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QUEZON’S

CHILDREN:
The Provincial Nutrition
Situation Facts and Figures
(Based on the Provincial Nutrition data from 2009-2014)
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

LIST OF FIGURES AND TABLES


TITLE PAGE
Figure 1 Six year trend of provincial prevalence rate on Undernutrition of preschool 5
children
Figure 2 Trend data on number of underweight and severely underweight preschool 11
children in Quezon province from 2012-2014
Figure 3 Trend data on the opt coverage of Quezon province from 2009-2014 12
Figure 4 Comparative data on total preschool population vs. Preschool weighed 12
from 2012-2014
Figure 5 Distributions of actual weighed and unweighed children in 2014 13
Figure 6 Nutritional classifications of actual weighed preschool children in 2014 14
Figure 7 Distributions of underweight preschool children by age group and gender 17
in 2014
Figure 8 Distributions of severely underweight preschool children by age group and 16
gender for 2014
Figure 9 Nutritional classification of pre-school children based on stunting data in 19
2014
Figure 10 Distributions of stunted preschool children by age group and gender for 20
2014
Figure 11 Three year trend of provincial prevalence rate on wasting of school 22
children
Figure12 Comparative nutritional status report of deped from 2012-2014 23
Figure 13 Comparative data on wasting and severely wasting by gender from 2012- 24
2015
Figure 14 Distribution of wasted and severely wasted in school children by gender 26
in 2014
Figure 15 Distribution of severely wasting in school children by grade level in 2014 27
Figure 16 Distribution of wasting in school children by grade level in 2014 28
Figure 17 Comparative data on total school chidren population vs. School children 28
weighed from 2012-2014
Figure 18 Distribution of actual weighed from the total enrollees 29
Figure 19 Nutritional status classification of school children weighed in 2014 30
Table 1 Ranking of municipalities based on opt 2014 and poverty incidence rate of 7
2013
Table 2 Ranking of municipalities based on the 2014 opt results 10
Table 3 Ranking of municipalities based on the stunting data of 2014 18
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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

INTRODUCTION

Malnutrition is attracting attention both in international and local regions. The damage
it does in the past has only recently begun to sink in. The damage malnutrition does in
infancy and childhood is irreversible. It also attracts attention because of its puzzling
failures more than in the grass roots level. The provincial government of Quezon in
lieu, shares the conviction that hunger, malnutrition and poverty can be overcome in
the near future. Through the scaled up effort of the Provincial Nutrition Action Office,
there is indeed an assurance that malnutrition in the province can be countered.
Nutrition problems in the province are the results of numerous factors such as poverty,
political will, food shortage and its unavailability. Another concern is the geographical
issue among the mainland and island municipalities, unequal distribution of wealth,
Barangay Nutrition Scholars competency and prevailing micronutrient deficiency adds
more to the perceived problems. According to FAO (2010) other factors of
malnutrition includes:
 Presence of incongruent ideologies and policies that govern the sector;
 Problems in collaboration and coordination in nutrition among different
agencies involved
 Limited evaluation of the effectiveness of nutrition intervention programs
 Lack of timely nutrition data for use in planning effective programs.

As indicated by the World Health Organization (WHO), malnutrition is by far the


largest contributor to child mortality globally, currently present in 45 percent of all
cases1. It is also the gravest single threat to global public health 2. Malnutrition remains
a major health and nutrition problem that relates to underweight and obesity among

1
World Health Organization Children: reducing mortality. Accessed from www. Who.org ON June 22,
2015.
2

2
The Economist (2008).Thestarvelings.Accessed from on June 23, 2015.
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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

children. It is a cycle that should be stopped. As indicated in the Starvelings (2008),


malnutrition in the first two years is irreversible. Malnourished children grow up with
worse health and lower educational achievements. Their own children also tend to be
smaller and stunted. Moreover, these issues have been attributed to the increasing
disparity among the rural and urban areas in the province.

Public action in reducing malnutrition is a moral imperative. Governments, have a


duty to ensure that the dimensions of holistic programs are given to the affected
populace. In this case, the provincial government of Quezon has a strong will in
eradicating malnutrition in its confines using economic and ethical standards.
Moreover, access to whatever programs and services is being utilized to ensure that
the public has the capacity to invest and improve their own nutrition situation.
Through self-help initiatives and massive nutrition campaigns this will lead to better
nutrition awareness that creates empowerment to people and the community as a
whole.

