Thank you for inviting me to your regional nutrition awarding ceremony. I am very pleased to be here in order to celebrate this special day with you – a day of appreciation, a day of commendation, a day of jubilation, and a day of pride for all outstanding achievers in the field of nutrition program management in Zamboanga Peninsula.

First, allow me to thank Director Aristides Tan for actively chairing the Regional Nutrition and Anti-Hunger Committee. Director Tan, we cannot thank you enough for your leadership in moving forward Zamboanga Peninsula’s nutrition programs.

Today, we pay tribute to you, our local chief executives as chairpersons of local nutrition committees, members and committee chairs of local legislative bodies, and other members of the local nutrition committees, for your outstanding performance in the management of nutrition programs in the region.

I wish to recognize in particular the Municipality of Piñan of Zamboanga del Norte for being the region’s Consistent Regional Outstanding Winner in

Nutrition for 2014. NNC conferred the award to Piñan last October 29 at the Philippine International Convention Center. With this award, we hope that Piñan will be inspired to level up pa more in the next two years to achieve the highest award bestowed by the nutrition community through the National Nutrition Council, the Nutrition Honor Award.

We also pay tribute to our beloved barangay nutrition scholars for your continued dedication, sincerity, commitment and hard work to bring nutrition, health, and related services directly to those who need it more.

The outstanding efforts of local government units and our volunteer workers are indeed worth praising. The achievements you have achieved so far should be your inspiration to commit further in order to improve the nutrition situation of Zamboanga Peninsula.

Why is this so? According to the latest National Nutrition Survey conducted by the Food and Nutrition Research Institute, Zamboanga Peninsula remains as one of the regions with nutrition challenges, foremost of which is the problem of stunting.

Region 9 has the highest prevalence of stunting among school-age children in all the regions which at 44.3 percent is much higher than the national average of 29.9 percent. This means that 2 out of 5 of your children aged 5-10 years are short for their age. The stunting prevalence for preschool children reflects the same trend because Zamboanga Peninsula ranks third with the highest prevalence of stunting among preschool children at 38.7 percent, much much higher than the national prevalence of 30.3 percent. Zamboanga Peninsula also suffers from a high stunting prevalence among adolescents 10-19 years old at 41.4 percent prevalence compared to the national prevalence of 31.5 percent.

So why are we concerned about stunting? It’s not uncommon for us Filipinos to disregard stunting. We often hear people say, “Kaya maliit sya kasi lahi sila ng maliliit” or “Maliliit talaga ang mga Pilipino kumpara sa mga foreigner.” But evidence from many studies globally assert that it is not just genetic make-up that determines height. We know that children who have proper nutrition and care would have the same growth potential regardless of race or nationality.

Stunting is not as simple as just being short. Stunting has consequences beyond the physical.

For one, children who are stunted have diminished cognitive and physical development which studies have shown reduce their likelihood to finish schooling.

Second, stunted children have poor health and higher risk of contracting non-communicable degenerative diseases such as diabetes. Stunted children who experience rapid weight gain after the age of 2 years have an increased risk of becoming overweight or obese later in life. Such weight gain is also associated with a higher risk of coronary heart disease, stroke, hypertension and type 2 diabetes.

Third, stunted children are expected to have reduced productive capacity in later life and will likely have lower incomes and will live in poverty. It is estimated that stunted children earn 20 percent less as adults compared to non-stunted individuals. According to The World Bank estimates, a 1 percent loss in adult height due to childhood stunting is associated with a 1.4 percent loss in economic productivity. And on a wider scale, stunting is an enormous drain on economic productivity and growth. Economists estimate that stunting can reduce a country’s gross domestic product by up to 3 percent.

Recognizing the enormous consequences of stunting and with Zamboanga Peninsula having the highest prevalence in the country, how can we address this?

The recent approval by the General Assembly of the United Nations, the Philippines included, of Agenda 2030 Sustainable Development Goals commits us to achieve a reduction in the number of stunted children under 5 years old, 15 years from now or by 2030.

Thus we see that addressing malnutrition will be a tall challenge for Zamboanga Peninsula.

Meeting this challenge will require us to start doing evidence-based nutrition actions. Meeting this challenge will require us to stop doing interventions that do not work. And meeting this challenge will require us to continue doing good practices that we have started.

