PROGRESS IN

REDUCING MALNUTRITION
PROVINCIAL NUTRITION SITUATION, FACTS AND FIGURES

Julius Carmelo A. Parcarey RN MSN (Author) Elenor M. Jetomo RN (Contributor) Allan B. Valencia RN (Contributor) Nigel Imperial RN (Contributor). The
writer and all contributors are members of the Provincial Nutrition Action Office. Any opinions stated herein are those of the authors and are not necessarily
representative of or endorsed by the Provincial Government of Quezon
 TABLE OF CONTENTS
TITLE PAGE

Introduction 3
FIGURE 1 Provincial prevalence rate on under nutrition of pre-school 5
children ages 0-71 months from 2009-2015
FIGURE 2 Number of underweight and severely underweight 6
preschool children in Quezon province from 2012-2015
FIGURE 3 Provincial Operation Timbang Plus coverage in Quezon 7
province from 2009-2015
FIGURE 4 Distribution of actual weighed and unweighed pre-school 8
children in 2015
FIGURE 5 Nutritional status classification of pre-school children 9
weighed in 2015
FIGURE 6 Distribution of pre-school children with normal weight 10
(weight-for-age) based on age and gender (2015)
FIGURE 7 Distribution of underweight and severely underweight 11
(weight-for-age) pre-school children based on their age
bracket and gender in 2015
FIGURE 8 Distribution of overweight (weight-for-age) pre-school 12
children based on their age bracket and gender in 2015
FIGURE 9 Prevalence rate of stunted and severely stunted children in 13
Quezon province from 2013-2015
FIGURE 10 Classification of pre-school children measured based on 14
stunting data of 2015
FIGURE 11 Distribution of preschool children with normal height 15
according to their age and gender in 2015
FIGURE12 Distribution of age and gender of children with stunted and 16
severely stunted height according to their age in 2015
FIGURE 13 Distribution of age and gender of children with tall height 17
according to their age in 2015
FIGURE 14 Provincial prevalence rate on under nutrition of school 24
children from 2012 to 2015
FIGURE 15 Nutritional status classification of school children weighed 25
1

in 2015
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FIGURE 16 Comparative data on wasting, severely wasting and 26
overweight from 2012-2015
FIGURE 17 Comparative data on wasting and severely wasting by 27
gender from 2012-2015
FIGURE 18 Distribution of school children with normal weight based
on gender and grade level in 2015 27
FIGURE 19 Distribution of overweight school children based on grade 28
level and gender in 2015
FIGURE 20 Distribution obese school children based on gender and 29
grade level in 2015
FIGURE 21 Distribution of wasted and severely wasted school children 30
based on gender and grade level in 2015

FIGURE 22 Comparative data on total school population and pre school 31

children weighed from 2012-2015

TABLE 1 Municipalities with highest prevalence of under nutrition 18

TABLE 2 Municipalities with highest poverty incidence rate 18
TABLE 3 Ranking of municipalities with largest number of UW and 20
SUW pre-school children
TABLE 4 ranking of municipalities with highest opt coverage in 2015 20
TABLE 5 municipalities with highest prevalence of stunting 22
TABLE 6 municipalities with highest number of stunted (ST + SST) 22
Summary 31

2
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 INTRODUCTION

With existing co-operation among local government units, the battle for malnutrition
eradication and improving the nutritional status of the province has been clear since
the inception of the Provincial Nutrition Action Office and the re-organization of the
Provincial Nutrition Multi-Sectoral Council in 2014. However with the new influence
controlling the nutrition sector, there have been struggles to create and develop
nutrition policies that will help in asserting sustainable impact for the populace.
Essentially, the main concern is the baseline data needed for the development and re-
establishment of the provincial nutrition action plan. Hence a report in 2014 (Quezon‟s
Children: the Provincial Nutrition Situation Facts and figures 2014) was presented to
different agencies to denote the importance of baseline data in crafting a well-
developed plan. This follow-up report is the reference of the nutrition plans and
programs that the provincial government will implement in the coming years. The
author and the contributors have been involved in consolidating this report. This
proactive engagement and initiative efforts are part of a holistic approach the
Provincial Nutrition Action Office has been doing for the past two years. Given this
instance, what we have is a primary reference data on the nutrition condition of the
province. Moreover, in assessing the condition there have been policy challenges and
policy issuances made in the past year that entails the following:

1. Programs and projects have been formulated and implemented separately in

every municipality (as reflected in the PNAO‟s accomplishment report in
2014).
2. The province‟s financial instability affects the implementation of crafted
programs;
3. Strategies have not been sufficiently clear that will provide coherent
interlinked actions with strong impact;
4. Actions of local government units in their respective communities in relation to
malnutrition eradication has not been sufficient;
5. Responsibilities of local government units should be given emphasis
6. Policies of the provincial government have not been evaluated.

Finding solutions require adopting development paths for the benefit of affected
children and communities. Approaches must be based on fundamental requirements
such as:
1. Ensuring a broad and profound commitment of each LGU in sustainable
3

development that must be translated to principles and practice through

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changes.
 2. Integrate development to everyday way of living so that adjustment to attitudes
and behavior of parents and family members in nourishing their young may
have deep impact.

Moreover, emphasis will be given to the data gathered from the Operation Timbang
Plus results of every municipality and its implication as part of the provincial nutrition
situation presented. In addition, this will determine existing conditions in the province
of Quezon and its analysis as part of the data interpretation. The report is divided in
three parts. Operation Timbang Plus results, ranking of municipalities based on the
submitted reports and the Nutritional Status Classification of School children based on
the submitted report of the Department of Education Division of Quezon.

Although this report does not claim to make progress towards defining what should be
the role of each local government unit in program implementation, it aims to be the
first step towards reflecting nutrition issues and problems in the province. This is a
necessity in the context of improving the programs and projects that are implemented
under the present administration. Any opinions stated herein are those of the author
and are not necessarily representative of or endorsed by the Provincial Nutrition
Action Office or the Provincial Government of Quezon.