In connection, this document theprovincial nutrition situation 2015 will give the
overall picture of Quezon Province in terms of nutrition. Compared to the last six
years, the nutrition situation in the province has been improving, lessening the
numbers of malnourished children. However, there are deviations with regards on the
data presented. For instance, while the provincial prevalence rate on malnutrition of
pre-school children drops, the prevalence on school-children increases. This factor
affects not only the education sector but the whole province as well. The data
presented herein are obtained from the collated reports from the:
 Operation Timbang Plus in 2014 and the collected data from the
 Department of education Division of Quezon.
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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

Some salient findings of the most recent OPT+ campaign conducted by the
Municipalities and compiled by the Provincial Nutrition Action Office includes the
following:
 11.14 percent is the provincial prevalence rate for 2014 a minimal decrease of
0.2% from the previous year.
 77 percent OPT coverage where identified all over the province lower than the
expected 88% turn out.
 218, 595 out of 284,304 children were weighed during the OPT+ campaign
 Stunting among pre-school children

The interpretations of data are based from the author’s perspective in managing
nutrition programs of the province. The data are presented in a format that is likely
easy to understood and interpreted. Relationships of data to identified literatures are
solely from the author without using statistical correlation. This cans serve as a useful
reference especially in determining provincial nutrition programs.

JULIUS CARMELO A. PARCAREY RN MSN


Provincial Focal Person for Nutrition
Author

Approved:

ROBERTO D. GAJO
Contributors: Provincial Nutrition Officer
 Allan B. Valencia RN
 Nigel Imperial RN
 District Nutrition Program Coordinators
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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

20
18 17.92
16
14
12.9 12.87
12 12.3
11.34 11.14
10
8
6
4
2
0
2009 2010 2011 2012 2013 2014

Figure 5SIX YEAR TREND OF PROVINCIAL PREVALENCE RATE ON UNDERNUTRITION OF PRE SCHOOL CHILDREN

The figure presented herein is the six year trend on the prevalence of under nutrition of
pre-school children ages 0-71 months. The last prevalence data in Quezon province
suggests that there have been a decrease since 2009. A decrease of 6.78% prevalence
have been seen or a fall of 37% from the baseline data. While progress has been made,
it is still insufficient leaving thousands of underweight children in the province.
Nonetheless, the decline in the prevalence rate is a substantial number compared to
other provinces in the Philippines. However, in the regional (CALABARZON) level,
Quezon has the highest prevalence rate among the 5 provinces. According to the FNRI
8th National Nutrition survey (2013), there is one in every 5 (19.9%) Filipino pre-
school children (ages 0-5) which are underweight for their age. In CALABARZON
the prevalence rate is 18.1% and in Quezon province its 25.4% topping the national
and regional levels.

Similarly, the reduction trend may be co-related to the outstanding nutrition programs
of the provincial government. One can see that a major dip in the trend have been
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identified between the years 2009 and 2010. As such, the administration of the recent
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

provincial governorwhich started in 2010 had a major impact in the formulated


programs for nutrition.

Overall, the prevalence of malnutrition declines significantly over the years. However
the rates remains in a high level compared to the national and regional levels.

MUNICIPALITIES WITH HIGHEST MUNICIPALITIES WITH HIGHEST


PREVALENCE OF UNDERNUTRITION3 POVERTY INCIDENCE RATE4
1 PATNANUNGAN 25.08 1 SAN FRANCISCO 60.86
2 JOMALIG 22.44 2 SAN ANDRES 59.14
3 CATANAUAN 20.76 3 BUENAVISTA 58.13
4 BURDEOS 19.63 4 SAN NARCISO 57.99
5 SAN ANDRES 18.60 5 JOMALIG 55.00
6 MACALELON 18.31 6 MULANAY 54.52
7 PITOGO 17.95 7 MACALELON 53.60
8 PANUKULAN 17.77 8 BURDEOS 52.39
9 QUEZON 17.44 9 GENERAL LUNA 51.87
10 PADRE BURGOS 17.19 10 CATANUAN 51.19
11 POLILLO 16.07 11 GENERAL NAKAR 50.77
12 SAN FRANCISCO 15.41 12 PADRE BURGOS 50.61
13 TAGKAWAYAN 15.36 13 PEREZ 50.01
14 GUINAYANGAN 15.24 14 QUEZON 47.93
15 SAN NARCISO 15.14 15 PATNANUNGAN 47.37
16 PLARIDEL 14.60 16 POLILLO 47.00
17 REAL 14.33 17 UNISAN 46.83
18 CALAUAG 13.88 18 PITOGO 46.44
19 GEN. NAKAR 13.48 19 TAGKAWAYAN 45.91
20 BUENAVISTA 13.45 20 GUINAYANGAN 45.80
21 PEREZ 13.25 21 AGDANGAN 44.23
22 MULANAY 13.17 22 PLARIDEL 44.02
23 INFANTA 11.76 23 CALAUAG 42.23
24 MAUBAN 11.33 24 MAUBAN 42.20
25 SAMPALOC 11.06 25 SAN ANTONIO 42.05
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3
Operation Timbang Plus results 2014
Page

4
2003 City and municipal level poverty estimates. National Statistics Coordination Board.
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

