Philippines

Data Source: Nutritional Status of Filipino Children and
Selected Population Groups Survey 2011 (Food and Nutrition
Research Institute [FNRI] 2012), unless noted otherwise

NUTRITION PROFILE						MarchApril 2014
2014

Why Invest in Nutrition?
• Of the 11.2 million children under 5 years of age in
the Philippines, approximately 3.7 million (34%) arestunted. These undernourished children have an
increased risk of mortality, illness and infections,delayed development, cognitive deficits, poorer
school performance, and fewer years in school.
• The mortality rate for children under 5 is 34 per
1,000 live births—nearly 45% of these child deaths
are attributable to various forms of undernutrition.

• Malnutrition undermines human capital and economic
productivity and can limit progress in achieving atleast 6 of the 8 Millennium Development Goals andtargets set by the World Health Assembly.
• Investing in nutrition in the Philippines is necessary
to sustain further gains in development, significantly
reduce child mortality, improve children’s school
performance, and result in greater economic
productivity for the nation.

Summary of Nutritional Status and Priorities
Levels of stunting, low birth weight, and wasting haveremained essentially unchanged in the Philippines
in the last decade, while levels of overweight andobesity, particularly among women (of whom 27% areaffected), have increased. Anemia affects two-thirdsof children 6–11 months and 44% of pregnant women,
although other micronutrient deficiencies such asvitamin A and iodine have been reduced significantly.
Interventions in the Philippines need to address early
determinants of stunting and wasting, particularly
low birth weight which affects 1 in 5 births, as well as
postnatal determinants such as suboptimal infant andyoung child feeding (IYCF), particularly early initiationof breastfeeding, exclusive breastfeeding, and dietary
diversity of complementary foods.
Stunting. A third of children under 5 are stunted in thePhilippines, a number that has remained essentiallythe same in the last decade. Prenatal factors such as
low birth weight and maternal malnutrition (including
anemia) contribute to stunting in the Philippines, as do
suboptimal IYCF practices, including delayed initiationof breastfeeding, low rates of exclusive breastfeeding,and low dietary diversity of complementary foods.
According to the 7th National Nutrition Survey, 12–14%
of children under a year of age are already stunted,
increasing to more than a quarter of children by 1 yearof age. Infectious disease and intestinal parasites also
play a role in stunting and other forms of malnutrition(such as anemia) in the Philippines.
Maternal malnutrition and low birth weight. As of
2008, 1 out of 5 births in the Philippines are low birthweight (UNICEF 2013), indicating a significant role ofmaternal and prenatal factors in the development ofmalnutrition in children. Wasting, which is more common
in low birth weight infants, affects 11–12% of children
under a year of age in the Philippines (FNRI and DST2008) compared to 7% of all children under 5 years.
Maternal overweight and obesity. The Philippines isexperiencing the “double burden of malnutrition”—atthe same time that a third of children are stunted and
14% of women of reproductive age are underweight,
27% of women are overweight or obese (FNRI
and DST 2003). Overweight and obesity are morecommon in older women than among adolescents.
Overweight and obesity among children under 5 has
been increasing in the past decade, although overall
numbers are still low—from 2.8% in 2003 to 4.8% in2011.
Anemia. Almost half of pregnant women are anemic,
at least partially reflecting low iron supplementation
utilization and low deworming coverage. Amongchildren 6–11 months, two-thirds suffer from anemia,roughly twice the rate of the under-5 population as awhole (36%) (FNRI and DST 2003).
Micronutrient deficiencies. Vitamin A deficiency
has decreased in the Philippines, estimated to affect19% of preschool-age children in 2007–2008, downfrom 40% in 2003 (National Nutrition Council 2012;
UNSCN 2010). Iodine deficiency does not appear to
be a problem as median urinary iodine concentration
among school-age children was 201 ug/L in 2003,
which is classified by WHO as “more than adequate”(WHO 2007; National Nutrition Council 2012).