JULIUS CARMELO A. PARCAREY RN MSN

Author

ELENOR M. JETOMO RN
Contributor

ALLAN B. VALENCIA RN
Contributor

NIGEL IMPERIAL RN
Contributor
4
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 PART I
CONSOLIDATED PRESCHOOL CHILDREN DATA AGES 0-71 MONTHS

PROVINCIAL UNDER NUTRITION DATA

20

18
17.92
16

14

12 12.9 12.87 12.3 10.75

10 11.34
11.14
8

0
2009 2010 2011 2012 2013 2014 2015

Figure 1. PROVINCIAL PREVALENCE RATE ON UNDERNUTRITION OF PRE-SCHOOL CHILDREN AGES 0-71 MONTHS
FROM 2009-2015

Operation Timbang Plus in the province of Quezon was done during the first quarter
of every year from the months of January to March. As presented in the data above, it
is imperative to know that the provincial
prevalence rate on undernutrition is decreasing
from 2009 until the present year. The
proportion of undernourished children in the
overall population has fallen. There has been a
steady decline of the prevalence rate from
2009-2015 that ranges from 1.02 percent a
year. From the previous year (2014), a decline
of 0.39% has been established due to insistent
programs and projects made by the Provincial
Nutrition Action Office through the leadership
Photo credits: Save the Children Foundation
of Governor David C. Suarez and the
Provincial Nutrition Officer Mr. Roberto D. Gajo. Moreover, in the Regional and
National setting there was a general tendency for levels of under nutrition to decrease
5
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in the same years. However, Quezon province still poses on top in the
CALABARZON region with highest prevalence of under nutrition. Related concerns
in this decline of under nutrition rate are the consistent programs of each local
government unit in combating malnutrition that leads to improvement of nutrition
levels amongst children ages 0-71 months. With this, the net effect has been a slow
reduction in seven years‟ time.

30,000

25,000
27,303
24,346 21,957
20,000 22,419

15,000

10,000

5,000

0
2012 2013 2014 2015
Figure 2. NUMBER OF UNDERWEIGHT AND SEVERELY UNDERWEIGHT PRESCHOOL CHILDREN IN QUEZON
PROVINCE FROM 2012-2015

The above data shows

the number of
underweight and
severely underweight
pre-school children in
Quezon province. It is
noted that from 2012 to
present years there have
been a decrease of five
thousand three hundred
forty six children
(5,346) with ages 0-71
months in the roster of
6

severely underweight and underweight children. In the optimistic scenario in the

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international level, the rate of improvement in the number of children with normal

Photo credit to Noel Valeros, taken at Tiaong Quezon with BNS Lydia F. Manucad.
nutritional status will spike while the number of undernourished children will plummet
in a slow rate projection.

100%
90%
80% 89%
70% 79% 78% 71%
73% 73%
60% 66%
50%
40%
30%
20%
10%
0%
2009 2010 2011 2012 2013 2014 2015
Figure 3. PROVINCIAL OPERATION TIMBANG PLUS COVERAGE IN QUEZON PROVINCE FROM 2009-2015

The indicators presented in this graph points

to a downgrade number of accomplished
OPT+ coverage in the whole province of
Quezon. For 2015, accomplished target of
71% were recorded. However, it is not
sufficient to ensure the validity of collected
data are enough. As one can notice, the year
2009 is the only year that the province
covered the needed target of at least eighty
(80%) percent. Year 2013 has the lowest
OPT+ coverage with only 66%
accomplished. This is due to new imposed
population targets given by the Department
of Health. Hence since 2010, Quezon
7

province has been inconsistent in achieving

Page

the OPT+ coverage from the recent years.

 UNWEIGHED
29%
84,272

WEIGHED
71%
204,177

Figure 4. DISTRIBUTION OF ACTUAL WEIGHED AND UNWEIGHED PRE-SCHOOL CHILDREN IN 2015

Based on the received data of the Provincial Nutrition Action Office out of 288,449
targeted pre-school children, there have been seventy one percent (71%) or 204,177
weighed preschool children while the remaining twenty nine percent (29%) or 84,272
pre-school children are not weighed
due to common factors such as:

 Transfer of pre-school
children from one locale to another.
 High expected coverage and
targets from the Department of
Health.
 Low or no manpower
(Barangay Nutrition Scholars) to
conduct the operation timbang plus
campaign.
 Old BNSs to conduct
and complete the task and
 Presence of geographically
isolated areas.
8
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Photo taken at Mauban Quezon with DNPC Jun Reynard Lastimosa

 NORMAL UNDERWEIGHT SEVERELY UNDERWEIGHT OVERWEIGHT

3% 2%
8%

87%

Figure 5. NUTRITIONAL STATUS CLASSIFICATION OF PRE-SCHOOL CHILDREN WEIGHED IN 2015

Recent numbers in this category can be scrutinized from available OPT data of each
locale. Moreover, the data presented above is the nutritional status classification of
preschool children weighed in 2015. This data were extracted from the weight-for-age
category of the Operation Timbang Plus. According to the World Health
Organization1 the “Weight-for-age reflects body mass relative to chronological age. It
is influenced by both the height of the child (height-for-age) and his or her weight
(weight-for-height), and its composite nature makes interpretation complex”. In
Quezon province, Eighty seven percent (87%) or 177,690 of all weighed children
ages 0-71 months are normal in weight eight percent (8%) or 16,431 children are
underweight, three percent (3%) or 5,526 are severely underweight while the
remaining two percent (2%) or 4,530 are overweight. In comparison with last years
(2014) data, the distributions per category are much the same in percentage with
differences on the number of children.
9
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1
WHO (World Health Organization) Child growth indicators and their interpretation. Accessed
November 15, 2015 http://www.who.int/nutgrowthdb/about/introduction/en/index2.html
 0-5 months 5,406 5,467

6-11 months 5,354 5,232

12-23 months 11,271 11,075

24-35 months 11,526 11,204

GIRLS
36-47 months 11,710 11,113 BOYS

48-59 months 12,110 11,328

60-71 months 9,149 8,904

TOTAL 90,444 87,246

100,000 50,000 0 50,000 100,000

Figure 6. DISTRIBUTION OF PRE SCHOOL CHILDREN WITH NORMAL WEIGHT (WEIGHT-FOR-AGE) BASED ON AGE
AND GENDER (2015)

The data above states the distribution of preschool children with normal weight
(weight-for-age) based on their age bracket and gender. The figure presents the male
gender in blue and female gender in pink. Age are indicated in the left side of the table
based on the OPT age brackets. There are more normal weighed males than females in
2015 OPT data. Moreover, the age bracket of 48-59 months old has the largest
weighed children in both genders with 12,110 males and 11,328 females followed by
the age brackets of 36-47 months, 24-35 months, 12-23 months, 60-71 months and 0-5
months. The age bracket 6-11 months has the lowest number of identified children
with normal weight with 5,354 males and 5,232 females. All in all there are 90,444

10
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Photo credit to Noel Valeros, taken at Jomalig Quezon.

males and 87,246 females with normal weight. It is imperative to know that eighty
seven percent of the total populations of children are with normal weight.