26 UNISAN 10.31 26 PANUKULAN 41.55


27 LOPEZ 9.37 27 ALABAT 41.17
28 GUMACA 8.91 28 LOPEZ 37.85
29 DOLORES 8.59 29 REAL 36.17
30 SARIAYA 8.02 30 GUMACA 35.46
31 GEN. LUNA 8.02 31 SARIAYA 32.89
32 LUCBAN 7.72 32 TIAONG 32.14
33 PAGBILAO 7.11 33 ATIMONAN 31.84
34 SAN ANTONIO 6.66 34 INFANTA 29.08
35 AGDANGAN 6.53 35 SAMPALOC 29.05
36 TIAONG 6.31 36 DOLORES 26.05
37 ATIMONAN 5.79 37 PAGBILAO 26.02
38 CANDELARIA 3.89 38 CANDELARIA 20.99
39 ALABAT 3.19 39 LUCBAN 16.01
Table 1 RANKING OF MUNICIPALITIES BASED ON OPT 2014 AND POVERTY INCIDENCE RATE OF 2013

(A) One in every 10 pre-school children in the province is undernourished.The total


prevalence rate of Quezon province in 2014 is 11.14% highest in the
CALABARZON region. The municipality of Patnanungan has the highest
prevalence rate with 25.08% followed by the Municipalities of Jomalig (22.44%),
Catanauan (20.76%), Burdeos (19.63%) and San Andres (18.60%). On the
contrary, the municipality of Alabat got the lowest prevalence rate with 3.19%.
Among the top ten municipalities, four are island municipalities all from the first
congressional district, five from the Bondoc Peninsula (third congressional
district) and one from the 4th district of Quezon. The ranking can be correlated
with the poverty incidence of the municipality that can be traced in the poverty
incidence ranking of the province. According to the FNRI (2013), the prevalence
of underweight was highest among children belonging to the poorest quintile of
society. It should be noted that the general view on malnutrition coincides with
poverty as its main cause. Other researchers have poverty statistical correlation in
malnutrition as indicated by Victoraet. Al (2008), by causing poor health, small
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body size, low levels of energy and reductions in mental functioning, hunger can
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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

lead to even greatest poverty by reducing people’s ability to work and learn, thus
leading to even greater hunger5.

(B) As indicated in the 2012 poverty incidence report of National Statistics


Coordination Board, Quezon has the highest incidence in the region at 22.8
percent lower than the National poverty incidence rate at 22.9 percent.The
municipality of San Francisco in Quezon, with an estimated poverty incidence of
60.9 percent, registered as the poorest municipality in the province and in the
CALABARZON region. This can only suggest that more than half of the
municipal populations are poor. It can also be observed that the five poorest
municipalities in the province are the top five poorest municipalities in the region
which are the municipalities of San Francisco (2nd class municipality), San Andres
(4th class municipality), Buenavista (3rd class municipality), San Narciso (1st class
municipality), and Jomalig (5th class municipality)6. The aforementioned
municipalities have fishing and farming as its main source of livelihood. On the
other hand the municipality of Lucban has the lowest poverty incidence rate in the
province with 16.01 percent three times lower than the identified highest poverty
stricken municipality in the province. According to Cadeline (2011), Quezon per
capita income is the lowest in the CALABARZON contributing to the highest
poverty incidence. The people of Quezon Province are on a downward slide in
terms of income and upward swing in terms of poverty. In comparison with other
country Quezon can be attributed to the country of Namibia in terms of poverty
incidence7. Reports from different organizations like the World Bank statistics
documented that, children who live in households lacking access to sufficient food

5
VictorIa CG, Adair L, Fall C, et al (2208) Maternal and child under nutrition: consequences for adult
health and human capital.Elesevier ltd. Accessed at ncbi.nlm.nih.gov on june 27, 2015.
6
National Statistics Coordination Board (2009).2003 City and municipal level poverty estimates. The
World Bank. Makati
8

7
Cadeline (2011).Quezon Province a Human Development Data accessed at nelcadelina.blogspot on
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June 30, 2015


QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

are more likely to predispose to poor nutrition and health related problems than
children from food secure households8. Both date presented excludes the cities of
Lucena and Tayabas.

(A) RANKING OF MUNICIPALITIES WITH (B) RANKING OF MUNICIPALITIES WITH


LARGEST NUMBER OF UW AND SUW HIGHEST OPT COVERAGE IN 2014
PRE-SCHOOL CHILDREN WEIGHED
1 SAN FRANCISCO 1602 1 SAN FRANCISCO 103%
2 CATANUAN 1423 2 CANDELARIA 102%
3 LOPEZ 1364 3 TIAONG 98%
4 SARIAYA 1339 4 JOMALIG 93%
5 CALAUAG 1311 5 LOPEZ 93%
6 SAN NARCISO 1013 6 PATNANUNGAN 93%
7 MULANAY 922 7 AGDANGAN 91%
8 MAUBAN 888 8 SAN ANTONIO 91%
9 INFANTA 872 9 ALABAT 87%
10 TAGKAWAYAN 836 10 PEREZ 86%
11 SAN ANDRES 828 11 SAN NARCISO 85%
12 TIAONG 827 12 CALAUAG 83%
13 GUMACA 815 13 POLILLO 82%
14 GUINAYANGAN 766 14 MULANAY 82%
15 CANDELARIA 761 15 BURDEOS 82%
16 BURDEOS 682 16 ATIMONAN 82%
17 PAGBILAO 675 17 PANUKULAN 77%
18 REAL 648 18 GUMACA 77%
19 POLILLO 642 19 REAL 75%
20 PATNANUNGAN 575 20 SAN ANDRES 75%
21 MACALELON 554 21 PITOGO 74%
22 BUENAVISTA 471 22 MAUBAN 73%
23 PITOGO 467 23 GENERAL LUNA 73%
24 PADRE BURGOS 403 24 GUINAYANGAN 71%
25 ATIMONAN 399 25 PADRE BURGOS 70%

8
World Bank (2006).Repositioning Nutrition as central to development: A strategy for large Scale
9

Action. Washington, DC 2006. Accessed from www.worldbank.orgonFebruray 2013.


