Partnering for better nutrition in rural fishing communities in the Philippines
By Guy Hubbard
Although designated a middle-income country, the Philippines still has large pockets of poverty and high rates of malnutrition. A community-based programme supported by the EU and UNICEF aims at promoting breastfeeding, proper nutrition and the importance of a balanced diet.
TIGBAUAN, Philippines, 15 May 2014 – Janelle Agoriles picks up her pink book and sets off for the local health centre. Pregnant with her fourth child, she's been coming here every month for the last five months. "I started to visit the health centre in the third month of my pregnancy," she says. "My husband advised and encouraged me to have my prenatal check-up for my sake and for my baby, so that we receive proper care."
Janelle's midwife, Mary Anne, begins the examination, while at the same time asking Janelle on her diet and eating habits. She also counsels her on how to feed and care for the baby to come, emphasizing exclusive breastfeeding for the first six months. "Since I started prenatal care, my midwife counselled me that we should not give birth at home but rather deliver at the health centre or at the hospital. The midwife also told me that after I deliver, I should breastfeed my baby for the baby's good."
Before she leaves, Mary Anne gives Janelle iron and folic acid tablets for her own health and micronutrient powder for her young child. Outside Mary Anne's office, the queue has grown. Each pregnant woman will receive the same care, same counselling and same nutritional supplements – and even once their babies have been born, they're encouraged to keep visiting.
"After the baby is born, it continues to be brought here," she says. "I counsel exclusive breastfeeding – they are not to be fed water or even vitamins for six months. When six months comes, I counsel mothers to begin complementary feeding."
Reaching the MDGs
Back in Janelle's barangay (village) a nutrition class for pregnant women and mothers with young children is in session. The classes target poor families – those who receive government benefits are obligated to attend. Here they learn about breastfeeding and proper nutrition, and they learn about the importance of a balanced and varied diet. Many of them don't know how best to feed their children, often relying heavily on rice and only occasionally supplementing with fish and vegetables. Although many of the husbands are fishermen, they sell everything they catch.
This comprehensive targeting of pregnant women and young children is part of a campaign aimed at combatting malnutrition in the Philippines. Funded by the European Union and coordinated by UNICEF in partnership with the Government of the Philippines, the programme aims to contribute to achieving the nutrition-focused Millennium Development Goals.
Although it has been designated a middle income country since 2009, the Philippines still has large pockets of poverty and high rates of malnutrition – 22 per cent of children are underweight and 32 per cent are stunted. In response, the programme aims to benefit 721,000 million children 0 to 23 months old and 1.1 million pregnant and lactating women in Bicol, Western Visayas and Zamboanga regions.
So far, it seems to be working. Dr. Josefa Monserate, Chief of Health at the Tigbauan Health Unit, has worked in the area for more than 15 years, and she has seen first-hand the impact of the programme. "In 2009, before this project, the prevalence rate of malnutrition here in our municipality is 17 per cent," she explains. "But after implementing this project now, we have a prevalence rate of 1.5 per cent combined severely wasted and wasted 0 to 71 months children."
At home, Janelle and her husband, Edgar, are cooking lunch together as they do every day. He's a fish vendor at the local market, and since learning more about nutrition and the importance of a balanced diet, he brings fish home every day. Janelle adds micronutrient powder to their youngest child's plate and the family sits down to eat together.
For Janelle, the prenatal care, counselling and supplements have really had an impact on her own family. "I believe that by breastfeeding my babies and then providing nutritious food, I give good health to my children. It also keeps them from getting sick and also helps them do well in school." she says, and then adds: "My message to pregnant mothers, is that they should have prenatal check-ups to receive counselling from the midwife and to receive vitamin supplements for the mother and also for the baby to have good nourishment and well-being."