PHILIPPINES NUTRITION PROFILE

Maternal and Child Malnutrition Indicators in the Philippines
Underweight (women)
Overweight/obese (women)
Overweight/obese (child)
Low birth weight
Stunting
Underweight
Wasting
Anemia (pregnant women)
Anemia (child)
Vitamin A deficiency

14%
27%
5%
21%
34%
20%
7%
44%
36%
19%
0%

10%

Children under 5 years

20%

30%

40%

50%

Women 15-49 years

Sources: 2011 national status survey (FNRI 2012); anemia, women underweight, and overweight:
6th National Nutrition Survey (FNRI and DST 2003); vitamin A deficiency: UNSCN 2010; low birthweight: UNICEF 2013
Note: The median urinary iodine concentration (UIC) for school-age children is 201 ug/L; theproportion of school-age children with low UIC (< 100 ug/L) is 23.8% (WHO 2007).

Key Drivers of Maternal and Child Malnutrition in Philippines
Immediate and Underlying

Basic• Suboptimal IYCF practices including delayed
initiation of breastfeeding, short duration of
exclusive breastfeeding, and low dietary diversityof complementary food• Natural disaster-prone and climate-changesensitive environment leading to population
displacement as well as illness and contaminatedwater• Maternal malnutrition and low birth weight• Infectious disease burden and inadequate healthseeking behaviors• Food insecurity due to disaster-prone environment
and vulnerability to food price shocks• Inadequate water, sanitation, and hygiene,
particularly water pollution and contamination ofdrinking water sources with solid waste and poor
hygiene/sanitation practices (open defecation inrural areas and low sewerage coverage)

2• Prolonged conflict in some parts of the country
leading to population displacement and insecurity• Increasing urbanization placing a strain on healthsystems and increasing the burden of disease
among the urban poor in particularPHILIPPINES NUTRITION PROFILE

Child Nutrition
Trends in Nutritional Status of Children Under 5,
2003–2011

Nutritional Status of Children by Age (in Months),
2008

40

50
40

34 32 34

20

Percent

Percent

30

21 21 20100

6StuntedUnderweight2003 (FNRI)

7

3

7

Wasted

4

30
20
10

5

0

Overweight/Obese2008 (FNRI)

0–5

6–11

12–23

Stunted2011 (FNRI)

Sources: 6th and 7th National Nutrition Surveys (FNRI and DST 2003 and 2008);
2011 national status survey (FNRI 2012)

24–35

36–47

Underweight

48–59
WastedSource: 7th National Nutrition Survey (FNRI 2008)

Ever breastfed

98%

Dietary Practices
Early initiationof
of Children
breastfeeding

45%

Exclusive breastfeeding
Ever breastfed
Timely introduction of complementary foods
Early initiation of breastfeeding
Minimum dietary
diversity
Exclusive
breastfeeding
Minimum meal
frequency(breastfedchildren)Timelyintroductionof complementary
foods
Minimum
dietary diversity
Minimum acceptable diet (breastfedchildren)
Minimum meal
frequency
Consumediron-richfoods (breastfed
past day children)
Minimum acceptable diet (breastfed children)
Consumedvitamin-A rich foods past day
Consumed iron-rich foods past day
Supplemented with vitamin A in past 6 months
Consumed vitamin-A rich foods past day
Supplemented
with
iron
in pastweek
3%
Supplemented
withvitaminA inpast 6 months
Households withadequately iodizedsaltSupplemented
with ironin past week

46%

29%

34%

90%

78%

91%

Children under 2 years

63%

25%
24%

Children under 5 years

81%

47%

0%
20%

0%

70%
66%

20%40%

49%
73%

90%
85%

37%

76%
73%

40% 60% 60%

80%
80%

100%
100%

Sources: Nutrition Update 2010 (Kothari and Abderrahim 2010); 2008

Children under 2 years
Children under 5 years
Demographic and Health Survey (NSO and ICF Macro 2009)Child Health Indicators

