutrition workers from the grassroots-levels up to the national level attended the webinar.

The webinar started with an opening remarks delivered by the chairperson of the Central Luzon’s Regional Nutrition Committee (RNC), Dr. Corazon I. Flores where she warmly welcomed the presence of all the participants and speakers and expressed her utmost support to the vision and mandate of NNC-Region III. RD Flores urged everyone to cooperate and to unite RNC member-agencies to implement programs that are aligned with the PPAN, 2017-2022.

Cabinet Secretary Karlo Alexei B. Nograles, Chair of the Inter-agency Task Force (IATF) on Zero Hunger and Enhanced Partnership against Hunger and Poverty (EPAHP) was Keynote Speaker of the Webinar. He advocated for the implementation of National Food Policy and programs identified under the IATF on Zero Hunger and EPAHP which are all aimed at addressing hunger and malnutrition in the country. He also highlighted the need for the government agencies, stakeholders, non-government organizations (NGOs), and the private sector to continue working together to holistically solve the multi-faceted nature of malnutrition.

Ms. Cristine G. Malabad, Senior Science Research Specialist of the Food and Nutrition Research Institute of the Department of Science and Technology (FNRI-DOST) shared The State of Philippine Food and Nutrition Security Before and During Pandemic. Ms. Malabad presented the magnitude of undernutrition and the lingering problem of micronutrient deficiency among children under-five years of age.  

As the data presented were from the National Nutrition Surveys (NNS), Ms. Malabad briefly discussed the mechanics and objectives of the NNS. She also mentioned four (4) important windows of opportunities to accelerate the reduction of undernutrition in the country which includes: 1) proper and safe infant feeding practices; 2) food and nutrient intake; 3) maternal nutrition; and 4) household food security.

For the nutrition situation in Central Luzon, only the provinces of Bulacan, Zambales, Pampanga, Nueva Ecija and the two (2) highly-urbanized cities (HUCs) of Central Luzon, namely Angeles City and Olongapo City were covered by the rolling surveys in 2018 and 2019 due to COVID-19 pandemic. Data collected from these LGUs served as the representation of the nutritional status of the region.

Ms. Malabad highlighted that 62.1% of the surveyed households or about 2 out of 3 households experienced moderate or severe food insecurity during the pandemic, which is an increase of about 22% from the previously recorded 40.2% food security prevalence in the region in 2019 prior to the pandemic. This is in comparison with the food security status of the national which had better estimates with more than half of the households were food secure.

The survey revealed that the nutritional status of preschool-age children in the country has improved (as indicated by the downward trends) prior to the pandemic, but is considered too slow to meet development goals. Meanwhile, the prevalence of underweight and stunting were relatively better, particularly in the province of Bulacan and in Angeles City than that of the national. It was also noted that overweight and obesity were significantly lower in Zambales and Olongapo City but higher in the province of Pampanga as compared to the national estimate.

For the breastfeeding practices, it was found that all six (6) areas that were covered in the survey reported to have poor breastfeeding practices, with low adherence to the Infant and Young Child Feeding (IYCF) guidelines and low proportion of meeting Minimum Dietary Diversification and Minimum Adequate Diet indicating poor quality of intake. Recommendations cited were to strengthen promotion of exclusive breastfeeding until six months of age and giving of appropriate complementary feeding at six months while continuing breastfeeding up to two years, encourage milk intake throughout childhood, increase household consumption of fruits and vegetables, ensure adequate maternal nutrition, and lastly increase frequency of distribution of vitamin A, especially in high-risk areas, as well as sustainable iron supplementation/distribution of supplements.

Dr. Cecilia Acuin, consultant from the United Nations Children's Fund (UNICEF) Philippines presented the Survey on Nutrition Service Disruption and Adaptation in the Health System. Data from this survey was collected online from 28 December 2020-28 February 2021 and focused on the provision of the nutrition services by the LGUs. Before diving right into the survey results, Dr. Acuin first discussed the COVID-19 situation and background in the country and in the region. This was very important as the recorded COVID-19 background and trends were needed to understand the impact of COVID-19 on the provision and utilization of the routine nutrition services through the health system.  Dr. Acuin then proceeded to explain the five (5) survey components which included: 1) BNS capacity; 2) nutrition services offered before and during COVID-19; 3) nutrition services adaptation; 4) nutrition information, education, and communication; and 5) food and starter packs, but also mentioned that she would only focus on the discussion of the BNS capacity, nutrition services offered, and food and started packs component of the survey.

