FACTS & FIGURES Nutritional Status of Filipino Children and Selected Population Groups: 2005 Update INTRODUCTION Anthropometry Since the First National Nutrition Survey (NNS) of FNRI-DOST in 1978 and the 1989/90 Update of the Nutritional Status of Filipino Children, the survey results are vital components in the formulation of national and sub-national policies, plans and programs for the nutrition and related development sectors. These plans and programs include the Medium-Term Philippine Plan of Action for Nutrition (MTPPAN), Medium-Term Philippine Plan of Action for Children (MTPPAC), Poverty Alleviation Programs, among others. It is also being used as gauge to the country’s progress on achieving the Millennium Development Goals (MDG), the country being a signatory to the UN Millennium Declaration of 2000. This Facts and Figures 2005 covers the anthropometric data generated from the 2005 Survey of the Nutritional Status of Filipino Children and Selected Population Groups which is a follow-up to the 2001 Update of the Nutritional Status of Filipino Children and the 2003 National Nutrition Survey. It provides reliable national estimates on the nutritional status of zero to 10 year-old children and 11 to 19 year-old adolescents, pregnant women and lactating mothers. The 2005 Updating Survey covered all the 17 regions and 79 provinces, excluding Batanes. The sample totaled to 12,560 individuals, which may be broken down into 3,560 preschool-age children (zero to five years), 3,264 school-age children (six to 10 years), 1,273 pre-adolescents (11 to 12 years), 3,114 adolescents (13 to 19 years), 360 pregnant women and 989 lactating mothers. A total of 5,774 males and 6,786 females participated in the survey. body_june20.pmd 1 2/20/2008, 9:00 AM 1 FACTS & FIGURES 2 Using the standard techniques of anthropometric measurements, the height, weight and recumbent length (for children less than two years old) were measured for each subject by locally trained professionals in the region. The weight and height measurements of the children zero to 10 years of age were assessed to determine nutritional status, using the International Reference Standards or the anthropometric references established by the NCHS/WHO (IRSNCHS, 1997) as shown in Table A. The study did not have index of thinness among the nine to 10 year old children primarily because of the limitation of the weight-for-height table of the NCHS-WHO where heights of children beyond eight years old were not available. The weight and height measurement of the pre-adolescents and adolescents 11 to 19 years of age were assessed using Body Mass Index-for-Age (Must, 1991) as presented in Table B. Table A. Cut-off points used in classifying nutritional status of children based on NCHS/WHO Reference Standards for Growth Classification body_june20.pmd Cut-off Points • Weight-for-Age Underweight Normal Overweight <-2SD -2SD to +2SD >+2SD • Height-for-Age Underheight or short Normal Above Average/Tall <-2SD -2SD to +2SD >+2SD • Weight-for-Height Thin Normal Overweight NEC (Not Elsewhere Classified – those whose heights are beyond the limits of the weight-for-height tables) 2 <-2SD -2SD to +2SD >+2SD 2/20/2008, 9:00 AM FACTS & FIGURES Table B. Cut-off points used in classifying nutritional status of subjects 11 to 19 years based on BMI-for-Age (Must, 1991) Classification Underweight Mild Normal Overweight Cut-off Points <P5 P5 to <P15 P15 to <P85 >P85 The weight and height of pregnant women were assessed using the criteria established for pregnant women by Magbitang et al., (1988) (Table C). Using the cut-off points, pregnant women whose weights fell below the 95th percentile of the reference