Received basic vaccinations by 12 months*

81%

Received basic vaccinations by 12 months

80%

Received deworming in past 6 months**

Received deworming in past 6 months

Symptoms of acute respiratory infection in past 2 weeks

5%

Symptoms of acute respiratory infection in past 2 weeks

84%

38%

5%

Care-seeking for acute respiratory infection

Care-seeking for acute respiratory infection

Symtoms
ofof
diarrhea
Symtoms
diarrheaininpast
past22weeks
weeks

50%

9%14%

Care-seeking
Care-seekingfor
fordiarrhea
diarrhea

Symptoms
ofoffeverSymptoms
feverininpast
past22weeks
weeks

50%

Children 12–23 months of age
Children under 5 years

38%
34%

19%
22%

Care-seeking
Care-seekingfor
forfever
fever

42%
39%
0%
0%

20%
20%

40%
40%

60%
60%

80%
80%

100%
100%

Source: 2008 Demographic and Health Survey (NSO and ICF Macro 2009)Children 12-23 months of age
Children under 5 years
Note: Basic vaccinations include BCG, measles, and three doses each of DPT and polio vaccine.

Child Mortality

60
Percent
Mortality
Rate per1,000 Live Births

70
60
50
40
30
20
10
0

50
40
30

62

48

58

48

51
35

20
10
0

18

17

40

46

29

25

16

No education
Neonatal

41

Primary
Infant

34

42

30

31

Secondary
Under 5 or higher

2001
(DHS)
(DHS)
(DHS)(DHS)
1998(DHS) 2006
2003
(DHS) 20112008
Note: Data are for the time period within the previous 4 years of the survey.

3

PHILIPPINES NUTRITION PROFILE

Maternal Health and Nutrition
Maternal Health Indicators
Maternal mortality ratio (per 100,000 live births)

99

Total fertility rate (children per women)

3.3Median age at first marriage (of women 25–49 years)

22.2

Median age at first birth (of women 25–49 years)

23.2% of women 15–19 years who have begun childbearing by 19

24.1

Median number of months since preceding birth (15–49 years)

No data% of married women currently using any method of family planning

50.7% of married women with an unmet need for family planning

22.0% of women 15–49 years with live birth in the past 5 years receiving antenatal care from a“medically-trained” or “skilled” provider (doctor, nurse, or midwife)

91.1% of women 15–49 years with birth in the past 5 years who delivered in a health facility

44.2% of women 15–49 years with birth in the past 5 years who delivered with a “medically-trained”
or “skilled” provider (doctor, nurse, or midwife)

62.2

Maternal Nutrition Indicators% anemic (pregnant: Hb < 11 g/dL; non-pregnant: Hb < 12 g/dL)

Pregnant

43.9

Lactating

42.1% of women with birth in the last 5 years given vitamin A supplementation after birth of last child

45.6% of women with birth in the last 5 years given any iron supplementation during last pregnancy

81.3% of women with birth in the last 5 years who took at least 90 days of iron supplementation during
pregnancy of last child

34.0% of women with birth in the last 5 years who took deworming medication in last pregnancy

13.3% living in houses with iodized salt (above 15 ppm)

54.5

Sources: 2008 Demographic and Health Survey (NSO and ICF Macro 2009); maternal mortality: UNICEF 2012; anemia: 6th National
Nutrition Survey (FNRI and DST 2003); iodized salt: FNRI 2012

Food Security; Diet Diversity; and Water, Sanitation, and Hygiene
Food Security Indicators
Global Hunger Index (2013)% of households with poor or limited food consumption (food insecure)13.2 (serious level of hunger)
No data% undernourished in total population (2011–2013)

16.2

Food supply (kcal/capita/day) (2009)

2,580

Depth of food deficit (kcal/capita/day) (2011–2013)

102

Diet Diversity Indicators% of dietary energy supply from cereals, roots, and tubers (2008–2010)

60

Average supply of protein from an animal source (grams/capita/day) (2008–2010)

26

Water, Sanitation, and Hygiene Indicators% of population with access to improved drinking water sources (2008)89% of population with access to sanitation facilities (2008)67*% of population using appropriate treatment method for drinking water (2008)

29

Sources: FAO 2013; Global Hunger Index: von Grebmer et al. 2013; food supply: FAOSTAT (http://faostat3.fao.org/faostat-gateway/
go/to/browse/FB/FB/E); water, sanitation, and hygiene indicators: NSO and ICF Macro 2009
* Compilation of all improved, not shared facilities.