0-5 months 386 228

6-11 months 653 335

12-23 months 1,900 1,152

24-35 months 2,270 1,624

FEMALES
36-47 months 2,403 2,052 MALES

48-59 months 2,557 2,184

60-71 months 2,381 1,832

TOTAL 12,550 9,407

-15000 -10000 -5000 0 5000 10000 15000

Figure 7. DISTRIBUTION OF UNDERWEIGHT AND SEVERELY UNDERWEIGHT (WEIGHT-FOR-AGE) PRE SCHOOL

CHILDREN BASED ON THEIR AGE BRACKET AND GENDER IN 2015

The data above states the distribution of children with severely underweight and
underweight cases (weight-for-age) based on their age bracket and gender. The figure
presents the male gender in blue and female gender in pink. There are more severely
underweight and underweight males (12,550) than females (9407) in 2015 OPT data.
Moreover, the age bracket of 48-59 months old has the largest weighed children in
both genders with 2,557 males and 2,184 females followed by the age brackets of 36-
47 months, 24-35 60-71 months, 24-35 months, 12-23 months, 6-11 and 0-5 months.
The age bracket 0-5 months has the lowest number of identified children with SUW
and UW with 386 males and 228 females. In total there are 21,957 underweight and
severely underweight children in Quezon province in 2015.

According to Lesiapeto et. al in 2010, boys were more likely to be either stunted
and/or underweight than girls. Several studies in Africa have shown that male
11
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preschoolers were at higher risk of being stunted than their female counterparts, the
reason for this is unknown2.

0-5 months 835 795

6-11 months 259 263

12-23 months 484 418

24-35 months 375 266

FEMALES
36-47 months 193 113 MALES

48-59 months 200 123

60-71 months 151 55

TOTAL 2,497 2,033

-3000 -2000 -1000 0 1000 2000 3000

Figure 8. DISTRIBUTION OF OVERWEIGHT (WEIGHT-FOR-AGE) PRE SCHOOL CHILDREN BASED ON THEIR AGE
BRACKET AND GENDER IN 2015

The graph above shows the distribution of children with overweight (weight-for-age)
cases based on their age bracket and gender. The figure presents the male gender in
blue and female gender in pink. There are more overweight males (2,497) than
females (2,003) in 2015 OPT data. In addition, the age bracket of 0-5 months old has
the largest weighed children in both genders with 593 males and 553 females followed
by the age brackets of 12-23 months, 24-35 months, 6-11 months, 48-59 months, 36-
47 months and 60-71 months. The figure decreases as the age increases with the
exemption of 12-23 and 24-35 months old. The age bracket 60-71 months has the
lowest number of identified children with OW children with 111 males and 43
females. According to Lesiapeto in 2009, Obesity occurs when the body continually
receives more energy than it expends over a long time. Attainment of a westernized
diet (a diet high in animal fat, reformed carbohydrates but low in fiber, fruits, and
vegetables) accompanied by reduced physical activity are associated with obesity
(Rey-Lopez et a!., 2008; Robertson & Cullen., 1999). In preschool children high
12

2
Lesiapeto et. al. 2010. “Risk factors of poor anthropometric status in children under five years of age
Page

living in rural districts of the Eastern Cape and KwaZulu-Natal provinces, South Africa” The south
African Journal of Clinical Nutrition. Accessed November 15, 2015 http://www.sajcn.co.za/index
intake of sugar-containing beverages might be an important factor since it can increase
total energy intake significantly (Dubois et al., 2007; 6 Connor et al., 2006). Increase
in fast food consumption has been associated with increased energy intake and body
weight in adults and adolescents (Colapinto et al, 2007; Pereira et al., 2005). As
alluded to earlier, the few studies on dietary intakes of South African children living in
rural areas reveal that they are of poor quality: high in carbohydrates, low in fats and
micronutrients. The contribution of diet to obesity in these children still remains to be
determined (Mamabolo et al., 2006)3

PROVINCIAL STUNTING DATA

According to the report by the National Nutrition Survey in 2013, stunting rate in the
whole nation has gone down. However, in Quezon province it is noted that stunting
rates are still in high severity.

30
27.64%
25
20.61%
20

15
16.17%
10

0
2013 2014 2015

Figure 9. PREVALENCE RATE OF STUNTED AND SEVERELY STUNTED CHILDREN IN QUEZON PROVINCE FROM
2013-2015

The above data shows the trend in stunting data in Quezon province from 2013-2015.
It is noted that the trend in this three year period is erratic from 20.61% in 2013 down
13

3
Lesiapeto, MS 2009. Factors associated with nutritional status of children aged 0-60 months residing
Page

in Eastern Cape and Kwanzulu-Provinces. Nort West University. Accessed November 15, 2015
http://dspace.nwu.ac.za/bitstream
to 16.17% in 2014. However in 2015 an increase of 11.47% was seen adding to the
recent data of 27.64% highest in the CALABARZON region.

Moreover based on the World Health Organization the low height-for-age or stunted
growth reflects a process of failure to reach linear growth potential as a result of sub-
optimal health and/or nutritional conditions. On a population basis, high levels of
stunting are associated with poor socio-economic conditions and increased risk of
frequent and early exposure to adverse conditions such as illness and/or inappropriate
feeding practices. Similarly, a decrease in the national stunting rate is usually
indicative of improvements in overall socioeconomic conditions of a country.
Moreover, according to Dr. Amado Parawan, Save the Children‟s Health and Nutrition
advisor in 2015, “The assumption has always been that Filipinos are just genetically
short but we what (we) actually see now are generations of stunted and malnourished
children. Because „shortness‟ is considered a racial trait, it is not seen as a serious
concern. Stunting is more than just being short; it impacts children‟s future because it
hinders physical and mental growth.”