were considered to have a high risk of delivering low birthweight (LBW) babies. For the lactating mothers, 20 years old and over, the Body Mass Index (BMI) for adults was used (NCHS/WHO, 1978). The BMI-for-Age was used for adolescent lactating mothers (Table D). Table C. Cut-off points used in classifying nutritional status of pregnant women based on weight-for-height (Magbitang, 1988) Classification body_june20.pmd Cut-off Points Nutritionally at-risk < P95 Not Nutritionally at-risk > P95 3 2/20/2008, 9:00 AM 3 FACTS & FIGURES 4 Table D. Cut-off points used in classifying lactating mothers using body mass index for adults (NCHS/WHO, 1978) and BMI-for-age for adolescents (Must, 1991) Lactating Classification Adolescent Underweight/CED Mild Normal Overweight Obese <P5 P5 to <P15 P15 to <P85 >P85 Adult <18.5 18.5 to <25.0 25.0 to <30 >30.0 Iodized Salt Survey The 2003 NNS results also showed general improvements in household utilization of iodized salt, but the rate of utilization at the national level (47.9%) is still short of the country’s Universal Salt Iodization (USI) target. There was also a dramatic improvement in median UIE among six to 12 years old children, from 71 µg/L in 1998 to 201 µg/L in 2003, and correspondingly, a dramatic shift in distribution of UIE values among the children such that a significant proportion has high UIE levels that may be indicative of very high iodine intake. There is, therefore, valid concern to ascertain the level of iodine in iodized salt at the household level, which will provide the scientific basis for any warranted review of the iodization level now prescribed under the ASIN Law. The iodized salt survey has two components. The first component is the survey on awareness and usage of iodized salt. The other component is the testing of iodized salt using rapid test kit and WYD iodine checker machine. 1. Awareness and Usage of Iodized Salt A face-to-face interview with the mothers or responsible adults of the household regarding the usage and awareness of iodized salt was conducted by the locally trained professionals. A structured and pre-tested questionnaire body_june20.pmd 4 2/20/2008, 9:00 AM FACTS & FIGURES was used in gathering the information. A total of 5, 345 households were covered in the survey. 2. Iodine Testing Using Rapid Test Kit In additon, on-site testing for the presence of iodine in household salt using the Rapid Test Kit was also simultaneously done with the interview. Respondents were requested to bring a small quantity of their household salt in the assembly area for the testing. Using WYD Iodine Checker Machine Quantitative measurement of iodine in household salt was also conducted to check whether the desired levels of 40-50 ppm, set by ASIN Law, was met. Only a sub-sample of 3,050 households, representing 25 percent of the full sample of the MS, was included. The mothers or responsible adults of the households were requested to bring about 100 grams household salt to be placed in the polyethylene containers that were provided a day before the interview. Collected samples were placed in black plastic bags and transported to the FNRI in Manila for laboratory analysis. Iodine in salt was analyzed using the WYD Iodine Checker machine under laboratory conditions. body_june20.pmd 5 2/20/2008, 9:00 AM 5 FACTS & FIGURES 6 RESULTS Anthropometry 1. AT THE NATIONAL LEVEL 1.1 Preschool-age Children (0 to 5 Years) • • • 74 in every 100 pre-school children have normal weight for their age, about 25 are underweight and two are overweight 73 in every 100 children have normal height for their age, 26 are short or underheight, and one in every 100 children is considered tall