4

PHILIPPINES NUTRITION PROFILE

Gender
The Philippines has made steady progress inpromoting gender equality. More girls than boys
complete high school, but overall the number ofadolescents completing high school is about 20%.
Other indicators have fluctuated or could be improved.
The age-specific fertility rate for adolescent girls
15–19 years was 56 in 1970, in 1998 it was 46, and asof 2008 it rose again to 54. Nearly 16% of women
20–49 years of age are married by the age of 18
and 24% of adolescent girls have given birth to achild by 19 years of age, as indicated in the 2008
Demographic and Health Survey. In that survey, 57%
of women reported being employed, among whom
41% reported being able to decide by themselves
how to dispose of their income and 54% reported
earning less than their husbands. In addition, domestic
violence is prevalent—24% of women of childbearing
age reported ever having experienced various formsof domestic violence in their lifetime. Seventy-sevenpercent of women of childbearing age 15–49 years
reported participating in decisions about their own
health, major household decisions, making purchases
for their daily household needs, and visiting relatives,
and this is consistent across all age groups among
women of childbearing age.

Government Policies and Program
Environment: Needs and Challenges
Policies. The Philippines has been graded “strong” innutrition governance in a past assessment (Engesveen
et al. 2009) and in July 2013 the Philippines reiterated
its commitment to reducing malnutrition by signingon to the Scaling Up Nutrition (SUN) Movement. The
current nutrition plan, the Philippine Plan of Action
for Nutrition 2011–2016, developed by the National
Nutrition Council (the highest-level policymaking
and coordinating body for nutrition), aims to reducestunting to 20.9%, wasting to less than 5%, and low
birth weight to less than 19.6%, and aims to reduce theproportion of “nutritionally-at risk” pregnant womenand reduce anemia. The plan also aims to maintainreductions in vitamin A and iodine deficiencies andprevent rises in overweight/obesity among children
and adults. Actions set forth by the plan of action
are focused on the first 1,000 days (from pregnancy
through the first 2 years of life), evidence-based
interventions, and targeting more vulnerable groups.
Actions include:• Provision of micronutrient supplementation andfortified foods to address continued vitamin A, iron,and iodine deficiencies• Capacity building of community-based support
groups and health and nutrition workers in IYCF,
home fortification of complementary food,establishment of lactation centers in workplaces,
IYCF promotion in schools and in the media, andenforcement of the International Code of Marketingof Breast Milk Substitutes• Promotion of good sanitary practices including
handwashing• Deworming

Nutrition-Specific Policies
The Philippine IYCF Strategic Plan of Action for
2011–2016
Revised Policy on Child Growth Standard, 2010
Philippine Code of Marketing of Breast Milk
Substitutes (revised in 2010)
Revised Policy and Guidelines on Micronutrient
Supplementation, 2010
Guidelines for the Monitoring of Milk Code
Activities, 2009
Adopting New Policies and Protocol on Essential
Newborn Care, 2009
Breastfeeding Promotions Act, 2009
Strategy for Maternal, Newborn, and Child Healthand Nutrition, 2008
Adoption of International ReferenceStandards, 2003
Zinc Supplementation and Reformulated
Oral Rehydration Salt in the Management of
Diarrhea, 2007
Revitalization of the Mother-Baby-Friendly
Hospital Initiative in Health Facilities with
Maternity and Newborn Care Services, 2007
Philippine Food Fortification Act, 2000
Early Childhood Care and Development Act, 2000
Updated Micronutrient Supplementation, 2003
Medium-Term Philippine Plan of Action for
Nutrition 1999–2004
Philippine Plan of Action for Nutrition, 1993

5

PHILIPPINES NUTRITION PROFILE• Adoption and implementation of community-based
management of acute malnutrition• Strengthening prenatal nutrition services throughimproved counseling and supplementation• Addressing overweight/obesity emergence throughpromotion of a healthy lifestyle including healthyeating and increased physical activity (National
Nutrition Council 2012).