TALL CHILDREN NOT

4% TAKEN WITH
HEIGHT
SEVERELY 3%
STUNTED
11%

STUNTED
17%
NORMAL
65%

Figure 10. CLASSIFICATION OF PRE-SCHOOL CHILDREN MEASURED BASED ON STUNTING DATA OF 2015

The figure above presents the distribution of children based on stunting data gathered
from the Operation Timbang Plus 2015. Majority of the pre-school children are with
normal height, while the other constitutes the remaining percentages. The breakdown
14

are as follows; sixty eight percent (68% or 133,358) of the total measured children are
with normal height, seventeen percent (17% or 34,243) are stunted, eleven percent
Page

(11% or 22,187) are severely stunted, four percent (4% or 7,693) children are
 measured tall on their height based
on their age while the remaining
three (3.28% or 6,698 children) are
not measured. According to
Badham and Sweet in 2010, the
worldwide variation of the
prevalence of stunting is
considerable, ranging from 5% to
65% among the less-developed
countries. In developing countries,
the prevalence of stunting starts to
In Quezon, two (2) out of ten (10) children ages 0-5
rise at about three months of age
years of age, are with low height based on their age
(stunted). and then slows at around two years
of age4. In Quezon province,
stunting rates range from 12-21% considerably. This is lower than the identified
stunting rate in the Philippines in 2011 by the World Bank at 33.6%. However in
2013, according to the National Nutrition Survey, 30.3% are identified stunted
nationwide. Therefore, the decrease every year is minimal. According to studies, poor
growth during childhood has important long term-consequence in adult life in terms of
body size, work and reproductive performance and risks if chronic diseases. It is
imperative to know that stunting rates in the province today will have societal impact
in the coming years.

15
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4
Badham Jane and Sweet Lara. 2010. Stunting: An Overview. JB consultancy Gauteng South Africa
Accessed November4, 2015 http://www.sightandlife.org
 0-5 months 5,937 6,043

6-11 months 5,459 5,555

12-23 months 10,540 10,695

24-35 months 11,150 11,193

GIRLS
36-47 months 12,007 11,289 BOYS

48-59 months 12,749 11,631

60-71 months 9,249 9,861

TOTAL 67,091 66,267

80,000 60,000 40,000 20,000 0 20,000 40,000 60,000 80,000

Figure 11. DISTRIBUTION OF PRESCHOOL CHILDREN WITH NORMAL HEIGHT ACCORDING TO THEIR AGE AND
GENDER IN 2015

The graph presented above is the distribution of age and gender of children with
normal height according to their age based on the Operation Timbang Plus 2015. The
breakdowns are as follows: there are more males (67,091) than females (66,267) with
normal height. moreover, the age bracket of 48-59 months old has the largest
measured children in both genders with 12,749 males and 11,631 females followed by
the age brackets of 36-47 months, 24-35 months, 12-23 months, 60-71 months, 0-5
months and 6-11 months correspondingly. The age bracket of 6-11 months has the
lowest number of identified children with normal children with 5,459 males and 5,555
females.

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 0-5 months 1,234 933

6-11 months 1,789 1,367

12-23 months 5,852 4,333

24-35 months 5,849 4,779

GIRLS
36-47 months 5,722 5,242 BOYS

48-59 months 5,729 5,427

60-71 months 4,282 3,892

TOTAL 30,452 25,973

40,000 30,000 20,000 10,000 0 10,000 20,000 30,000

Figure 12. DISTRIBUTION OF AGE AND GENDER OF CHILDREN WITH STUNTED AND SEVERELY STUNDED HEIGHT
ACCORDING TO THEIR AGE IN 2015

According to UNICEF, stunting is an important predictor of child development and is

associated with reduced school outcome. Compared to children who are not stunted,
stunted children often enroll later, complete fewer grades, and perform less well in
school. As a consequence, this underperformance leads to reduced productivity and
income-earning capacity in adult life. In the gathered data in the Operation Timbang
plus 2015, stunting was of high severity in Quezon Province. All in all there are more
stunted and severely stunted males (30,457) than females (25,973). The age bracket
48-59 has the highest numbers of ST and SST children with 5,729 in males and 5,427
in females. While the age bracket of 0-5 months has the lowest number of S and SST
children with 1,234 males and 933 females. The causes of stunting are numerous and
are affected by genetic and environmental factors throughout a child‟s growth period.
Unfortunately, the period of most rapid growth in childhood is also the period of
greatest vulnerability (Badham and Sweet 2010).
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 0-5 months 1,329 1,314

6-11 months 597 609

12-23 months 1,023 893

24-35 months 641 610

GIRLS
36-47 months 240 228 BOYS

48-59 months 86 72

60-71 months 20 31

TOTAL 3,936 3,757

5,000 4,000 3,000 2,000 1,000 0 1,000 2,000 3,000 4,000 5,000

Figure 13. DISTRIBUTION OF AGE AND GENDER OF CHILDREN WITH TALL HEIGHT ACCORDING TO THEIR AGE IN
2015

The figure above

shows the distribution
of children with tall
cases based on their
age bracket and
gender. The figure
presents the male
gender in blue and
female gender in pink.
There are more tall
males (3,936) than
females (3,757) in
2015 OPT data.
Moreover, the age Photo taken from Brgy Apad Jomalig Quezon, Beneficiaries of Nutricombo program 2015

bracket of 0-5 months old has the largest measured children in both genders with
1,329 males and 1,314 females followed by the age brackets of 12-23 months, 24-35
months, 6-11 months, 48-59 months, 36-47 months and 60-71 months. The age
bracket of 60-71 months has the lowest number of identified children with 51 children
with 20 males and 31 females. In total there are 7,693 numbers of pre-school children
18

with tall height according to their age.

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 PART II
2015 RANKING OF MUNICIPALITIES BASED ON OPT+ SUBMITTED
REPORTS