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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

26 LUCBAN 353 26 SARIAYA 69%


27 SAN ANTONIO 333 27 BUENAVISTA 68%
28 PANUKULAN 288 28 MACALELON 67%
29 QUEZON 285 29 PLARIDEL 66%
30 UNISAN 274 30 QUEZON 66%
31 GENERAL LUNA 259 31 INFANTA 64%
32 JOMALIG 250 32 TAGKAWAYAN 63%
33 GENERAL NAKAR 249 33 CATANUAN 61%
34 PEREZ 234 34 UNISAN 61%
35 DOLORES 233 35 SAMPALOC 58%
36 PLARIDEL 165 36 DOLORES 57%
37 SAMPALOC 137 37 PAGBILAO 56%
38 AGDANGAN 127 38 LUCBAN 56%
39 ALABAT 76 39 GENERAL NAKAR 42%
TOTAL 24,346 TOTAL 77%
Table 1 RANKING OF MUNICIPALITIES BASED ON THE 2014 OPT RESULTS

The detailed table above present’s two different rankings of the municipalities
(excluding Cities of Lucena and Tayabas) from the Operation Timbang Plus results in
2014. The thirty-nine municipalities were ranked based on; (a) Highest number of
underweight and severely underweight pre-school children weighed and (b)
Municipalities with highest number of OPT coverage.

(A) The municipalities of San Francisco,Catanuan, Lopez, Sariaya and Calauag have
the highest number of underweight and severely underweight children with 1,602,
1,423, 1,364, 1,339 and 1,311 numbers respectively. On the contrary, the
municipality of Dolores with 233, Plaridel with 165, Sampaloc with 137,
Agdangan with 127 and Alabat with 76 got the lowest numbers of underweight
and severely underweight children. In total, there are 24,346pre-school children
across the province identified as underweight (UW) and severely underweight
(SUW).Moreover, for the three years, Quezon province have been keen in
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addressing malnutrition problems thus as seen in the table below there have been a
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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

variations on the number of underweight and severely underweight children from


2012-2014.

30,000
27,303
25,000 24,346
22,419
20,000
15,000
10,000
5,000
0
2012 2013 2014
Figure 6 TREND DATA ON NUMBER OF UNDERWEIGHT AND SEVERELY UNDERWEIGHT PRESCHOOL CHILDREN IN
QUEZON PROVINCE FROM 2012-2014

(B) The municipalities of San Francisco, Candelaria, Tiaong, Jomalig, Lopez are the
top fivemunicipalities with highest operation timbang plus (OPT) coverage with
103 percent, 102 percent, 98 percent and 93 percent. 16 out of 39 municipalities
achieved the required 80 percent needed coverage of the operation timbang plus.
23 municipalities fall short to the required percentage lead by General Nakar with
only 42% coverage. To our knowledge, the undersized coverage were based on
factors identified by the municipal nutrition action officers themselves during the
first quarter meeting of 2015 and these are as follows: 1. High expected coverage
from the Department of Health, 2. Low or no manpower (Barangay Nutrition
Scholars) to conduct the operation timbang plus campaign, 3. Old BNSs to
conduct and complete the task and 4. Geographically isolated areas that cannot be
easily reached. In addition, the province of Quezon has been consistent in not
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achieving the required OPT+ coverage for the last years. As indicated in the
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following table:
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

100
89
80 79 78
73 73
66
60

40

20

0
2009 2010 2011 2012 2013 2014
Figure 7 TREND DATA ON THE OPT COVERAGE OF QUEZON PROVINCE FROM 2009-2014

300000
272877 279444
250000
236185
222544 218595
200000 198759
TOTAL PRE-SCHOOL
150000 POPULATION
TOTAL PRESCHOOL
WEIGHED
100000

50000

0
2012 2013 2014

Figure 8 COMPARATIVE DATA ON TOTAL PRESCHOOL POPULATION VS. PRE SCHOOL WEIGHED FROM 2012-
2014

The above data presents the comparative data on total pre-school population vs. the
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weighed pre-school in the province in the three year period. In 2012 OPT campaign,
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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

there are 236, 185 children in the province in relation to 222,544 children weighed. As
such, there has been an identified gap between the target children to be weighed and
the actual children weighed. On the course of the next two years this has been
increasing as seen on the figure above.