for his/her age 93 out of every 100 children have normal weight for their height, five are thin and two are overweight for their height Table 1. Percentage distribution of 0 to 5 year-old children by NCHS/ WHO weight-for-age, height-for-age, and weight-for-height classifications: Philippines, 2005 Classification / Nutritional Status Number Percent Distribution 895 2,601 64 24.6 73.5 2.0 964 2,557 39 26.3 72.5 1.2 175 3,316 63 6 4.8 93.0 2.0 0.2 Weight-for-Age Underweight Normal Overweight Height-for-Age Underheight Normal Tall Weight-for-Height Thin Normal Overweight-for-Height NEC body_june20.pmd 6 2/20/2008, 9:00 AM FACTS & FIGURES Based on the 2005 Projected Population, the estimated count of zero to five-year old children who are underweight is 3.7 M, underheight is 3.9 M, 717,643 are thin and 299,000 are overweight. By single age group • • • Twenty-nine in every 100 children ages one and five years have high prevalence rates of underweight. The three to five year-old children, on the other hand, have high proportion of short or underheight with 30, 35 and 36, respectively, out of every 100 children. The one-year-old children have the highest prevalence of thinness with 12 children out of every 100. Table 2. Percentage distribution of 0 to 5 year-old children by single age group by NCHS/WHO weight-for-age and height-for-age classification: Philippines, 2005 Age (Years) 0 1 2 3 4 5 All Age (Years) 0 1 2 3 4 5 All body_june20.pmd Percent Distribution by Weight-for-Age Number 551 570 598 601 594 646 3,560 Underweight Normal Overweight 10.2 28.9 24.7 25.6 27.7 28.7 24.6 85.9 69.8 73.4 72.5 71.2 69.4 73.5 3.9 1.3 2.0 1.9 1.1 1.8 2.0 Percent Distribution by Height-for-Age Number 551 570 598 601 594 646 3,560 7 Underheight Normal Tall 5.4 23.5 25.5 30.0 34.6 36.2 26.3 91.3 75.6 72.6 69.4 65.3 63.6 72.5 3.4 0.9 1.9 0.6 0.2 0.2 1.2 2/20/2008, 9:00 AM 7 FACTS & FIGURES 8 Table 3. Percentage distribution of 0 to 5 year-old children by single age group by NCHS/ WHO weight-for-height classification: Philippines, 2005 Age (Years) Percent Distribution by Weight-for-Height Number Thin 0 1 2 3 4 5 All Normal Overweight for their Height NEC 551 570 598 601 594 646 4.5 12.0 4.0 4.2 2.7 2.1 91.9 86.2 94.8 93.9 95.7 95.1 2.5 1.9 1.2 2.0 1.6 2.8 1.2 0.0 0.0 0.0 0.0 0.0 3,560 4.8 93.0 2.0 0.2 By gender • There are 25 and 24 boys and girls, respectively, in every 100, who are underweight; 27 and 26 respectively, are underheight and six and four respectively, are thin. • About two children among the boys and girls are overweight relative to his/ her age and height. • body_june20.pmd There is one boy and one girl out of 100 who are tall for their age. 8 2/20/2008, 9:00 AM FACTS & FIGURES Table 4. Percentage distribution of 0 to 5 year-old children by NCHS/ WHO weight-for-age, height-for-age and weight-for-height classifications and by gender: Philippines, 2005 Classification / Nutritional Status Boys Girls Number Percent Number Percent 475 1,347 32 25.0 73.1 1.9 420 1,256 32 24.1 73.9 2.0 512 1,320 20 26.8 72.1 1.1 452 1,237 19 25.8 73.1 1.2 103 1,712 36 1 5.5 92.2 2.2 0.1 72 1,604 27 5 4.2 93.8 1.7 0.3 Weight-for-Age Underweight Normal Overweight Height-for-Age Underheight Normal Tall Weight-for-Height Thin Normal Overweight-for-Height NEC 1.2 School-age Children (6 to 10 Years) • 76 in every 100 have normal weight-for-age, 23 are underweight and two are overweight • 32 out of every 100 Filipino children are underheight • Three in every 100 children, six to eight years old are thin, 94 are normal and three are overweight for their height body_june20.pmd 9 2/20/2008, 9:00 AM 9 FACTS & FIGURES 10 Table 5.Percentage distribution of 6 to 10 year-old