MUNICIPALITIES WITH HIGHEST MUNICIPALITIES WITH HIGHEST

PREVALENCE OF UNDERNUTRITION5 POVERTY INCIDENCE RATE6
1 BURDEOS 22.92 1 JOMALIG 57.6
2 JOMALIG 22.80 2 PATNANUNGAN 55.4
3 MACALELON 20.52 3 SAN ANDRES 54.7
4 SAN NARCISO 19.98 4 BURDEOS 50.8
5 PITOGO 18.66 5 BUENAVISTA 46.6
6 SAN ANDRES 17.92 6 SAN FRANCISCO 45.1
7 AGDANGAN 17.66 7 SAN NARCISO 44.0
8 BUENAVISTA 17.01 8 GENERAL NAKAR 43.3
9 PANUKULAN 16.63 9 PANUKULAN 42.4
10 PADRE BURGOS 16.39 10 MULANAY 39.7
11 CATANAUAN 15.09 11 PEREZ 37.7
12 TAGKAWAYAN 14.40 12 ATIMONAN 37.3
13 PAGBILAO 14.08 13 GENERAL LUNA 32.5
14 CANDELARIA 13.30 14 TAGKAWAYAN 31.0
15 PEREZ 11.32 15 POLILLO 30.8
16 QUEZON 10.63 16 CATANAUAN 30.6
17 PLARIDEL 10.29 17 MACALELON 30.0
18 POLILLO 10.22 18 REAL 29.8
19 INFANTA 10.18 19 GUINAYANGAN 29.1
20 SAMPALOC 10.07 20 PITOGO 28.1
21 GUINAYANGAN 10.04 21 CALAUAG 28.1
22 SAN FRANCISCO 9.90 22 PADRE BURGOS 27.0
23 GEN. LUNA 9.50 23 MAUBAN 26.5
24 REAL 9.14 24 QUEZON 26.4
25 GUMACA 9.11 25 SAN ANTONIO 24.0
26 SARIAYA 8.80 26 UNISAN 23.9
27 MAUBAN 8.55 27 SARIAYA 23.2
28 CALAUAG 8.27 28 LOPEZ 23.1
29 MULANAY 7.68 29 AGDANGAN 21.6
30 PATNANUNGAN 7.66 30 PLARIDEL 16.6
31 LOPEZ 7.49 31 SAMPALOC 15.2
19
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5
Operation Timbang Plus results 2015
6
2013 City and municipal level poverty estimates. National Statistics Coordination Board.
 32 UNISAN 7.11 32 TIAONG 13.9
33 DOLORES 6.86 33 DOLORES 13.7
34 TIAONG 6.77 34 INFANTA 13.7
35 LUCBAN 6.30 35 ALABAT 13.4
36 SAN ANTONIO 5.83 36 GUMACA 13.1
37 ATIMONAN 5.42 37 CANDELARIA 12.8
38 GENERAL NAKAR 4.16 38 PAGBILAO 12.1
39 ALABAT 3.38 39 LUCBAN 5.3

According to UNICEF Philippines, the nutrition status of Filipino children and

pregnant women varies greatly, with higher income groups having advantage over the
poorest revealing major disparities across the country. These gaps reflect differences
in energy and nutrient intake between children from the affluent and poor households.
In Quezon province in 2015, the municipality with highest prevalence of under
nutrition is Burdeos with twenty two point ninety two (22. 92%) prevalence rate
followed by Jomalig, Macalelon, San Narciso, Pitogo, San Andres, Agdangan,
Buenavista, Panukulan and Padre Burgos with prevalence rates of 22.80%, 20.52%,
19.98%, 18.66%, 17.92%, 17.66%, 17.01%, 16.63% and 16.39% respectively. Among
the top ten municipalities three are from the first district of Quezon and the majority
comes from the Bondoc Peninsula area. The municipality of Alabat has the lowest
Prevalence rate with three point thirty eight percent (3.38%). Correlatively as
introduced by the World Health Organization, UNICEF and Save The Children
foundation, according to Dr. Francisca Cuevas (director for health and nutrition of
Save the Children) underweight cases are the highest in rural areas where there is food
insecurity, poor access to health services, water and sanitation, and behavior-changing
information7. With the data from the National Statistics Coordination Board in 2013,
the municipality of Jomalig has the highest poverty incidence rate with 57.6 percent,
followed by the municipalities of Patnanungan (55.4%) San Andres (54.7%), Burdeos
(50.8%), Buenavista (46.6%), San Francisco (45.1%), San Narciso (44.0%), General
Nakar (43.3%), Panukulan (42.4%) and Mulanay (39.7%). the Municipality of Lucban
has the lowest poverty incidence rate with five point 3 percent (5.3%). In addition,
one can identify that the municipalities with highest prevalence rate in under nutrition
are included in the municipalities with highest poverty incidence rate. In addition the
data reflected by the 8th FNRI national survey suggests that majority of
undernourished Filipino children belong to the poorest households, while overweight
children mostly belong to the wealthiest families. Furthermore, chronic poverty
presents constraints in attaining substantial improvement in health and nutrition of the
population and overall development of the country. Empirical evidence tends to show
that disadvantaged socio-economic conditions hinder one‟s capacity to earn a regular
20
Page

7
Rodriguez, Fritzie. 2014. Latest PH nutrition survey reveals little progress in bearing hunger. accessed
October 30, 2015 http://www.rappler.com
income, limits access to quality education and health services for their children, and
limits their ability to provide food on the table8.

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

LARGEST NUMBER OF UW AND SUW HIGHEST OPT COVERAGE IN 2015
PRE-SCHOOL CHILDREN
1 CANDELARIA 1,950 1 SAN FRANCISCO 100%
2 SARIAYA 1,437 2 JOMALIG 88 %
3 SAN NARCISO 1,293 3 SAN ANTONIO 88 %
4 PAGBILAO 1,242 4 MULANAY 86 %
5 CATANAUAN 1,075 5 PATNANUNGAN 85 %
6 SAN FRANCISCO 1,020 6 CALAUAG 82 %
7 TAGKAWAYAN 863 7 BURDEOS 81 %
8 SAN ANDRES 818 8 SAN NARCISO 81 %
9 LOPEZ 813 9 PADRE BURGOS 80 %
10 TIAONG 809 10 REAL 80 %
11 BURDEOS 808 11 PEREZ 78 %
12 CALAUAG 779 12 PITOGO 77 %
13 GUMACA 704 13 POLILLO 77 %
14 MAUBAN 670 14 SAN ANDRES 76 %
15 INFANTA 585 15 ALABAT 76 %
16 MULANAY 572 16 CANDELARIA 75 %
17 MACALELON 557 17 PAGBILAO 74 %
18 GUINAYANGAN 515 18 TIAONG 73 %
19 PITOGO 505 19 GUINAYANGAN 72 %
20 REAL 448 20 MAUBAN 72 %
21 PADRE BURGOS 441 21 LOPEZ 69 %
22 BUENAVISTA 411 22 TAGKAWAYAN 68 %
23 POLILLO 386 23 QUEZON 68 %
24 ATIMONAN 353 24 SARIAYA 66 %
25 LUCBAN 310 25 PANUKULAN 64 %
26 SAN ANTONIO 289 26 PLARIDEL 64 %
27 GEN. LUNA 272 27 GEN. LUNA 64 %
28 JOMALIG 243 28 GUMACA 64 %
29 PANUKULAN 237 29 DOLORES 64 %
30 DOLORES 213 30 CATANAUAN 63 %
31 AGDANGAN 207 31 ATIMONAN 63 %
32 PEREZ 185 32 SAMPALOC 61 %
21
Page