100%
90% 65,708
80%
70%
60% Number of Unweighed
Preschool Children
50%
Number of Weighed Preschool
40% 218,595 Children
30%
20%
10%
0%

Figure 5DISTRIBUTIONS OF ACTUAL WEIGHED and UNWEIGHED CHILDREN IN 2014

Based on the OPT result 2014 out of the 284,303 projected population to be weighed,
seventy-seven percent or 218,595 were actually weighed 65,708 were either
unweighed or no child have been weighed. Similarly, the reasons for this problem are
identified in the justification on table 2 section B.

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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

OVERWEIGHT, SEVERELY
UNDERWEIGHT,
4138 UNDERWEIGHT,
18354
5992

NORMAL , 190,111

Figure 6 NUTRITIONAL CLASSIFICATIONS OF ACTUAL WEIGHED PRE SCHOOL CHILDREN IN 2014

The figure above represents the classification of 218,595 pre-school children ages 0-
71 months old which are actually weighed in 2014. 190, 111 or eighty-seven percent
are normal for their age, 18,354 or eight percent are underweight, 5,992 or three
percent are severely underweight and 4,138 or two percentage are overweight.

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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

Figure 7 DISTRIBUTIONS OF UNDERWEIGHT PRESCHOOL CHILDREN BY AGE GROUP AND GENDER IN 2014

The figure represents the distribution of underweight preschool children by age group
and gender in 2014. The variables used to determine the age group is based on the age
grouping in the Operation Timbang Plus form 2A (revised in February2012). It was
observed that under nutrition is high in the male gender than the female gender.
Moreover, the age group 60-71 months has the largest number of undernourished
children with 3,850. The age group with the least number is the age group 0-5 months
old with only 569 recorded children. According to the World Bank in 2012, globally,
girls are less likely to attend school, have secure jobs, or hold public office. But by
most measures, they have an advantage in one area: malnutrition.9 Better-nourished
girls are more likely to stay in school and to learn more. They will miss fewer days to
illness and be more attentive when in class. They will grow up to become more
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9
The World Bank (2012).Child malnutrition: how did boys and girls fare in the past decade. Accessed at
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http://data.worldbank.org on June 25, 2015


QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

productive economically and more aware of the various livelihood options10. Thus as
seen in the figure above, more boys in the province of Quezon are underweight for
their age. Over all, there are 9,542 underweight boys fifteen percent larger compared
to 7,890 in girls.

Figure 8 DISTRIBUTIONS OF SEVERELY UNDERWEIGHT PRESCHOOL CHILDREN BY AGE GROUP AND GENDER FOR
2014

As indicated in the figure, there are more severely underweight male children than in
females. In total there are 3,205 severely underweight boys and 2,924 girls. However
in this case, the province of Quezon posed to have more severely underweight boys by
4.6 percent than girls. As reported, the age group 36-47 months has the highest
number of severely underweight children across the province this is due to the fact that
boys have slightly higher nutritional requirements related to their slightly higher
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10
Ruth Oniang’o and Edith Mukudi (2002), "Nutrition and Gender.” In Nutrition: A Foundation for
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Development, Geneva:ACC/SCN.
QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

average height and weight. If boys and girls were fed equally, more boys than girls
would become underweight because of their higher nutritional requirement (Ananta,
201311). However, based on other researches there is no disparity on gender as
evidence by various researches.

TOTAL NO. OF
TOTAL NO. OF
STUNTED & PREVALENCE
MUNICIPALITY CHILDREN
SEVERELY RATE
MEASURED
STUNTED
1 PATNANUNGAN 2272 1113 48.99%
2 BURDEOS 3481 1564 44.93%
3 SAN NARCISO 6405 2669 41.67%
4 PANUKULAN 1621 674 41.58%
5 PITOGO 2527 1041 41.20%
6 GEN. LUNA 2779 1136 40.88%
7 PLARIDEL 1165 445 38.20%
8 MACALELON 3025 1142 37.75%
9 QUEZON 1634 588 35.99%
10 JOMALIG 1114 400 35.91%
11 SAN ANDRES 4598 1608 34.97%
12 GUINAYANGAN 5037 1758 34.90%
13 GEN. NAKAR 1847 613 33.19%
14 PADRE BURGOS 2344 772 32.94%
15 POLILLO 3995 1277 31.96%
16 SAMPALOC 1236 388 31.39%
17 CALAUAG 9448 2960 31.33%
18 PEREZ 1766 551 31.20%
19 MAUBAN 7837 2401 30.64%
20 TAGKAWAYAN 5443 1652 30.35%
21 REAL 4660 1384 29.70%
22 LOPEZ 10734 3178 29.61%
23 UNISAN 2657 725 27.29%
24 LUCBAN 4571 1136 24.85%
25 ATIMONAN 6675 1599 23.96%
26 GUMACA 8252 1966 23.82%
27 PAGBILAO 8989 1906 21.20%
28 DOLORES 2711 542 19.99%
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11
Ananta, Aris (2013) the Indonesian crisis: A human development perspective. Institute of south East
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Asian Studies. Singapore


QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

29 SAN FRANCISCO 2767 523 18.90%


30 TIAONG 13114 2218 16.91%
31 AGDANGAN 1357 207 15.25%
32 SARIAYA 16377 2181 13.32%
33 ALABAT 2391 224 9.37%
34 SAN ANTONIO 4999 441 8.82%
35 CANDELARIA 19626 1312 6.69%
36 BUENAVISTA 0 0 0.00%
37 CATANAUAN 0 0 0.00%
38 INFANTA 0 0 0.00%
39 MULANAY 0 0 0.00%
TOTAL 179,454 44,294 24.68%
Table 3 RANKING OF MUNICIPALITIES BASED ON THE STUNTING DATA OF 2014

The table presents the overall ranking of municipalities based on the stunting data of
Quezon province in 2014 from the OPT results conducted. The province posed at
24.68 percent of stunting which is highest in the region. 2 out of 10 pre-school
children measured are short for their age. As indicated in the FNRI data in 2013, 3 in
every Filipino 0-5 years old were short for their age. The national prevalence on
stunting is 30.3 percent while the CALABARZON region has 25.3 percent. Quezon
has the highest prevalence in the region lower than the national and regional stunting
rate. Moreover, as reported in the FNRI, 44.8% of stunted children belong to the
poorest quintile of society. Children with low height for age are stunted. This
condition is usually associated with long term chronic malnutrition and long term
factors such as frequent infection and poor feeding practices12 (UNICEF, 2000).
Moreover, Africa and Asia has more stunting rates in comparison to other regions of
the world and more than 90% of the worlds stunted children live in these continents
(UNICEF, 2009). As indicated in a study done in the Philippines by Rohner et al in
2013, among children from urban and predominantly poor and very poor households,
26% were stunted, 18% were underweight, and 5% were wasted. Forty-two percent
were anemic, 28% were iron deficient, and 3% were vitamin A deficient. Of the
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12
United Nations International Children's Education Fund (UNICEF), Nutritional assessment in
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Kenya. Nairobi, Kenya: UNICEF; 2000.


QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

factors investigated, low socioeconomic status, use of cheaper cooking fuel, and
nonuse of multivitamins were all independently associated with stunting. The
prevalence of anemia, iron deficiency, and vitamin A deficiency were independently
associated with the same factors and poorer sanitation facilities, lower maternal
education, current unemployment, and inflation13.

SEVERELY
STUNTED, 16,667 TALL , 5,501

STUNTED, 27,627

NORMAL, 129,659

Figure 9 NUTRITIONAL CLASSIFICATION OF PRE-SCHOOL CHILDREN BASED ON STUNTING DATA IN 2014

The figure represents the classification of all measured children ages 0-5 years old.
Out of 179, 454 measured children there are 129,659 or 72 percent children with
normal height for their age while 27,627 or 16 percent are stunted, 16,667 or 9 percent
are severely stunted while the remaining 5,501 or three percent are tall for their age.
According to Wolde (2014) the age of a child increase the likely hood of a child to be
stunted will be increased this might be due to the fact that stunting is a chronic

13
Rohner et al (2013) Infant and young child feeding practices in the urban Philippines and their
19

associations with stunting, anemia and deficiencies of iron and vitamin A. PubMed. Accessed on July
Page

25, 2015 at http://www.ncbi.nlm.nih.gov/pubmed/24049993


QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

nutritional problem in which, once a child is stunted it might be difficult to revise in


the late childhood. This also indicates that, Malnutrition can affect someone's physical
and mental health. People who are suffering from malnutrition are more likely to get
sick; in very severe cases, they may even die from its effects. Kids who are chronically
malnourished don't grow as tall as they should (a condition referred to as stunted
growth) and are underweight as well14.

Figure 10 DISTRIBUTIONS OF STUNTED PRESCHOOL CHILDREN BY AGE GROUP AND GENDER FOR 2014

The data presented in the figure is the stunting of pre-school children of the province
as distributed by age group and gender. There are more stunted boys than girls in this
data by 5.6 percent. The total number of stunted boys is 14,449 while the girls are
12,878. In total there are 27,327 stunted children ages 0-71 months in the province

14
Gavin, Mary (2012). Hunger and malnutrition accessed on July 25, 2015 at http:// kidshealth.org/
20

teen/food_fitness /nutrition/hunger.ht
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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

higher than the underweight children in the province. However as indicated by


UNICEF (200915), a child who is underweight can also be stunted or wasted or both,
but in this case the provincial nutrition office cannot foresee that the stunted children
in this data are those children which are underweight and severely underweight.
Instantaneously, the provincial nutrition action office will correlate the stunting and
underweight data through a separate study that will give us a better outlook on both
malnutrition incidences in the province. In addition, as Mwaniki and Makokha in
2013 indicates, that the high levels of stunting among boys could have been
contributed by high prevalence of disease among boys which could also be associated
to the low rates of hand washing with soap. Inadequate energy intake among the
children could have contributed to the high stunting levels among boys than girls
mainly because boys (above 10 years of age) require more food than girls of the same
age16. It could also be explained by the fact that more girls than boys were involved in
food preparation and therefore likely to consume more food than boys overtime.
Further, since stunting increases with age, it is likely that more boys than girls were
stunted in their childhood.

