Taking action to address stunting among Filipino children

With the whole country just having celebrated the start of a new year, I find myself looking back at my childhood and how my family greeted New Year’s Eve. Like many Filipino families, we had our own traditions, one of which involved us siblings, prodded by our parents, to kick off the new year by jumping as high as we could – ostensibly so that we could grow taller that year.

“Pag-ambak ug taas, anak, aron motaas ka!”

Eventually I would realize that this did nothing to make me taller – nothing I read in my science textbooks supported what was obviously a very tall tale.

What the science does tell us is that the development and growth of children is dependent on these factors: genetics, their overall quality of life and, most importantly, their health and nutrition.

As I wrote in my previous article, it is a sad reality that many Filipino children do not get adequate nutrition; data show that one in three Filipino children below the age of five are considered stunted or, simply put, short for their age.

Unfortunately, the effects of stunting go beyond height, or the lack thereof. Studies have shown that stunted children are more prone to non-communicable diseases such as hypertension and diabetes and are more likely to suffer from obesity compared to children who do not suffer from stunting. Stunted children tend to be more apathetic and to be more anxious; they are also vulnerable to depression and may suffer from lower self-esteem compared to non-stunted children.

Stunted children not only fail to reach their potential height; as a general rule, they also fail to fulfill their full academic and professional potential.

Government interventions

Because the effects of stunting are irreversible, government interventions have been focused on preventing it. Government policy makers have long recognized the complexity of the problem, as it deals not only with early child care and development, but maternal care as well. To wit, previous administrations have introduced laws to help improve the state of health of mothers and children, with the end in view of preventing stunting and other child malnutrition issues.

One of these is Republic Act (RA) 10028 or the Expanded Breastfeeding Promotion Act, which was passed in 2009. Congress passed this measure after health experts convinced legislators of the unique advantages of breastfeeding, which benefits not just the mother, but her child, as breastmilk contains essential nutrients completely suitable for the infant’s needs.

The passage of this law underscored the need to further promote breastfeeding, and for health and non-health facilities, establishments or institutions to create lactation stations. The law also requires the conduct of continuing information, education and training programs for physicians, nurses, midwives, nutritionist-dietitians, community health workers and traditional birth attendants and other health workers regarding the latest developments in lactation management.

Another relevant law, passed nine years later in 2018, is RA 11210 or the Expanded Maternity Leave Act. Passed during my third and last term in Congress, this law grants female workers 105 days of maternity leave with full pay, almost double the previously mandated 60 days. The enactment of this law is supposed to encourage female workers to better assume their maternal roles and have ample transition time to regain health and overall wellness before resuming work.

The extended leave allows new mothers to focus their energy on raising their newborn, ensuring proper early child care as well as proper nutrition for their young child.

In the same year, RA 11037 or the Masustansyang Pagkain para sa Batang Pilipino Act was also passed. This law mandates national government agencies to closely collaborate with each other in order to institutionalize a National Feeding Program for undernourished children in public day care centers, kindergarten and elementary schools to combat hunger and malnutrition.

The National Feeding Program is composed of several components.

First, the Department of Social Welfare and Development (DSWD), in close coordination with local government units, is in charge of implementing supplemental feeding programs for undernourished children between the ages of three to five, with each identified child provided with fortified meals for at least 120 days.

Second, the Department of Education (DepEd) is tasked to implement a school-based feeding program for undernourished school children in public schools. Included in the program are children from kindergarten to grade six. They are also to be provided with fortified meals for at least 120 days.

Third, the DSWD and the DepEd are enjoined to coordinate with the Department of Agriculture, the National Dairy Authority and other concerned organizations to ensure that fresh milk and fresh milk-based food products are included in the fortified meals provided to our children.

Other aspects of the law include the government providing micronutrient supplements, schools being encouraged to devote land space to cultivate vegetables and other nutrient-rich plants, the incorporation of nutrition education in school curriculums and Water, Sanitation and Hygiene (WaSH) programs.

Another landmark law that was also passed that protects and promotes the right to health of all Filipinos is the RA 11223 or the Universal Health Care Act. Enacted in 2018, this law provides Filipinos better access to health care information, education and, most importantly, services that would enable them to have an improved quality in life.

The first 1,000 days

Among all the laws that have been passed in recent years, one that has been most celebrated by children’s rights advocates – and one close to my heart – is RA 11148, also known as the Kalusugan at Nutrition ng Mag-Nanay Act or, alternatively, The First 1,000 Days Law, a measure I co-authored in the House of Representatives.

Recognizing that the first 1,000 days of a child’s life is crucial in ensuring their health, The First 1,000 Days Law was introduced primarily to provide comprehensive, sustainable, multi-sectoral strategies and approaches to address health and nutrition challenges of mothers and children. Part of this is to provide evidence-based nutrition interventions to support women and children two years and younger to prevent malnutrition.

This law also outlines several programs and policies to support mothers and children to ensure that mothers are supported before, during and after they give birth, while specific interventions are introduced and sustained for children up to two years of their life. Some of these interventions and programs include the further training of local health workers, the creation of women and child-friendly spaces during times of calamities, the availability of lactations stations, provisions for counseling throughout the mother’s pregnancy stages, among others.

Through these interventions the government hopes to lend a helping hand to mothers in this crucial stage of a child’s life to prevent stunting and its irreversible effects.

Lahat kasali, lahat kasalo

The government recognizes that its anti-stunting initiatives would benefit immensely from the support of various sectors, as what is at stake is, quite literally, the future of millions of Filipino children. Multi-sectoral movements like Pilipinas Kontra Gutom (PKG), which brings together the government, members of the academe, non-profit organizations and some of the biggest private corporations in the country to collectively combat the issue of hunger, provides a venue for everyone to pitch in and be part of the solution in addressing the different hunger-related issues, including stunting.

Since PKG was launched in November, more companies and organizations have joined the movement and have participated in its various activities. They have generously shared their knowledge and expertise – not to mention their considerable resources – to collaborate with us in order to find sustainable and impactful ways to address the extraordinarily multi-faceted problem that is hunger.

As we usher in the new year, I urge everyone to jump – to jump in and contribute to efforts to ensure that future generations of Filipinos no longer suffer from stunting. Given all the challenges we face, this will no doubt be a daunting task; but if we continue to work together – to work hand in hand with various sectors – to protect and promote the health of our children, then a brighter and better future for millions of Filipino children will be within our reach.

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Cabinet Secretary Karlo Nograles is chairman of the Inter-Agency Task Force on Zero Hunger. Prior to his appointment to the Cabinet in November 2018, the former House appropriations chair served three consecutive terms in the House of Representatives representing the first district of Davao City.