Malnutrition in the Philippines. Ravenholt A. 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.
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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.
MANILA, PHILIPPINES (22 August 2005) – A lack of basic vitamins and micronutrients in the diet is damaging the health of one third of the world’s population and hampering economic development, according to a recent joint report from the United Nations Children’s Fund and the Micronutrient Initiative (MI). Simple iron deficiency in Indonesia reduces gross domestic product by some 0. 5% each year ($485 million) through lost productivity, as estimated in 2003’s Global Assessment Report on Vitamin and Mineral Deficiencies.
Yet food fortification offers a low-cost method for facing the problem, and ought to be the first public-policy choice for delivering nutrition improvement programs and lowering clinical malnutrition. With food fortification strategies supported and maintained through market-based systems, governments can focus the delivery of food supplements, nutrition services, and dietary education to disadvantaged populations with limited access to fortified food. A Simple and Cheap Technology
Fortifying flour, salt, and oil, for example, offers an effective and inexpensive way to get essential vitamins and minerals into food for low-income and at-risk populations. The technology is simple, the product quality is unaffected, and the incremental price is low. Salt can be iodized, for example, for as little as five cents per person, per year. Using food fortification to reduce micronutrient deficiencies helps strengthen economies by lowering health care costs and increasing worker productivity. It also improves children’s cognitive development, further elping expand and sustain economic development. Access to fortified food, however, is often limited because of low purchasing power and underdeveloped distribution channels. Control of micronutrient deficiencies through food fortification, nonetheless, is gaining international attention. For example, the Global Alliance for Improved Nutrition (GAIN) – funded primarily by the Bill & Melinda Gates Foundation, bilateral donors, and the MI – provides resources to alliances of governments, industry, and civil society to implement large-scale food fortification programs that reach low-income populations.
The Copenhagen Consensus, which addresses some of the biggest challenges facing the world, and assesses development opportunities and their costs, rated food fortification with micronutrients as the most successful intervention to reduce the prevalence of iron deficiency anemia, and iodine and vitamin A deficiencies. Lack of iron not only has an influence on fetal and childhood development, but also has a direct negative effect on the productivity of adults.
Iodine deficiency in childhood reduces brain development, and vitamin A deficiency can permanently damage eyesight or even cause blindness. Fortification: A National Challenge To be successful, national fortification programs must be sustainable and market driven, and governments must back them up with adequate regulations, standards, and public education. International experience shows that government policy, standards, and regulations are critical to establishing an environment that enables the private food sector to invest, produce, and distribute quality, fortified products.
Government is key to creating producer awareness, building consumer demand, and shaping the marketplace with clear regulations and transparent regulatory enforcement procedures. Food control and monitoring systems for fortified flour, salt, and other foods require technical and managerial capacity as well as coordination among government agencies charged with regulating domestic and imported food. There is also a need to strengthen food control and monitoring systems for fortified food at the market and household levels. New Approaches in Indonesia
Vitamin A deficiency, iodine deficiency disorders, and iron deficiency anemia are common problems in Indonesia. These micronutrient deficiencies contribute to disease, mortality, growth retardation, brain damage, and reduced cognitive and working capacity among children and adults. That puts a severe strain on education and health systems, lowers productivity, and raises levels of sustained poverty. In urban slum areas, the prevalence of underweight children is especially high, and anemia rates among young children remain alarmingly high.
More than half the children under 5 years of age are vitamin A deficient. A recent study showed that consumption of palm oil by poor families was sufficient to deliver 30% of the recommended daily allowance for vitamin A, suggesting that vitamin A fortification of palm oil presents a promising opportunity to reduce the prevalence of vitamin A deficiency. While iron supplementation is widely implemented to treat and prevent iron deficiency anemia in adults, realistic alternatives for young children remain very limited.
Therefore, “in-home” fortification with multimicronutrient fortificants, which are also called “sprinkles,” is a new option to address iron deficiency anemia in young children. It consists of microencapsulated iron and other essential micronutrients to treat and prevent iron and other deficiencies in infants and young children. The encapsulation is a thin lipid (vegetable fat) coating that prevents the iron from dissolving into the weaning food, thus, preventing any change in color, flavor, and taste of food.
Multimicronutrient fortificants can be added to complementary food to reduce vitamin A deficiency and iron deficiency anemia in children 6-59 months of age. “Sprinkles” have proved effective in Benin, People’s Republic of China, Ghana, India, and Mongolia. Although the product is not yet commercially available, “sprinkles” may promise an alternative for Indonesian children who suffer micronutrient deficiencies. To combat malnutrition in Asia and the Pacific region, ADB has provided technical assistance on nutrition and food fortification to 16 developing member countries since 1996.
In addition, two grant projects – launched since 2001 and funded through the Japan Fund for Poverty Reduction (JFPR) – aim to promote sustainable food fortification programs in the Central Asian republics and Mongolia. To address the alarming rates of micronutrient deficiencies in Southeast Asia, ADB has launched its first food fortification project for Indonesia, with $1. 75 million financed through the JFPR. The grant project pilots palm oil fortification with vitamin A and assesses the technical feasibility to locally produce multimicronutrient fortificants.
It is estimated that about 70% of the population, particularly the poor, could be reached if palm oil is fortified with vitamin A. The oil fortification technology is uncomplicated and widespread. The project also aims to establish public-private partnerships for marketing and distributing “sprinkles. ” About ADBThe Philippines is already experiencing over-population. Our country is one of the most over-populated country. It is the 12th most over-populated country in the whole world.
Many of the people here in the Philippines, especially teenagers, are engaged in prostitution and pre-marital sex, which is two of the most common causes of over-population. Over-population is existing and increasing because also of poverty. Many of the female teenagers nowadays tend to sell “themselves” just for money, so that they will be able to have something for their expenses, and in some cases, for their school fees and/or their families. In fact, because of these things Philippines is also starting to suffer from some diseases, such as, AIDS, STD, HIV, and also malnutrition – only common to some parts or provinces of the Philippines.