21

16
UNICEF. 2009. Tracking progress on child and maternal nutrition: A survival and development
Page

priority. New York


QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

CONSOLIDATED DATA ON MALNUTRITION FROM THE DEPARTMENT


OF EDUCATION DIVISION OF QUEZON

20.6

20.4 20.43
20.39

20.2

20

19.8
19.67
19.6

19.4

19.2
2012 -2013 2013-2014 2014-2015

Figure 11 THREE YEAR TREND OF PROVINCIAL PREVALENCE RATE ON WASTING OF SCHOOL CHILDREN

The above figure is the three year trend of wasting among school children in the
Division of Quezon. The captured information comes from the height-for-length data
of the Division of Quezon which excludes both the schools division of Lucena and
Tayabas. The prevalence of wasting and severely wasting in the identified school
children are high. Moreover, the data presented also comes from different school
levels from kinder to grade 6 with the inclusion of the SPED pupils. It is worth noting
that the data from the Department of Education has a variation from decreasing in
2012-2013 and major increase in wasting in 2014. From 20.43 percent in 2012 a
decrease of 0.76 percent has been noted. However a drastic increase in the prevalence
was seen at 0.72 percent in 2014. In addition, the figure indicates the number of
wasted and severely wasted children in the three year period. For 2012 there are
22

31,026 wasted and severely wasted identified school children, 50,767 in 2013 and
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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

37,931 in 2014. Moreover, it only suggests that the number of wasting are varies in a
three year period. The drastic increase calls for an extensive nutrition interventions in
school children. As indicated in a study in 2014, under-nutrition in the schoolchildren
has multiple factors; Low maternal education and household food insecurity status
were the independent factors for under-weight. Having large family size, inadequate
carbohydrate intake and household food insecurity status were independent predictors
for low BMI for age status. Having Trichuristrichura infection, living in a food
insecure household, poor maternal education and children aged 10-14 years were risk
factors for stunting.17 Moreover, it is imperative to know as indicate in the study of
Wolde, if severe malnutrition in infancy occurs in a context of a life history which is
generally favorable for intellectual development; an early acute episode of
malnutrition appears to have a negligible effect on intellectual function.

40000 36766
35000

30000
26375
25000 23190

20000
14001
15000
11556
10000 7836
4504
5000 2970 3152

0
2012-2013 2013-2014 2014-2015

SEVERELY WASTED WASTED OVERWEIGHT

Figure12 COMPARATIVE NUTRITIONAL STATUS REPORT OF DEPED FROM 2012-2014

17
Woldeet. Al (2014).Determinants of health, stunting and wasting among school children. Retrieved
23

from http://www.biomedcentral.com/1471-2458/15/8#B11 June 25, 2015


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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

Based on the figure above, a three year trend on nutritional status based on three
categories is presented. The academic year 2013-2014 has the highest number of
affected school children in all three categories in comparison to years 2012 and 2014
respectively. Although the prevalence rate on that particular year as seen in figure 12
has been low, the number of wasted and severely wasted children increased. The
possibility of this indifference may be determined as hidden hunger. As such, it is
related to Richardson’s (1976) study which indicates that hidden hunger malnutrition
is because of micronutrient deficiencies that contributes to poor growth and also
debilitates children’s immunity and cognitive development and predisposes them to
lower productivity and higher risk of degenerative diseases later in life18.

30000
27428

25000 23339
21052
20000
16825 16879

15000 14201

10000

5000

0
2012-2013 2013-2014 2014-2015

MALE FEMALE

Figure 13 COMPARATIVE DATA ON WASTING AND SEVERELY WASTING BY GENDER FROM 2012-2015
24

18
Ananta, Aris (2013) the Indonesian crisis: A human development perspective. Institute of South East
Page

Asian Studies. Singapore


QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

The figure presented above is the comparison of wasting and severely wasting by
gender from 2012-2014. As presented in the figure there are more wasted and severely
wasted in boys than in girls in the three year period. The academic year 2013-2014
poses the highest number of wasting and severely wasting among the three
comparative years. Moreover, there have been no major implication on the gender and
wasting issues of school children as reviewed in the new literatures presented.
However, the wasting and severely wasting problem can be related to past
malnutrition experiences of an individual and the intelligence quotient as backed by
Richardson in 1976, he states that the difference in IQ between boys who did and did
not experience severe malnutrition in infancy varies under different conditions of
height and social background when those are held constant for both groups. Under the
most favorable conditions of being tall and having an advantageous social history the
average IQ of the malnourished boys is only 2 points lower than those not
malnourished. Under the most unfavorable conditions of short stature and a
disadvantageous social background the IQ of the malnourished boys is 9 points lower
than those not malnourished19.

