'Kulang sa timbang': Removing the stigma of child malnutrition

Che de los Reyes, ABS-CBN News

Posted at Apr 25 2017 06:57 PM | Updated as of Apr 26 2017 12:07 PM

95 Filipino children die every day from malnutrition

MANILA – With poverty, neglect, and stigma causing the number of malnourished children in the country to rise, a new government health program hopes to engage communities to overcome malnutrition.

A mid-upper arm circumference (MUAC) tape detects if a child is malnourished. Green means that a child is well-nourished, yellow shows moderate acute malnutrition, and red indicates severe acute malnutrition, which means the child needs immediate treatment. Che de los Reyes, ABS-CBN

The program called Philippine Integrated Management of Severe Acute Malnutrition was born as part of a holistic government response to address malnutrition. According to non-government organization Save the Children, malnutrition has caused the deaths of about 95 children in the Philippines each day.

The program will attend to 38,289 children with severe acute malnutrition, aged six months to five years. The Department of Health (DOH) is targeting 17 provinces this year and another 21 provinces next year.


Malnutrition, especially acute malnutrition, is an invisible emergency.

“Most of the time, these children are neglected, especially the under-five year olds…We tend to forget that those under five need it (food) more,” said Dr. Celna Mae Tejare of humanitarian group Action Against Hunger.

This is rooted in traditional practices where families with limited food prioritize feeding the breadwinners. Such neglect leads to chronic malnutrition, she said.

Nearly three out of every 10 Filipino children below two years old suffer from chronic malnutrition. This is the worst rate in 10 years, according to 2015 data from the Food and Nutrition Research Institute.

If not treated, chronically malnourished children become stunted, or short for their age. This affects a child’s ability to learn and, by age five, becomes irreversible.

Children with chronic malnutrition quickly slip to acute malnutrition when they get sick. A child with severe acute malnutrition is nine times more likely to die than a well-nourished child.

According to Kristine Calleja, program manager of Gem’s Heart Foundation, it is important to treat malnutrition as early as possible. A child suffering from chronic malnutrition, for example, has a “window of opportunity” for treatment before he reaches two years of age. 


United Nations (UN) Special Rapporteur on the Right to Food Hilal Elver’s mission to the Philippines in February 2015 said, “access to sufficient and nutritious food is limited by poverty and income levels.”

This, despite the fact that Philippine economy has risen to middle income level, according to the World Bank.

“We are leaving those in the margins. Our progress does not reach the communities that really need it more,” Tejare said.

One of the biggest barriers is the stigma of having a malnourished child.

“It implies that you have been very negligent as a parent…Because of this, many parents would rather not seek medical treatment for their children because they feel they will be blamed for the situation,” Tejare said.

This mindset, she said, has to change.

The first step is to avoid calling underfed youngsters “malnourished children” because the label can sound harsh, and might stay with them all their lives.

“We’d rather call them ‘kulang sa timbang' (underweight) because it’s a bit positive, meaning that if you get to improve the weight, we could bring back these children into good health,” she said.

One such solution is to give underweight children ready-to-use therapeutic food (RUTF), more commonly known as Plumpy’Nut. This is what humanitarian aid organizations distribute in Africa and areas where many children are suffering from malnutrition.

Under the government’s anti-malnutrition program, the DOH will begin distributing 50,000 boxes of RUTF, worth about P145 million, in March, said Dr. Anthony Calibo, head of the agency’s Family Health Office. 

Ready-to-use therapeutic food (RUTF), more commonly known as Plumpy'Nut, can help treat children with severe acute malnutrition. Che de los Reyes, ABS-CBN

The program’s priority target provinces, 17 in all, have the highest rates of acute malnutrition, have high rates of poverty, and are vulnerable to natural calamities and disasters, Dr. Calibo says.

The new government program relies on strong community involvement. For children with less severe malnutrition, the solution is a feeding program to supplement their food intake at home.

“We encourage parents, even those neighbors who see these cases, to help these families seek consultation because there is treatment. There is hope,” Dr. Tejare said.

For more information about malnutrition, contact Gems Heart Foundation at 0905-2590011/0933 439 2038 or visit www.gemsheart.org. 

For more information about the ‘First 1,000 Days’ bill visit facebook.com/philcan

For more information about treating malnutrition, visit the Department of Health’s Family Health Office at (+632) 651-7800 or visit Action Against Hunger’s website at actionagainsthunger.org.

A version of this report was submitted for a multimedia reporting course that is part of the M.A. Journalism program at the Ateneo de Manila University.