Chapter I

The Problem and It’s Scope

INTRODUCTION

Malnutrition continues as a global threat among vulnerable children in the

country. Children with poor nutrition are prone to become stunted and manifested

by their height which is too short for their age. Researches shows that 159 million

of children under five years old are stunted due to severe malnutrition worldwide.

Through there are nutritional programs to combat malnutrition, still there are

children with continuous poor access to nutrition. Comprehensive strategies were

formulated to dynamically change the nutritional programs yet we find them

ineffective correlating to constant and increasing number of malnourish children.

Looking into the Philippine setting, as of 2019, according to UNICEF (United

Nations International Children’s Emergency Fund) that many children and

adolescents in the Philippines are not growing up healthy due to poor diets,

inadequate nutrition and food systems.

The Department of Health together with the National Nutritional Council

are collaborating to extract the source of these issues and continuously formulate

effective strategies to resolve malnutrition. Formulated strategies are then

considered which are delivered to different Municipalities for intensive and

comprehensive implementation. The Municipality of Villanueva is tremendously

active through the initiatives of our Local Chief Executive (LCE) to fight
malnutrition in the locality for she is a witness on how malnutrition affects every

lives of our children. Categorized as one of the top 10 Municipality with the

highest cases of malnourish children in the Province of Misamis Oriental,

currently the Municipality of Villanueva has overcome this remarkable situation.

Appointing a Municipal Nutrition Action Officer (MNAO) has improved the

strategies in the Municipality, mobilizing the Barangay Nutritional Scholars (BNS)

through the supervision of the MNAO, children are intensively monitored and

evaluated for signs of malnutrition.

Correlative to this study, the Rural Health Midwives (RHMs) of the Local

Government Unit of Villanueva would like to seek risk factors that contributes to

constant cases of malnutrition in the Municipality. Regularly, the Municipal

Nutrition Action Officer (MNAO) are continuously implementing nutritional

strategies for malnutrition, hence as Rural Health Midwives who are in direct care

for these children, we would like to understand the origin of poor nutrition. On the

contrary, there are assessments from the Nutrition Office which are apparent to

the Barangay Health Stations. Thus, collaborative study will intensify the

formulated strategies to better and fully eradicate malnutrition in the Municipality.

Furthermore, as Rural Health Midwives covering holistic care towards the

people in the community should consider variety of concepts to effectively

implement health strategies. Malnutrition in particular should be a major concern

of the Municipal Nutrition Action Officer (MNAO) but we would like to deep dive
closer in identifying the risk factors that contributes to the problem. Identifying the

major cause would suggest formulation of strategies as Midwives since we are

the direct health implementer in the community.

CONCEPTUAL FRAMEWORK

The conceptual framework of the study merely elaborates the

determinants of stunting among children ages 0 to 5 years old. The framework

gives the researchers an idea on what to focus on during the identification of risk

factors that contributes to stunting among the children of Villanueva, Misamis

Oriental. Apparently, there is a huge factor on household and family factors,

delayed initiation and non-exclusive breastfeeding, inadequate complementary

feeding, infection and illness and underlying community and societal factors.

Furthermore, these identified factors are on the context of duties and

responsibilities of Rural Health Midwives. Family and household factors can be

regulated by the Midwives since the community trust them in the promotion of

health programs. Initiation of breastfeeding is within the scope of the Midwives to

ensure early breastfeeding during delivery. Complimentary feeding can be

initiated by the Nutrition Office but continuously monitored by the Midwives in the

community. Infection and illness through environmental sanitation, prevention

measures through vaccinations and information and education campaign (IEC)

are one of the daily routine of Midwives. Lastly, underlying community and
societal factors are previously identified by the Midwives to ensure effective

implementation of health programs.

Figure 1: Conceptual Framework on the determinants of Stunting among

children

The researchers would like to identify factors that contributes to stunting

among the under five children of Villanueva, Misamis Oriental. Thus, we

formulated our Dependent and Independent variables are shown in figure 2.

Diving into the factors identified by the Conceptual Framework, the researchers

has formulated our Schematic Diagram.

INDEPENDENT VARIABLE DEPENDENT VARIABLE

CHILDREN BELOW 5
YEARS OLD:
1. AGE
2. GENDER 1. ACCESS TO
3. WEIGHT NUTRITION
4. HEIGHT 2. FOOD IDENTIFIED
5. SOCIO- SECURITY RISK
ECONOMIC 3. HOUSEHOLD FACTORS
PROFILE HYGIENE
6. NO. OF SIBLINGS
7. PARENTS
EDUCATION
ATTAINMENT

Figure 2: Schematic Diagram of Stunting among below 5 years old

children

The schematic diagram demonstrates the independent variables of the

study which includes age, gender, weight and height upon assessment, socio-

economic profile, number of siblings and parents educational attainment. Age

can be a factor for stunting for this assesses the nutritional needs of the child,

while gender contributes to the physiologic needs during the growth and

development of the child. Weight and height of children are taken during the data

gathering procedure as primary data for malnutrition. Number of sibling affects

the nutritional needs of children anchored with socio-economic profile

contemplating to the financial capacity of the family. Lastly, parent’s educational

attainment contributes to the knowledge and awareness of parents towards

adequate nutrition that their children needs.