children by NCHS/WHO weight-for-age and height-for-age classification: Philippines, 2005 Classification Number Percent Distribution Weight-for-Age Underweight Normal Overweight Height-for-Age 752 2,466 46 22.8 75.6 1.6 Underheight Normal Tall 1,086 2,162 16 32.0 67.5 0.5 Table 6.Percentage distribution of 6 to 8 year-old children by single age group by NCHS/WHO weight-for-height classification: Philippines, 2005 Age (Years) Number Thin Normal Overweight NEC Percent 6 659 2.9 94.1 3.0 0.0 7 646 3.8 93.0 2.8 0.4 8 643 2.9 94.1 2.4 0.5 1,948 3.2 93.7 2.8 0.3 All By single age group • • • • body_june20.pmd The six year-old children have high prevalence rate of underweight, 25 in every 100, as well as the seven and eight year-old with 24 in every 100. The prevalence rate of underweight-for-age for the older children, nine and 10 years of age is 21 out of every 100 children. The prevalence rates of underheight or short relative to their age are even higher for every single age group with 31 to as high as 35 children in every 100. Translating these percentages into actual counts, there are 2.4 M and 3.4M underweight and underheight children aged six to 10 years, respectively. 10 2/20/2008, 9:00 AM FACTS & FIGURES Table 7.Percentage distribution of 6 to 10 year-old children by single age group by NCHS/WHO weight-for-age and height-for-age classification: Philippines, 2005 Age (Years) Number Percent Distribution by Weight-for-Age Underweight Normal Overweight 6 659 24.6 73.7 1.6 7 646 23.8 74.0 2.2 8 643 24.0 74.1 1.9 9 640 20.6 77.7 1.7 10 676 20.7 78.6 0.8 All 3,264 22.8 75.6 1.6 Age (Years) Number Percent Distribution by Height-for-Age Underheight Normal Tall 6 659 30.6 69.1 0.3 7 646 31.4 67.9 0.7 8 643 31.6 67.9 0.5 9 640 31.3 68.2 0.4 10 676 35.0 64.2 0.8 All 3,264 32.0 67.5 0.5 By gender • There are 26 boys and 20 girls out of every 100 who have low weight relative to their age and about two boys and one girl in every 100 who are overweight for their age. • There are 37 boys and 27 girls in every 100 who are short for their age. There is hardly one boy or girl recorded tall for his/her age. body_june20.pmd 11 2/20/2008, 9:00 AM 11 FACTS & FIGURES 12 Table 8. Percentage distribution of 6 to 10 year-old children by NCHS/ WHO weight-for-age and height-for-age classification and by gender: Philippines, 2005 Classification / Nutritional Status Boys Girls Number Percent Number Percent 438 1,201 33 25.9 71.9 2.2 314 1,265 13 19.5 79.5 1.0 641 1,024 7 36.7 62.8 0.5 445 1,138 9 27.1 72.3 0.6 Weight-for-Age Underweight Normal Overweight Height-for-Age Underheight Normal Tall 1.3 Comparison with past surveys in the New Millennium: 2001, 2003 and 2005 1.3.1 Preschool-age Children (0 to 5 Years) • There are reductions of 6.0, 5.1 and 1.5 percentage points in the prevalence of underweight, underheight and thinness, respectively for the zero to five year-old children, between 2001 and 2005. • For this period, the average yearly reduction in the prevalence of underweight and underheight translate to about 1.5 and 1.3 percentage points per year, respectively. • The prevalence of overweight for age and overweight for height increased by 1.0 and 0.6 percentage points, respectively. The prevalence of overweight for age increased two times in four years. body_june20.pmd 12 2/20/2008, 9:00 AM FACTS & FIGURES Table 9. Comparison in the prevalence of underweight, underheight, thin and overweight among 0 to 5 year-old children: Philippines, 2001, 2003 and 2005 Classification / Nutritional Status 2001 2003 2005 30.6 68.4 1.0 26.9 71.7 1.4 24.6 73.5 2.0 31.4 68.0 0.5 29.9 69.5 0.6 26.3 72.5 1.2 6.3 92.1 1.4 0.1 5.3 92.4 2.1 0.3 4.8 93.0 2.0 0.2 Weight-for-Age