19
Richardson (1976). The relation of severe malnutrition in infancy to the intelligence of School
25

children with differeing life histories.. International pediatrics research foundation inc. accessed on
Page

july 25, 2015 at http://www.nature.com/pr/journal/v10/n1/pdf/pr197611a.pdf


QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

17426
45% Male
21516 Female
55%

Figure 14 DISTRIBUTION OF WASTED AND SEVERELY WASTED IN SCHOOL CHILDREN BY GENDER IN 2014

The figure above is the distribution of wasted and severely wasted school children by
gender in 2014. There were more wasted boys than girls. The figure shows that 55
percent or 21,516 of the total weighed children with wasting and severely wasting
incidence are male with while 45 percent or 17,426 are female. It is well documented
that boys are more likely to suffer from under nutrition than girls due to increased
nutritional needs in boys than in girls and/or influences of early childhood diseases in
boys20.

26

20
Sharma B, Mitra M, Chakrabarty S, Bharati P. Nutritional status of preschool children of Raj Gond―a
Page

tribal population in Madhya Pradesh, India. Malays J Nutr 2006;12:147-155.


QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

SPED 25 14

Grade 6 647 511

Grade 5 968 647

Grade 4 968 717


Female
Grade 3 1,208 762 Male

Grade 2 1,157 729

Grade 1 1,097 948

Kinder 721 654

-1500 -1000 -500 0 500 1000 1500

Figure 15 DISTRIBUTION OF SEVERELY WASTING IN SCHOOL CHILDREN BY GRADE LEVEL in 2014

As seen on both figures, there are more wasted and severely wasted in boys in both
categories. One can identify that there are more wasted and severely wasted in grades
1-3 or six to nine years old.

27
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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

SPED 56 37

Grade 6 1,856 1519

Grade 5 2,021 1676

Grade 4 2,183 1834


Female
Grade 3 2,497 1810 Male
Grade 2 2,059 1760

Grade 1 2,477 2056

Kinder 1,576 1752

-3000 -2000 -1000 0 1000 2000 3000

Figure 16 DISTRIBUTION OF WASTING IN SCHOOL CHILDREN BY GRADE LEVEL IN 2014

200,000 186614
180,000
154,258 186009 TOTAL SCHOOL
160,000 152,316 CHILDREN POPULATION

140,000
151879 152410
120,000
TOTAL
100,000 SCHOOLCHILDREN
80,000 WEIGHED

60,000
40,000
20,000
0
2012 2013 2014

Figure 17 COMPARATIVE DATA ON TOTAL SCHOOL CHIDREN POPULATION VS. SCHOOL CHILDREN WEIGHED
FROM 2012-2014
28
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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

As seen on the comparative data above, there has been an increasing trend in the
number of school children enrolled for three years. Moreover, the total school children
weighed category has been consistent in not accomplishing weighing all the enrolled
school children. The average percentage population weighed is 99.71 percent
coverage in 2012, 98.80 percent coverage in 2013 and99.68 percent coverage in 2014.

unweighed , 605

actual weighed ,
186,009

Figure 18 DISTRIBUTION OF ACTUAL WEIGHED FROM THE TOTAL ENROLLEES

Out of 186,614 total enrollees in 2014 there have been 186,009 school children
actually weighed. 605 of them were unweighed due to reasons such as: transferred to
other schools or dropped out.

29
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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

Obese Severely Wasted


844 11,991

Wasted
27,169
Overweight
3,300

Normal
149,713

Figure 19 NUTRITIONAL STATUS CLASSIFICATION OF SCHOOL CHILDREN WEIGHED IN 2014

The figure presented above is the nutritional classification of school children weighed
in 2014. Out of 186,009 actual school children weighed, there are 78 percent or
149,713 normal for their weight and height, 14 percent or 27, 169 wasted, 6 percent
11,991 severely wasted and 2 percent or 3,300 overweight.

SUMMARY:

This document provides evidence that Quezon province is acute and nutritional
stressed based on the identified data. Overall, there is a high prevalence of wasting and
stunting across the province. Malnutrition is caused by different factors as presented
above. In Quezon province there is one threat that mainly affects the nutritional status
30

of our children – poverty. The present economic condition in the province further
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QUEZON’S CHILDREN: The Provincial Nutrition Situation Facts and Figures

aggravates the malnutrition problem with about 11% of Quezonian children. However
the declining trends in the presented data were noted for the past 5 years. Moreover,
there is a need to further enhance/ create researches that focuses on micronutrient
malnutrition. This will subsequently give us a complete picture on the micronutrient
deficiencies of Quezonian children.

In totality, there is so much to be done to improve the nutritional status of Quezonian


Children. Promotion and campaign of good nutrition should be established not only in
the pre-school children sector but also in school children as well. The Provincial
Nutrition Action office with its mandate to promote good nutrition should implement
more qualitative and quantitative programs and projects that will guarantee an
effective and efficient delivery of nutritional services. Also, the PNAO staffs are
encouraged to do researches that will enable them to create impact base programs that
will last for years.

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