Dr. Acuin highlighted the training profile of the BNSs of Central Luzon with training in measuring Mid-Upper Arm Circumference (MUAC) garnering the highest percentage for majority of the seven provinces in the region. The training on Infant and Young Child Feeding (IYCF) placed second for all provinces, except for Bataan Province as it top the list in providing IYCF training to health and nutrition workers, followed by the training on the Philippine Integrated Management of Acute Malnutrition (PIMAM), and training on Nutrition in Emergencies (NiE). The training on NiEm was the least among the trainings provided and was the weakest area of the BNSs as only a few were trained per province or none at all.

For the continuity of nutrition services being provided during the COVID-19, it has been found that majority of the provinces in Central Luzon continuously provided nutrition services such as micronutrient supplementation, IYCF counseling, child growth monitoring, diet supplementation, among others, even with the ongoing pandemic with the exception of the province of Aurora as only five (5) out of the 14 of the nutrition services were continued, despite the fact that Aurora had a relatively higher BNS to population ratio compared to the other provinces. Despite these low results for Aurora, Dr. Acuin mentioned that their low coverage may have been due to the fact that movement in the province was more restricted to keep their COVID-19 rates relatively low compared to the rest of the provinces in Central Luzon.

To quote Dr. Acuin’s concluding statement “COVID-19 pandemic brought in illness and death which resulted to movement restrictions and imposition of lockdowns and quarantines by the government which the affected and disrupted the economy, food supply, service delivery, and support systems, thereby ultimately resulting into food insecurity, poorer nutrition, more illnesses, and death.”

Landscape Analysis of Childhood Overweight and Obesity in the Philippines: Implications for Policies and Programs was the third topic for the webinar which was presented by Dr. Mary Christine Castro, Executive Director of the Nutrition Center of the Philippines (NCP). Discussions focused on 1) overweight among children in the region; 2) extent of childhood overweight in the Philippines; 3) risks factors for overweight and obesity in children; 4) risks factors for overweight and obesity in later childhood; and 5) systems and obesogenic environments in the Philippines.

The landscape analysis also identified the following gaps: 1) lack of written national government policy specific for childhood overweight and obesity; 2) the limited visible support from the national government for action on childhood obesity; 3) no care package for childhood overweight and obesity; 4) limited implementation of and support to the Food-Based Dietary Guidelines; 5) limited regulation of marketing of high-fat-salt-sugar (HFSS) food products to children; 6) data on enforcement of related policies such as the Philippine Milk Code are also not publicly accessible; 7) limited funding for research on childhood obesity prevention and management; 8) and no available monitoring reports on Health Impact Assessments, among many others.

Recommendations that was cited was the development of a framework for action which includes overarching actions (whole-of-society approach), and interconnected actions relevant to the health systems, education system, active society, environment, and people.

Dr. Marivic S. Samson, Nutrition Officer III and OIC of the Nutrition Policy and Planning Division NPPD) of the National Nutrition Council discussed the Philippine Multi-Sectoral Nutrition Project (PMNP). The PMNP which is a joint project between NNC and the Department of Social Welfare and Development (DSWD), with the collaborative efforts from the Department of Health (DOH), Department of the Interior and Local Government (DILG), Department of Agriculture (DA), and Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), is targeted to run for four (4) years starting in January of 2022. The project aims to increase the utilization of a package of nutrition-specific and nutrition-sensitive interventions and improve key health behaviors known to reduce stunting in targeted regions. The target sites include 12 regions, 26 provinces, 235 municipalities, 5,936 barangays, and an additional 40 municipalities in the Bangsamoro Autonomous Region in Muslim Mindanao. One municipality of Nueva Ecija was identified as one of the PMNP target areas and is the only target area in Central Luzon. The first year of implementation will focus on the preparation and capacity building for implementers, with the next two years serving as the roll-out for the program, and the last year being the year where consolidation of all sustainability initiatives and mechanisms for the project will be done, including policy advocacy with the local government level.

After all the presentations, the NNC-Region III Nutrition Program Coordinator, Ms. Ana Maria B. Rosaldo wrapped up the webinar by presenting her ways forwards to motivate the participants to step up and take actions in their respective LGUs and/or organizations. She recommended to convene the Regional Nutrition Committee (RNC), reactivate the Regional Nutrition Cluster and the Regional Bantay-Asin Task Force (RBATF), at the regional level while LGUs were encouraged to convene, activate, and re-activate their respective Local Nutrition Committees. Ms. Rosaldo advocated to the participants to engage other partners to intensify and mobilize integrated action to implement mix of programs under the Philippine Plan of Action for Nutrition 2017-2022.

The conclusion of the webinar served as a start of the series of webinars that will answer the questions WHO, WHAT, and HOW hunger and malnutrition can be addressed in Central Luzon.

Author: Antonette Gail D. Garcia, 
Nutrition Officer I