Programs. Since 1991, responsibility for
implementation of public health services, including
nutrition, was transferred to local government units
which include provincial, city, municipal, and village
governments. Municipal and village (barangay) local
government units and their respective nutritioncommittees have the main responsibility for nutrition
programs (Solon 2006). In the communities,
specifically-trained village-based nutrition workers(barangay nutrition scholars) lead community
mobilization efforts for nutrition activities, assisted
by barangay health workers who receive incentives
for their work (ibid). Implementation of thePhilippine Plan of Action for Nutrition is the primary
responsibility of local government units, with national
government agencies providing policy-level support,
capacity-building in nutrition program management(including planning, monitoring and evaluation, andcoordination), and logistics support (National NutritionCouncil 2012). Nongovernmental organizations will
also be involved in implementation of the plan ofaction in close coordination with local government
units and national government agencies.
Needs and challenges. The decentralization ofhealth services has increased opportunities for
improved allocation of resources and local decision
making, but has also created logistical difficulties
and greater need for training in nutrition program
planning, implementation, and monitoring andevaluation at the lower levels of government(municipalities and barangays) (Solon 2006).

6

Development Partner Support• JICA funds several maternal and child healthprojects that seek to improve and strengthenmaternal, newborn, and child health andnutrition services.
• The EU and UNICEF, through the MYCSNIA
Program, provide communication and counselingfor IYCF, promote consumption of locally-produced
micronutrient-rich foods, distribute and promote
the use of micronutrient powders, and help local
and national institutions with data analysis andinterpretation to better inform national policies
and programs.
• UNICEF is supporting the government inestablishing IYCF support centers for working
mothers, distributing fortified rice to vulnerable
populations, and supporting treatment centers for
acute malnutrition.
• WFP implements school feeding programsin conflict-affected areas, implements foodand cash-for-assets programs, and provides
micronutrient-fortified ready-to-use food andmicronutrient powders for children 6–24 months
to help reduce the prevalence of anemia and othermicronutrient deficiencies.
• FAO implements an IYCF project to increase theprevalence of exclusive breastfeeding and reduce
the prevalence of malnutrition through promoting
continued breastfeeding to 2 years and through theintroduction of nutritious locally-available food.

PHILIPPINES NUTRITION PROFILE

Recommended Nutrition Priorities
Key nutrition priorities for the Philippines include
focusing on stunting, maternal undernutrition andlow birth weight, maternal overweight and obesity,
anemia, and micronutrient deficiencies. USAID has
invested on health activities and programs, however
none of these resources were allocated to nutrition
specifically. Given the slow rate of improvement in
the prevalence of stunting, increasing the allocation
for nutrition could be used to implement key targeted
activities. Among existing USAID-funded activities andprograms this includes integrating evidence-based
nutrition-specific interventions and actions. Additional
opportunities include:• Expanding efforts to improve IYCF practices
specifically related to exclusive breastfeeding,complementary feeding, diet quality, and dietdiversity• Addressing anemia in children under 5 and womenof reproductive age• Expanding technical assistance and support forwater and sanitation• Providing direct technical assistance in nutrition
In terms of opportunities to support the Governmentof the Philippines, opportunities include:• Engaging with the government to support thedecentralized health system and support the
integration of nutrition into the health service
delivery system

Recommended Indicators to
Monitor Nutritional Impact
It is recommended that USAID incorporate thefollowing key nutrition indicators into new and existing
implementation plans in order to specifically monitor
the impact of USAID programs on maternal and childnutrition status.
1. Prevalence of underweight children under 5 yearsof age (< -2 SD)
2. Prevalence of stunted children under 5 years of age(< -2 SD)
3. Prevalence of stunted children under 2 years of age(< -2 SD)
4. Prevalence of wasted children under 5 years of age(< -2 SD)
5. Prevalence of underweight women (BMI < 18.5)
6. Women’s dietary diversity: mean number of foodgroups consumed by women of reproductive age
7. Prevalence of exclusive breastfeeding of children
under 6 months of age
8. Prevalence of children 6–23 months receiving aminimum acceptable diet
While nutrition-sensitive interventions can have an
impact on the indicators listed above, it is critical to
implement nutrition-specific activities that address
the direct causes of malnutrition in order to see
reductions in these key indicators.