Underweight Normal Overweight Height-for-Age Underheight Normal Tall Weight-for-Height Thin Normal Overweight-for-Height NEC 1.3.2 School-age Children (6 to 10 Years) • There are 10.1 and 9.1 percentage points reduction in the prevalence rates of underweight and underheight for the six to 10 year-old children from 2001 to 2005. • These translates to 2.53 percentage points average reduction per year for underweight and 2.28 average percentage points reduction for underheight per year among the six to10 year-old children. • The prevalence rate of overweight for age doubled from 0.8 rate in 2001 to 1.6 prevalence rate in 2005. body_june20.pmd 13 2/20/2008, 9:00 AM 13 FACTS & FIGURES 14 Table 10. Comparison in the prevalence of underweight, underheight and overweight among 6 to 10 year-old children: Philippines, 2001, 2003 and 2005 Classification / Nutritional Status 2001 2003 2005 32.9 66.2 0.8 25.6 73.1 1.3 22.8 75.6 1.6 41.1 58.7 0.2 35.8 63.7 0.4 32.0 67.5 0.5 Weight-for-Age Underweight Normal Overweight Height-for-Age Underheight Normal Tall 1.4 Trends in the Nutritional Status of Children, 1989-90 to 2005 1.4.1 Preschool-age Children (0 to 5 Years) • In the span of 15 years, from 1989/90 to 2005, there has been a reduction of 9.9 (from 34.5 percent to 24.6 percent) and 13.6 percentage points (from 39.9 percent to 26.3 percent) in the prevalence of underweight and underheight among zero to five yearold children, respectively. • These translate to average yearly reductions of 0.66 percentage point for underweight and 0.91 percentage point for underheight among these children. Within the same time frame, overweight prevalence increased by 1.4 percentage points. body_june20.pmd 14 2/20/2008, 9:00 AM FACTS & FIGURES 1.4.2 School-age Children (6 to 10 Years) • • • Among the six to 10 years old children, the prevalence of underweight and underheight decreased by 11.4 and 12.8 percentage points, respectively, between 1989 to 90 and 2005. This averages to a yearly reduction of 0.76 percentage points for the underweight and 0.85 percentage points for underheight prevalence. The prevalence of overweight increased by 1.5 percentage points during the 15-year period. Table 11. Trends in the prevalence of underweight, underheight, thin, and overweight among 0 to 5 and 6 to 10 year-old children: Philippines, 1989-90 to 2005 Nutritional Status 1989-90 1992 1993 1996 1998 2001 2003 2005 Percent Prevalence 0 to 5 Years Old Underweight 34.5 34.0 29.9 30.8 32.0 30.6 26.9 24.6 Underheight 39.9 36.8 34.3 34.5 34.0 31.4 29.9 26.3 Thinness 5.0 6.6 6.7 5.2 6.0 6.3 5.3 4.8 Overweight-for-age 0.6 0.7 0.4 0.5 0.4 1.0 1.4 2.0 Underweight 34.2 32.5 30.5 28.3 30.2 32.9 25.6 22.8 Underheight 44.8 42.8 42.2 39.1 40.8 41.1 35.8 32.0 Overweight-for-age 0.1 0.2 0.6 0.4 n 0.8 1.3 1.6 6 to 10 Years Old • • body_june20.pmd The overall trend indicate that undernutrition remains to be the overriding problem among the zero to five year-old and six to 10 year-old children and still need to be the priority concern. The increasing magnitude of overweight among the age group need not be ignored due to associated risks such as cardiovascular diseases and other health-related diseases during childhood. 