And to do this, we start with the First 1000 Days.

For some of you who are not yet aware, the First 1000 Days represent the nine months while the child is in the womb and the next two years just before the child reaches his or her second birthday. Ensuring optimal nutrition in the First 1000 Days includes an intervention package composed of services to the pregnant woman including prenatal care and nutrition, exclusive breastfeeding in the first six months and appropriate complementary feeding starting 6 months while continuing breastfeeding.

The Updated Philippine Plan of Action for Nutrition formulated by the inter-agency National Nutriton Council has identified priority nutrition actions along the First 1000 Days. There should be a continuum of care from pre-conception, prenatal, birth and delivery, newborn and until the child reaches 2 years of age.

During pregnancy, a key concern is to track pregnant women effectively, and early on in pregnancy so they can avail of pre-natal care services. Pre-natal care services involve the provision of iron-folic acid, and iodine supplements, tetanus toxoid vaccination, and nutrition counseling. Financing these services can be done through the PhilHealth window, specifically the Maternity Care Package.

At birth and delivery, key services are delivered in health facilities with financing through the Maternal Care and Newborn Care Package. A large segment of the services provided are on ensuring exclusive breastfeeding and addressing complications. The baby should also undergo newborn screening and immunization.

At this point it is critical to have early initiation of breastfeeding within the first hour of birth and to provide lactation management and breastfeeding support. Once the mother and child go back to their homes, there must be in place in the community, organized community support groups that will provide counseling and support to the mother and her baby to successfully and exclusively breastfeed.

Also included in the continuum of care is the 4Ps/Health conditionality that is linked to a Php 500 a month cash transfer, on the condition that key services including growth monitoring are availed. For growth monitoring, LGUs can provide growth charts, height boards, and ECCD checklists to monitor the child’s developmental milestones. We hope that all barangays will be able to do Operation Timbang Plus to monitor the height of children regularly. Eventually, we will no longer be measuring weights but the heights of our children to determine their nutritional status.

When the child reaches 6 months, it important to provide appropriate complementary feeding while continuing breastfeeding. This has been a major challenge, as mothers would prefer to buy commercially prepared baby food instead of preparing it from the family pot.

One strategy that we introduced under the Millennium Development Goal Fund – Nutrition project is to organize mothers to undergo recipe trials of preparing complementary foods. This was done in selected areas including Zamboanga City and Aurora, Zamboanga del Sur being the project areas.

Despite the termination of the project, the Infant and Young Child Feeding support groups organized in the project should continue to provide support to the mother and to the baby to be able to ensure that the child will receive proper complementary feeding. Most often, this is at this stage when malnutrition, measured by underweight-for-age and stuntingor underheight-for-age, starts to set in and the recovery of the child will be difficult beyond 2 years.

Livelihood programs should be provided to help the family earn enough to put food on the table. Indeed, how can they feed their baby well if they have no food at all?

These actions I mentioned are the actions that we should be focusing on. And to do that, as I said previously, we must stop the interventions that do not work. This includes the highly popular supplementary feeding for older children. If LGUs continued to implement feeding programs, we strongly suggest to target pregnant women and children 6 to 24 months old.

By focusing on the First 1000 Days, we hope to have a healthier and more productive next Filipino generation. We cannot undo the current stunting among our children anymore. Our next actions will benefit the next generation. That will be our legacy to our children’s children.

I am confident that Zamboanga Peninsula, with its local nutrition committees in the provinces, cities, municipalities and barangays will be able to think of ways to address stunting. Learn from the good practices within the region and even from outside.

It is through hard work and dedication for nutrition and your love for the region and its constituents that will help you overcome nutritional problems. I hope that your presence here in the regional awarding ceremony will renew your commitment to the nutrition program to be able to address malnutrition, particularly high levels of stunting, in region 9.

Congratulations once again to all the winners!

May you help the country address malnutrition and take the challenge of addressing stunting in Zamboanga Peninsula.

And so instead of saying, may your tribe increase, let me wish you this, may your height increase.

Mabuhay at tumangkad pa sana tayong lahat!

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¹Delivered during the annual Regional Nutrition Awarding Ceremony held on 10 November 2015 at Zamboanga City.