Factors Affecting Undernutrition among School Children in Cebu, Philippines

ABSTRACT

School children in vulnerable areas continue to be at risk for undernutrition. This study investigated the factors associated with the nutritional status of school children in a rural municipality in Cebu, Philippines. Children aged 6–12 years (n = 327) and their parents were asked to participate. Children’s anthropometric measurements were taken in schools, while interviews and measurements of parents were conducted at home. Children’s nutritional status was assessed using height-for-age (HAZ) and weight-for-age (WAZ) z scores, while body mass index (BMI) was used for parents. Children’s dietary patterns and physical activity, and household characteristics, such as food insecurity, eating practices, water/sanitation/hand washing facilities, and sociodemographic status, were collected. Of 327 school children, 37.3% were stunted, while 35.1% were underweight in this rural community. HAZ and WAZ were negatively associated with household size, and positively associated with household income and parental BMI in multivariate least-squares regression models. Severe food insecurity was negatively associated with WAZ, which suggested that the experiences of severe food insecurity (i.e., not eating for a day) had a significant impact on nutritional status of children.

KEYWORDS:

• Food insecurity
• undernutrition
• stunting
• underweight
• schoolchildren
• Philippines

Acknowledgments

The study was supported by NIHU (National Institutes for Humanities) Transdisciplinary Project Minpaku Unit “The Constellation of Food and Foodways in Human and Natural History” (led by Professor Atsushi Nobayashi). We would also like to thank San Remigio Rural Health Unit led by Dr. Orleta Ursal and Dr. Gerard Ysmael, and the school personnel and principals for accommodating us in their communities. We also acknowledge the research assistants for their diligence during data collection. Finally, we would like to thank all of the parents, guardians, and children for their participation and cooperation in this study.

Disclosure statement

The authors declare there are no potential conflicts of interest with respect to the research, authorship, and/or publication of this article

Ethical standards disclosure

This study was approved by the Ethics Committee, University of Tokyo (No. 11915). Written informed consent was obtained from parents or guardians prior to data collection. It was emphasized that participation in the study was voluntary and did not, in any way, affect their children’s school performance. Official letters describing the purpose and procedures of the study were given to the local government, rural health unit, and schools before obtaining their permission.

Additional information

Funding

This work was supported by the National Institutes for the Humanities, Japan.