8
Save the Children . 2015. Sizing up the stunting and child malnutrition in the Philippines. Accessed
November 5, 2015 https://www.savethechildren.org.ph
 33 UNISAN 183 33 MACALELON 59 %
34 QUEZON 181 34 LUCBAN 59 %
35 PATNANUNGAN 164 35 AGDANGAN 58 %
36 SAMPALOC 132 36 UNISAN 58 %
37 PLARIDEL 113 37 GENERAL NAKAR 56 %
38 GENERAL NAKAR 103 38 INFANTA 49 %
39 ALABAT 71 39 BUENAVISTA 46 %
TOTAL 21,957 TOTAL 71 %

The data presented above are the rankings of (A) Municipalities with largest number
of UW and SUW pre-school children and (B) Municipalities with highest coverage of
Operation Timbang Plus in 2015. Accordingly, the top ten municipalities with the
largest number of SUW and UW pre-school children are Candelaria (1,950), Sariaya
(1,437), San Narciso (1,293), Pagbilao (1,242) Catanaun (1,075), San Francisco
(1,020) Tagkawayan (863), San Andres (818) and Lopez (813) the municipality with
the least number of UW and SUW is Alabat with 71 children. On the contrary, table B
identifies the ranked municipalities based on their OPT coverage in 2015. Only the
municipality of San Francisco completed the operation Timbang Plus coverage with
100% followed by the municipalities of Jomalig and San Antonio both has 88%
coverage. The following municipalities are included in the top ten performing
municipalities which accomplished the required at least 80% and above coverage:
Mulanay (86%) Patnanungan (85%) Calauag (82%) Burdeos (81%) San Narciso
(81%) Padre Burgos (80%) and Real (80%) the rest of the municipalities did not meet
the required coverage. Consistently, Buenavista fall short with only 46% coverage in
2015 similar with the result of the previous years.

22
Page

Photo credit to Noel Valeros, taken at Macalelon Quezon.

 MUNICIPALITIES WITH HIGHEST MUNICIPALITIES WITH HIGHEST NUMBER
PREVALENCE OF STUNTING9 OF STUNTED (ST+SST)
1 BURDEOS 46.23 1 SARIAYA 4,398
2 SAN NARCISO 44.66 2 LOPEZ 3,260
3 GENERAL LUNA 43.61 3 TIAONG 3,256
4 JOMALIG 41.09 4 CANDELARIA 3,144
5 BUENAVISTA 39.07 5 SAN NARCISO 2,922
6 PITOGO 38.71 6 PAGBILAO 2,913
7 MACALELON 37.88 7 CALAUAG 2,883
8 PANUKULAN 37.82 8 MAUBAN 2,548
9 GUINAYANGAN 35.25 9 CATANAUAN 2,338
10 QUEZON 34.70 10 SAN FRANCISCO 2,136
11 PADRE BURGOS 34.39 11 GUMACA 2,003
12 POLILLO 33.97 12 MULANAY 1,983
13 PAGBILAO 33.03 13 TAGKAWAYAN 1,896
14 CATANAUAN 32.82 14 GUINAYANGAN 1,719
15 SAN ANDRES 32.50 15 ATIMONAN 1,655
16 MAUBAN 32.24 16 BURDEOS 1,630
17 PLARIDEL 32.02 17 SAN ANDRES 1,484
18 TAGKAWAYAN 31.63 18 REAL 1,273
19 CALAUAG 30.62 19 GENERAL LUNA 1,249
20 LOPEZ 30.27 20 POLILLO 1,218
21 PATNANUNGAN 28.74 21 LUCBAN 1,072
22 PEREZ 28.72 22 PITOGO 1,048
23 REAL 28.42 23 MACALELON 1,028
24 GUMACA 28.36 24 BUENAVISTA 944
25 SARIAYA 26.87 25 PADRE BURGOS 925
26 MULANAY 26.61 26 UNISAN 629
27 TIAONG 26.57 27 PATNANUNGAN 615
28 ATIMONAN 25.41 28 QUEZON 591
29 SAMPALOC 24.64 29 DOLORES 541
30 UNISAN 24.53 30 PANUKULAN 539
31 LUCBAN 21.80 31 SAN ANTONIO 479
32 CANDELARIA 21.46 32 PEREZ 446
33 SAN FRANCISCO 20.72 33 JOMALIG 438
34 DOLORES 17.47 34 PLARIDEL 349
23

35 GENERAL NAKAR 12.21 35 SAMPALOC 328

Page

9
Operation Timbang Plus results 2015
 36 SAN ANTONIO 9.66 36 GENERAL NAKAR 302
37 AGDANGAN 8.00 37 ALABAT 131
38 ALABAT 6.24 38 AGDANGAN 117
39 INFANTA NO DATA 39 INFANTA NO DATA

The table presented above is the ranking of (A) municipalities with highest prevalence
of stunting and (B) ranking of municipalities with highest number of stunted children
(ST + SST) ages 0-71 months in Quezon Province in 2015.

The top ten municipalities with the highest prevalence of stunting are the
municipalities of Burdeos (46.23%) San Narciso (44.66%), General Luna (43.61%)
Jomalig (41.09%) Buenavista (39.07%) Pitogo (38.71%) Macalelon (37.88%)
Panukulan (37.82%) Guinayangan (35.25%) and Quezon (34.70%). Alabat showed the
lowest stunting prevalence rate with 6.24%. However, the municipality Infanta like the
previous years has not submitted data which pertains to stunting.