 The dependent variable was used by the researchers during the process

method. Correlatively, the independent variable has a tremendous effect on the

dependent variable for the identification of risk factors of stunting among below 5

year old children directly bounced back to the primary profile of our respondent.

The dependent variable chosen by the researchers are access to nutrition, food

security and household hygiene. Access to nutrition directly correlates to the risk

factors for this is the main criteria relative to malnutrition. Food security measures

the ability of the family to provide adequate food for their children. Lastly,

household hygiene directly affects nutrition for health starts with proper hygiene.

STATEMENT OF THE PROBLEM

The researchers aims to identify the risk factors of stunting among children

below 5 years old by answering the following questions relative to the study.

1. What is the profile of children below 5 years old in relation to age and

gender?

2. What is the current weight and height of children below 5 years old?

3. What is the socio-economic profile of below 5 years old children’s

profile?

4. How many under five children currently living in the household?

5. What is the educational attainment of under five children’s parents?

6. Does the children have access to adequate nutrition?

 7. Is the food security enough for adequate supply of children?

8. What is the current hygiene status of household including the under

five children?

9. Is there s significant difference between children below five years old

and their nutritional status?

NULL HYPOTHESIS

As we aim to answer our objectives, below is the null hypothesis

formulated by the researchers.

1. There is no significant different between under five children of

Villanueva, Misamis Oriental and risk factors of stunting using a 0.05

margin of error.

SIGNIFICANCE OF THE STUDY

The significance of the study aim to identify the risk factors of stunting

among the under five children of Villanueva, Misamis Oriental.

BELOW FIVE CHILDREN. Implementation of strategies based on the identified

risk factors by the researchers. Increasing coverage of adequate food and

access to nutrition based on their metabolic needs.

PARENTS AND GUARDIANS. Awareness and knowledge on the existence of

stunting among under five children which likely contributes to malnutrition.

Formulation of contingency plan which ensures access to adequate food towards

their children.

NUTRITION OFFICE. Collaborative implementation of nutritional programs

together with the Rural Health Midwives. Reinforcing information and education

campaign during the “PABASA SA NUTRITION” activities relative to stunting.

RURAL HEALTH UNIT OF VILLANUEVA. Mobilization of Barangay Health

Workers and Barangay Nutrition Scholars to easily identify stunted children in the

Municipality. Master listing of children that needs immediate care due to poor

nutrition.

LOCAL GOVERNMENT UNIT OF VILLANUEVA. Formulation of resolution and

enough fund source for the sustainability of Nutritional programs. Job

opportunities and hiring of Barangay Nutrition Scholars to maintain monitoring

and evaluation of under five children.

SCOPE AND LIMITATION OF THE STUDY

The researchers identifies the scope and limitation of the study to under

five children (0 – 5 years old) and specifically those children diagnosed as

stunted by the Municipal Nutrition Action Officer (MNAO) of Local Government

Unit of Villanueva, Misamis Oriental. The researchers will cover all the

diagnostically considered stunted where data will be fully extracted. Time frame

of the study will be based during the data gathering procedures.

DEFINITION OF TERMS

The researchers aims to define the following terms used during the study

and how this concepts were used on identifying the risk factors of stunting among

under five children of Villanueva, Misamis Oriental.

STUNTED CHILDREN. Identified by the Municipal Nutrition Action Officer

(MNAO) as children with height that is too low for their age. These children are

the primary respondents for the study.

MUNICIPAL NUTRITION ACTION OFFICER. Appointed officer of the Local

Government Unit of Villanueva which monitors, evaluation, formulate strategies

and implements nutrition programs to the community of Villanueva, Misamis

Oriental.

MALNUTRITION. Nutritional status of children relative to their weight and height

parallel to their age. The term itself correlates on the severe effects of inadequate

or poor nutrition among children.

RISK FACTORS. The main target of the study which the researchers would like

to identify relative to stunted children. Distinguishing the source of malnutrition

through awareness of the risk factors can be an effective foundation for strategic

planning in battle for nutrition.

RURAL HEALTH MIDWIVES. Primary health care providers in the community

which implements Department of Health programs, guided by the Municipal

Health Officer and Public Health Nurse. Health professionals who collaborates

with the Municipal Nutrition Action Officer (MNAO) on the battle to eradicate

malnutrition in the Municipality of Villanueva.