The population of the Philippines was 65.3 million in 1993, growing at a rate of 2.3% per annum. The nation consists of more than 7,000 islands, the main groups being Luzon in the north (where the capital, Manila, is), Visayas, and Mindanao in the south.
Following the election of President Ramos in 1992, some economic growth has restarted. The Philippines has yet to experience the rapid economic growth of neighbours in ASEAN, but there are hopes for this, which could bring quicker resolution of persistent nutrition problems. Nutritional trends have previously been described in the ACC/SCN's Update Report (1989, p. 120-123) and in the Second Report on the World Nutrition Situation (vol.II, p.32-37, 1993).
Recent Trends in Nutrition
Two separate sources of data on nutrition are available for the Philippines. One is from repeated national surveys, carried out by the Food and Nutrition Research Institute (FNRI). The second is from the national weighing programme. Both these indicate some recent improvements in underweight prevalences. Trends may be compared between the two data sources, but estimates of levels are not directly comparable, because both sampling and cut-offs are different.
The FNRI nutritional survey of 1992 showed little change in underweight prevalences from 1990 - estimated at 33.5% in 1990 and 33.0% in 1992 (stunting prevalences did decrease somewhat more over this period, while wasting increased slightly - in line with the observation of little change in underweight). Recently published data gave an estimate of 29.6% prevalence of underweight in 1993, showing substantial improvement over 1992. Thus the national-level surveys indicate significant progress over 1990-93, equivalent (taking these two data points) to an improvement of 1.3 percentage points per year.
The national weighing programme data (Operation Timbang - OPT) that have been collected annually for more than 15 years now, show similar trends. Using the previous Philippine growth standards, the prevalence of children below 75% weight-for-age declined from 17.8% in 1990 to 16.3% in 1991 and 15.0% in 1992. This is an improving rate of around 1.5 percentage points per year. The OPT surveys, which are used for local nutrition programming, are among the most extensive anywhere. In 1992, coverage of preschool children was more than 85%, roughly 9.7 million children.
Source: FNRI (1993).The trends in underweight using the FNRI surveys are compared by region for 1989/90 and 1992 in Figure 1. The wide regional variations in levels and trends in underweight, which were observed in previous reports, are confirmed in the most recent surveys. Reductions in the prevalence of underweight between 1989/90 and 1992 were observed in Central Luzon, Southern Tagalog, Bicol, Eastern Visayas, Western Mindanao, Southern Mindanao and the Cordillera Administrative Region. However, significant increases in underweight were observed especially in Central Visayas. The four regions with the highest underweight (and stunting) prevalences in 1992 were Central Visayas, Western Visayas, Eastern Visayas, and Ilocos, while regions whose average prevalences were lowest were Western Mindanao, Central Luzon, the Cordillera Administrative Region, and the National Capitol Region (Metro Manila). The most important improvements in nutrition occurred in Bicol and Eastern Visayas, both of which had historically had high rates of underweight.
Factors Affecting Trends in Nutrition
Economic Growth. In 1993 GNP per capita in the Philippines was estimated at U.S.$830. Per capita GDP grew at an average annual rate of 0.65% between 1986 and 1993. Growth was more rapid than this average for 1986 to 1990, but virtually stopped thereafter.
Despite considerable recovery during 1986 and 1989, Philippines is behind its neighboring countries regarding foreign investment inflows, export performance, and income growth. A string of major natural disasters in 1990 and 1991 worsened the growth.
Helped by an economic recovery programme and lower inflation, the most recent report by the World Bank indicates that the poverty incidence in the country has declined somewhat from 45% in 1985 to about 41% in 1991, with most of the gains accruing to the poorest. This trend inpoverty is generally in line with the slight improvements in the nutrition situation in the early 1990s compared to the last half of the 1980s.
Household Food Security. Food access and utilization are the most significant food security constraints, with aggregate food supplies generally adequate at the national level although domestic food production is often unstable. Inflation for the economy as a whole has risen faster than food prices, making food relatively less expensive than non-food items. However, chronic deficiencies in dietary quality persist as a problem among both adults and children.
Overall, the nutrition situation in the Philippines seems to be improving as the economy grows and poverty declines somewhat. Along with economic growth and poverty reduction, calorie availability has increased.
Health, Education, Women's Status. One of the positive trends in the health sector is the continued increase in the coverage of immunization of infants. DPT immunization now covers 88% of all infants, compared to 79% in 1988, and measles vaccination now covers 85% compared to 77% in 1988. The level of access for women to antenatal care now reaches 80%.
The absolute per capita expenditures for education and health in the national budget have risen, although the proportions of the total budget for education shows a declining trend.
A recent DHS survey in the Philippines indicates that the current fertility level remains relatively high, with a total fertility rate of 4.1 children per woman. This result indicate that the Filipino women have the highest fertility rate amongst women in the Southeast Asian region. The trend also indicates that the fertility dropped only slightly compared to the mid-1980s, which was estimated at 4.3 children per woman.
The DHS surveys also showed that breastfeeding of children is less common in the Philippines than in other developing countries, with only about a third of all infants exclusively breastfed at age younger than three months. Weaning is done at a very young age. By age 4 to 6 months, the proportion of infants that are exclusively breastfed drops to less than 10%. These sub-optimal practices contribute to the high levels of underweight and stunting in very young children.
Philippines
(Estimates in 1993)
|
Population |
: 66 million |
|
Population Density |
: 210 per sq. km. |
|
Population Growth Rate |
: 2.3% per annum |
|
Urban Population |
: 45% |
|
IMR |
: 45 |
|
GNP US$ (Per Capita) |
: 830 |
|
PPP estimates of GDP |
: 2440 |
Underweight preschool children (Percent below -2 s.d. weight for age)
Infant mortality rate (Per 1,000 live births)
ECONOMICS
GDP per capita (1987 Mkt. prices, Pesos / capita)
Debt service ratio (Debt service/exports)
FOOD
Food production index (Per caput, 1979-81=100)
Dietary energy supply (Kcals/caput/day)
Consumer price index (1980=100)
FPI/CPI ratio (1980=100)
HEALTH
Immunization coverage (Percent)
Access to local health care (Percent)
PUBLIC EXPENDITURES
Education and health expenditures (US $ per capita)
Education and health expenditures (Percent of government expenditures)