On the other hand, the top municipalities with highest number of children with
stunting and severely stunting cases are the following: Sariaya (4,398), Lopez (3,260),
Tiaong (3,256) Candelaria (3,144) San Narciso (2,922), Pagbilao (2,913) Calauag
(2,883) Mauban (2,548) Catanuan (2,338) and San Francisco (2,136). The
municipality with lowest number of stunted children is the municipality of Agdangan
with 117 children. According to the Save the Children foundation in 2015, Filipino
shortness is not just a genetic trait but is attributed to generations of stunted children
who are too small for their age because of malnutrition. In addition, stunting is
considered the most common
indicator of childhood
malnutrition found in nearly all
low and middle income
10
countries . This reflects chronic
under nutrition and thought to
begin prior to birth. The
nutritional status of the mother,
along with maternal stunting,
poor health care could lead to
intrauterine growth restrictions11.
Photo credit to Noel Valeros, taken at Tagkawayan Quezon.
24

10
Victora, C., et. al., 2008. “Maternal and child undernutrition: consequences for adult health and
human capital”. Lancet. Vol. 371.
Page

11
, Stewart C., et. al., 2013. “Contextualising complementary feeding in a broader framework for
stunting prevention”. Maternal and Child Nutrition. 9 (Suppl. 2).
 PART III

SCHOOL CHILDREN DATA FROM THE DEPARTMENT OF EDUCATION

DIVISION OF QUEZON

25

20
20.43 % 19.67 % 20.39%
16.63%
15

10

0
2012 2013 2014 2015
12
Figure 14. PROVINCIAL PREVALENCE RATE ON UNDERNUTRITION OF SCHOOL CHILDREN FROM 2012 TO 2015 .

In 2015, the Department of Education has a

total enrollment of 205,480 in the division
of Quezon. However among the total
population, only 204,550 were weighed
resulting to 99.55% coverage. In
connection, the graph presented above is
the provincial prevalence rate on under
nutrition of school children from levels
kinder to grade six plus the SPED children.
It is imperative to know that the rate had a
major decline for the past year. A dip of
3.76% was seen in 2014-2015 from
20.39% down to 16.63%. However, the
Photo credits to Allan Valencia taken at Lucena City, Quezon. In photo is a student of
Gulang-gulang elementary School Beneficiary of the DEPED supplementary feeding program.
data presented above were incomplete; out
25
Page

12
Data presented were from the Nutritional Status of School Children from the Department of
Education division of Quezon which excludes the cities of Lucena and Tayabas.
of 39 municipalities 11 have not submitted their data.

SEVERELY WASTED OVERWEIGHT

5% 2%

WASTED
12%

NORMAL
81%

Figure 15. NUTRITIONAL STATUS CLASSIFICATION OF SCHOOL CHILDREN WEIGHED IN 2015

The data presented above

is the nutritional
classification of school
children weighed in 2015.
The colors presented were
green for normal, yellow
for wasted, red for
severely wasted and
orange for overweight.
The distributions were as
follows; school children
with normal weight
comprise more than two
thirds of the population or
Photo credits to Hannah Alvarez taken at Tiaong Quezon during the monitoring and evaluation of Nutricombo Program 2015
(81% or 165,933).
Wasted school children are twelve percent (12% or 24,106), severely wasted with nine
thousand nine hundred twenty seven (5% or 9,927) and overweight with three
26

thousand six hundred twenty seven (2% or 3,627).

Page
 40000
36766

35000

30000
26375
25000 24106
23190

20000

15000 14001
11556
9927
10000 7836

4504
5000 2970 3152 3627

0
2012-2013 2013-2014 2014-2015 2015-2016

SEVERELY WASTED WASTED OVERWEIGHT

Figure 16. COMPARATIVE DATA ON WASTING, SEVERELY WASTING AND OVERWEIGHT FROM 2012-2015

Based on the figure above, a four 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, 2014 and
2015 respectively. Although the prevalence rate on that particular year has been low,

27
Page

Photo credits to Noel Valeros taken at Tiaong Quezon during the monitoring and evaluation of Nutricombo Program 2015
the number of wasted and severely wasted children increased. The possibility of this
indifference may be determined as hidden hunger. Academic year 2012-2013 has the
lowest number of affected school children in all three categories. The graph were color
coded based on their categories; red for severely wasted, yellow for wasted and orange
for overweight.

30000
27428

25000 23339
21052
20000 19204
16825 16879
14829
15000 14201

10000

5000

0
2012-2013 2013-2014 2014-2015 2015-2016

MALE FEMALE

Figure 17. COMPARATIVE DATA ON WASTING AND SEVERELY WASTING BY GENDER FROM 2012-2015

Based on the figure presented above, a four year comparative assessment on wasting
by gender from 2012-2015. As presented, there are more wasted and severely wasted
boys than girls in the four year period. The academic year 2013-2014 poses the highest
number of wasting and severely wasting among the four comparative years with
twenty seven thousand four hundred twenty eight (27,428) males and twenty three
thousand three hundred thirty nine (23,339) females with a total of 50,767 school aged
children. On the other hand academic years 2012-2013 has the lowest number of
wasting and severely wasting incidence in both genders with 16,825 males and 14,201
females with a total of 31,036. Moreover, there have been no major implication on the
gender and wasting issues of school children as reviewed in the new literatures and
researches.
28
Page
 Kinder 9,968 9,197

Grade 1 11,334 10,974

Grade 2 12,075 12,083

Grade 3 12,670 12,129

Grade 4 14,271 13,218 Female

Male
Grade 5 12,704 12,718

Grade 6 10,766 11,401

SPED 239 186

Total84,027 81,906

100,000 50,000 0 50,000 100,000

Figure 18. DISTRIBUTION OF SCHOOL CHILDREN WIH NORMAL WEIGHT BASED ON GENDER AND GRADE LEVEL
IN 2015

The data presented above describes the distribution

of grade level and gender of school children with
normal weight in 2015. The figure presents the
male gender in blue and female gender in pink.
Grade levels are indicated in the left side of the
table based on the Nutritional Status Classification
of the Department of Education Quezon Province
Division. There are more normal weighed males
than females. Moreover, level 4 has the largest
normal weighed children in both genders with
14,271 males and 13,218 females. The SPED level
has the lowest number of Wasted and Severely
Wasted totaling to four hundred twenty and five
(425). All in all there are 84,027 males and 81,906
females with normal weight. It is imperative to
29

know that eighty seven percent of the total

populations of children are with normal weight.
Page

Photo credits to Faybel Rapadas taken at Macaleleon Quezon . In photo is one of the beneficiary of Nutricombo Program of
the Provincial Government of Quezon.
 Kinder 285 122

