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Good nutrition in the first 1,000 days can prevent stunting

By MYLENE MENDOZA-DAYRIT, The Philippine STAR Published Jul 14, 2020 10:42 am

Mother’s milk is best: Stunting begins when the baby is inside the mother’s womb. After birth, there appears to be a pattern of growth faltering until the age of two.

One in every three Filipino pre-schoolchildren is stunted. And while many will say that Filipinos are short genetically, the National Nutrition Council (NNC) informs the public that stunting can be prevented. And so for this year’s Nutrition Month (July) they adopted the theme “Batang Pinoy, SanaAll... Iwas Stunting, Sana All! Iwas All din sa CoVID-19!”

NNC has released information materials loaded with data, discussion points and action plans. In the report, they revealed that globally one out of every five children are stunted. The rate that was 32.6 percent in 2000 fell to 22.2 percent in 2017. While the Philippines improved from 44.7 percent in 1987 to 33.8 percent in 2003, NNC laments that despite the economic growth and increased health budget, stunting remained at 30 to 33 percent in the last 15 years.

They cite other low- to middle-income countries like Mongolia, Ghana, Cote D’Ivoire, Peru and Bolivia, that remarkably reduced their percentage of stunted children. Peru, for instance, reduced their percentage from 22.9 percent in 2005 to 17.9 percent in 2010. The report claims that this reduction is due to “high-level political commitment, integration of nutrition into social protection strategies and an effective behavior change strategy that increased awareness of parents about the impact of undernutrition.”

NNC emphasizes that stunting begins when the baby is inside the mother’s womb. “After birth, there appears to be a pattern of growth faltering until the age of two. There is little catch-up growth between two to five years of age. This implies that interventions must be done at the age when linear growth is most responsive, that is in the First 1,000 Days or the period from conception until children reach their second birthday,” NNC noted.

Malnutrition is identified as the main reason for stunting in the country. Poor dietary intake, lack of physical activity and disease are specified as immediate causes. Household food security, health services, environmental quality and care are considered as underlying factors.  Just last month, the World Bank released a study on the drivers of stunting in the Philippines based on the 2015 National Nutrition Survey. 

“What appears to be the drivers of stunting based on the detailed analysis are affected by factors before birth and factors after birth. Stunting is likely to happen with poor maternal health and nutrition, which is likely to result in low birth-weight babies and small for gestational-age baby. The risk is higher with adolescent pregnancy, which is increasing in the country. After birth factors include poor dietary diversity of children that is driven by both feeding practices and high prices of nutrition foods. Low consumption of meat, eggs and milk is associated with high levels of stunting. Most of stunted children belong to families that are moderately or severely food insecure, which would explain the poor diet diversity. Infants who do not have access to clean drinking water and during the first six months are raised by single mothers have higher risk of stunting,” NNC highlights from the World Bank report.

The Philippine Plan of Action for Nutrition (PPAN) 2017-2022, which provides the overall framework to address malnutrition including stunting and its underlying factors, aims to lower the stunting percentage of the Philippines to 20 percent. “One of the strategic thrusts of PPAN 2017-2022 is the focus on the First 1,000 Days of Life. The PPAN gives priority to the nutritionally vulnerable (pregnant and lactating women, infants, and young children 0-23 months old) and those who are already malnourished, among others. PPAN 2017-2022 involves the implementation of nutrition-specific programs to address the immediate causes of malnutrition, and nutrition-sensitive programs to address the underlying and basic causes,” NNC explained.

“Based on the analysis of the drivers of stunting, significant reduction in stunting would occur when there are improvements in the health and nutrition of pregnant women and adolescents and in food security and diversity. Pregnant adolescents and women should have access to nutrition and health services to improve birth outcomes, as well as responsible parenting to manage fertility. Children must also have access to a variety of foods especially those that are rich in protein such as meat, fish, poultry, and eggs. This will entail improving access and availability of nutritious food. Attention should also be given to ensure that households have access to clean drinking water supply and sanitation and wastewater systems,” NNC added.

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