• Engaging with the government to support
community-level governance for nutrition
USAID can also work in close coordination with other
donors to:• Support the SUN Movement and other government
initiatives to promote nutrition service delivery• Align resource allocation to limit duplication ofactivities and leverage donor investments tostrategically invest in nutrition, focusing on areasthat need added resources such as IYCF and quality
nutrition service delivery

7

PHILIPPINES NUTRITION PROFILE

References
Engesveen, K. et al. 2009. “Assessing countries’ commitment
to accelerate nutrition action demonstrated in PRSPs,
UNDAFs, and through nutrition governance.” SCN News. Vol.
37, pp. 10–16.
FAO. 2013. “Statistics: Food Security Indicators.” Available
at http://www.fao.org/economic/ess/ess-fs/fs-data/en/#.
UwY1EvldXTo.

NSO et al. 1999. Philippines National Demographic and Health
Survey 1998. Manila: NSO and Macro International Inc.
Solon, F.S. 2006. “Good governance for nutrition in thePhilippines: Elements, experiences and lessons learned.” Foodand Nutrition Bulletin. Vol. 27, No. 4, pp. 343–352.
UNICEF. 2012. “Information by Country and Program.” Available
at http://www.unicef.org/infobycountry/.

FNRI. 2012. “Nutritional Status of Filipino Children and
Selected Population Groups Survey 2011,” in Nutrition Summit
on the Nutritional Status of Filipino Children and Selected
Population Groups: 2011. Makati City, Philippines.
FNRI and Department of Science and Technology (DST).
2003. 6th National Nutrition Survey Philippines.
———. 2008. 7th National Nutrition Survey: 2008.
Kothari, M.T. and Abderrahim, N. 2010. Nutrition Update 2010.
Calverton, MD: ICF Macro.
National Nutrition Council. 2012. Philippine Plan of Action for
Nutrition 2011-2016.
National Statistics Office (NSO) and ICF Macro. 2009.
Philippines National Demographic and Health Survey 2008.
Calverton, Maryland: NSO and ICF Macro.

UNICEF. 2013. “Statistics by Area/Child Nutrition: Lowbirthweight.” Available at http://www.childinfo.org/low_birthweight_table.php.
UNSCN. 2010. Sixth Report on the World Nutrition Situation:
Progress in Nutrition. Geneva: UNSCN Secretariat c/o World
Health Organization.
von Grebmer, K., et al. 2013. 2013 Global Hunger Index: The
Challenge of Hunger: Building Resilience to Achieve Foodand Nutrition Security. Bonn, Washington, DC, and Dublin:
Welthungerhilfe, International Food Policy Research Institute,and Concern Worldwide.
WHO. 2007. “Vitamin and Mineral Nutrition Information System:
Summary tables and maps on iodine status worldwide” Available
at http://www.who.int/vmnis/database/iodine/iodine_data_
status_summary/en/index.html.

NSO and ORC Macro. 2004. Philippines National
Demographic and Health Survey 2003. Calverton, Maryland:
NSO and ORC Macro.

FANTA III
FOOD AND NUTRITIONT E C H N I C A L A S S I S TA N C E

Contact Information:
Food and Nutrition Technical Assistance III Project (FANTA)
FHI 360
1825 Connecticut Avenue, NW
Washington, DC 20009-5721
Tel: 202-884-8000
Fax: 202-884-8432
Email: fantamail@fhi360.org
Website: www.fantaproject.org
Recommended Citation:
Chaparro, C.; Oot, L.; and Sethuraman, K. 2014. Philippines
Nutrition Profile. Washington, DC: FHI 360/FANTA.

This nutrition profile is made possible by the generous support of theAmerican people through the support of the Office of Health, Infectious
Diseases, and Nutrition, Bureau for Global Health, U.S. Agency forInternational Development (USAID) and USAID Bureau for Asia under termsof Cooperative Agreement No. AID-OAA-A-12-00005, through the Foodand Nutrition Technical Assistance III Project (FANTA), managed by FHI 360.
The contents are the responsibility of FHI 360 and do not necessarilyreflect the views of USAID or the United States Government.
The intended purpose of this profile is to provide a broad overview ofthe status of nutrition in the Philippines in order to inform potential USsupported efforts. For more information on USAID health programming in
the Philippines, please visit: www.usaid.gov/philippines. To view USAID’s
Global Health nutrition portfolio and its extensive contributions, please visit:www.usaid.gov/what-we-do/global-health/nutrition.