Grade 1 260 212

Grade 2 240 179

Grade 3 308 238

Grade 4 383 252 Female

Male
Grade 5 362 247

Grade 6 330 183

SPED 14 12

Total 2,182 1,445

2,500 2,000 1,500 1,000 500 0 500 1,000 1,500 2,000

Figure 19. DISTRIBUTION OF OVERWEIGHT SCHOOL CHILDREN BASED ON GRADE LEVEL AND GENDER IN 2015

The graph presented above is the distribution of grade level and gender of overweight
school children in 2015. There are more overweight males (2,182) than females
(1,445) across the different levels. There are more overweight children in grade 4
compared to other grade levels. SPED has the lowest overweight population with 26
school children only in 2015. In total there are three thousand six hundred twenty
seven (3,627) recorded overweight school children in Quezon province in 2015.
According to the World Health Organization (WHO) in 2015, the 2011 Global School-
based Health Survey also shows that about 13% of adolescents in the Philippines are
overweight and obese. Evidence shows that overweight and obese children are likely
to stay obese into adulthood and more likely to develop non-communicable diseases
(NCDs) like diabetes and cardiovascular diseases at a younger age. NCDs are now the
leading killers in the Philippines, comprising more than 50% of all deaths each year. 30
Page
 Kinder 60 54

Grade 1 82 41

Grade 2 130 47

Grade 3 124 38

Grade 4 111 48 Female

Male
Grade 5 104 31

Grade 6 53 27

SPED 5 2

Total 669 288

800 600 400 200 0 200 400

Figure 20. DISTRIBUTION OBESE SCHOOL CHILDREN BASED ON GENDER AND GRADE LEVEL IN 2015

Obesity is a state of malnutrition in which there is excessive accumulation of depot

fats such that functioning is disturbed. The consequences of obesity are psychological
difficulties (i.e. Discrimination, negative self-image, decreased socialization),
increased height with possible inappropriate societal expectations and increased
frequency of hyperlipidemia, hypertension and abnormal glucose tolerance. The
longer the child has been overweight, the more likely that this state will continue into
adulthood (Cruz et al, 200913) . The figure above shows that more males (669) than
females (288) are obese. This data were from the Department of Education Division of
Quezon in 2015. Grade level two has the highest number of obese children with one
hundred seventy seven students in comparison to the other grade levels. It is
correlatively connected with the studies of Cruz et.,al which they indicated that; the
role of decreased physical activity and the choice of food eaten are factors that
contribute to the development of overweight and obesity among children. In all the
age groups, there appears to be a significant degree of inactivity. Even if there is
performance of physical activity the frequency of either vigorous or moderate intensity
activities remain to be low.
31

13
Cruz et al. 2009. Obesity in School Aged children prevalence and Cuases. University of the
Page

Cordilleras. University of the Cordilleras. Accessed October 20, 2015

http://www.eisrjc.com/documents
 Kinder 2,010 2,034

Grade 1 2,839 2,194

Grade 2 2,698 2,048

Grade 3 2,956 2,125

Female
Grade 4 3,199 2,259
Male

Grade 5 2,899 2,298

Grade 6 2,547 1,826

SPED 56 45

Total 19,204 14,829

Figure 21. DISTRIBUTION OF WASTED AND SEVERELY WASTED SCHOOL CHILDREN BASED ON GENDER AND
GRADE LEVEL IN 2015

The above graph represents the wasted and severely wasted school children distributed
according to their grade level and gender in 2015. There are more wasted and severely
wasted male (19,204) than female (14,829) students across the province. Grade four
levels have the highest incidence of wasting among school children in the province
with a total number of 5,458. Wasting in school children comprises of 17% of the total
population of school children in the province. According to a study in 2014 there are
determinants of underweight, stung and wasting among school children these are:
Older age group having Trichuris Trichura infection increased the risk of being
stunted. Children whose mothers have completed primary education are less likely to
be stunted than children whose mothers do not have formal education. Having large
family size and inadequate intake of carbohydrate were independent predictors of
wasting. Children whose mothers completed primary education are less likely to be
underweight. Children live in food insecure households are more likely to be stunted,
under-weight and wasted than children live in food secure households14.
32
Page

14
Wolde, Berhan and Chala. 2014. Determinants of underweight, stunting and wasting among school
children. Biomed Central 2015. Accessed November 19, 2015. http://bmcpublichealth.biomedcentral
 300000 279444
272877

250000 236185
222544 218595 205460
198759
200000

204550
150000
Total school Children
Population

100000

Total School Children Weighed

50000

0
2012 2013 2014 2015

Figure 22. COMPARATIVE DATA ON TOTAL SCHOOL POPULATION AND PRE SCHOOL CHILDREN WEIGHED FROM
2012-2015

As seen on the trend data above,

there has been an increasing trend in
the number of school children
enrolled for four years. Moreover,
the total school children weighed
category has been consistent in not
accomplishing weighing all the
enrolled school children. Academic
year 2015 has the smallest gap in
weighing all the enrolled school
children. While 2013 has the largest
gap of children not weighed in that
particular year.

Photo credits to Allan Valencia taken at Lucena City, Quezon. In photo is a student of Gulang-gulang
elementary School Beneficiary of the DEPED supplementary feeding program.
33
Page
SUMMARY:

The provided document and data presented indicates that malnutrition (under nutrition,
over nutrition and stunting) is a public health issue both in pre-school and school
children in the province. However, the available data, especially data on micronutrient
deficiencies/ status is very limited. It is highly recommended that the provincial
government should include diagnostic examinations in addition to the normal
anthropometric measurement used in the conduct of Operation Timbang Plus.
Diagnostics examinations which include blood analysis that can detect micronutrient
deficiencies most common in the province. This will also pinpoint the specific
interventions that the provincial government will do upon examining the results of
such examinations.

Moreover, the findings presented herein need for nutrition interventions both from the
government and non-government sectors of society. More high quality researches are
encouraged to re-assess nutritional status with focus in all forms of malnutrition.
These predetermined study and researches will identify actions that address under
nutrition problems in the province.

In addition the Local Government Units should - at a minimum – double the share of
budgets allocated for nutrition improvement in all levels. Stronger machinery and
government frameworks are needed to guarantee that commitments from different
stakeholders create new champions of advocacy to strengthen plausible outcomes.

Lastly, there are many opportunities for improving the nutrition sector in the province.
There are gaps that should be addressed immediately. LGUs need to pay attention to
the effectivity of ongoing programs that could answer malnutrition reduction in the
locale. Together we could end hunger and malnutrition.

34
Page

Photo credits to Noel Valeros taken at Jomalig, Quezon. In photo is Mrs. Anna Villaraza-Suarez distributing malunggay lugaw to beneficiaries of Nutricombo Program in Brgy. Talisoy Jomalig Quezon