15 2/20/2008, 9:00 AM 15 FACTS & FIGURES 16 1.5 Adolescents (11 to 19 Years) • • The mean weight and mean height of Filipino pre-adolescents, 11–12 years old, and adolescents, 13–19 years old, are 32.7 kg and 45.7 kg, and 139.4 cm and 154.0 cm, respectively. For both age groups, the mean weight of males is 43.0 kg while that of the females is 40.9 kg. Their mean height is 152.1 cm and 147.4 cm, respectively. Table 12. Mean weight and height of adolescents, 11 to 19 years old by age group and by gender: Philippines, 2005 Age Group (years) Male Female Both Gender M ean Weight (kg) M ean Height (cm) M ean Weight (kg) M ean Height (cm) M ean Weight (kg) M ean Height (cm) 11-12 31.66 137.93 33.79 140.85 32.74 139.41 13-19 47.34 157.50 43.90 150.21 45.70 154.02 All 43.00 152.08 40.86 147.39 41.96 149.80 By age group • • • There are proportionally more pre-adolescents compared to adolescents who are underweight (23 vs. 13 out of 100). There are more adolescents (65.6 percent) than the pre-adolescents (50.0 percent), who have normal BMI-for-age. Six and four out of 100 of the pre-adolescents and adolescents, respectively, are overweight. By gender • body_june20.pmd In terms of gender differences, there are more females (69 out of every 100) than males (53 out of 100) who have normal BMI-for-age, and more males (21 in every 100) than females (11 in every 100) who are underweight among the 11 to 12 year-olds and 13 to 19 year-olds. 16 2/20/2008, 9:00 AM FACTS & FIGURES Table 13. Percentage distribution of adolescents, 11 to 19 years old by BMI classification, by age and by gender: Philippines, 2005 Gender & Age Group Sample size Underweight < P5th Male 11-12 13-19 All 622 1,628 2,250 27.8 17.8 20.5 Female 11-12 13-19 All 651 1,486 2,137 Both Sexes 11-12 13-19 All 1,273 3,114 4,387 • Mild P5th to < P15th Normal P15th to P85 th Overweight > P85 th 23.0 20.7 21.3 42.9 57.2 53.3 6.3 4.3 4.9 18.0 8.2 11.1 19.9 12.6 14.8 56.9 74.7 69.3 5.2 4.6 4.8 22.8 13.2 16.0 21.4 16.8 18.1 50.0 65.6 61.1 5.8 4.4 4.8 In both sexes, 16 in every 100 adolescents 11 to 19 years are underweight. • While for overweight, there are the same number of male and female adolescents who are overweight at five in every 100 adolescents. • Adequate nutritional status is an important concern to adolescents because of the increased nutritional need to support growth and development during this period. In addition, adequate nutrition especially among the female adolescents is an essential condition in preparation for pregnancy in later years. body_june20.pmd 17 2/20/2008, 9:00 AM 17 FACTS & FIGURES 18 1.6 Trends in the Nutritional Status of Adolescents, 1993 to 2005 • Looking at the trends in the nutritional status of the 11 to 19 year-old children from 1993 to 2005, the prevalence of underweight practically did not change (15.8 vs 16.0) during these periods. • Overweight, on the other hand, had increased twice from 2.4 in 1993 to 4.8 in 2005. • Considering the gender differences, underweight among the 11 to 19 year-old males decreased between 1993 and 2005 from 21.6 to 20.5 percent (1.1 percentage points). However, among the females, underweight increased by 1.6 percentage points from 9.5 percent in 1993 to 11.1 percent in 2005. Table 14. Trends in the prevalence of underweight and overweight among adolescents, 11 to 19 years old: Philippines, 1993-2005 Underweight Overweight Gender/Age 1993 1998 2003 2005 1993 1998 2003 2005 Male 11-12 13-19 All 27.1 19.1 21.6 34.0 19.3 23.0 31.0 17.0 20.5 27.8 17.8 20.5 2.6 2.5 2.6 1.8 1.0 1.2 4.9 2.9 3.4 6.3 4.3 4.9 Female 11-12 13-19 All 19.2 5.9 9.5 27.2 12.9 16.4 20.6 6.4 10.1 18.0 8.2 11.1 1.5 2.5 2.2 3.2 5.2 4.7 3.4 3.9 3.8 5.2 4.6 4.8 23.5 12.6 15.8 30.6 16.2 19.8 25.9 12.0 15.5 22.8 13.2 16.0 2.2 2.5 2.4 2.5 3.1 2.9 4.2 3.4 3.6 5.8 4.4 4.8 Both 11-12 13-19 All body_june20.pmd 18 2/20/2008, 9:00 AM FACTS & FIGURES 19 1.7 Pregnant and Lactating Women 1.7.1 Pregnant Women • • Among the pregnant women, 72 in every 100 are considered not nutritionally at-risk and 28 are nutritionally-at-risk. Between 2003 and 2005, there was 1.8 percentage points increase in the proportion of nutritionally at-risk pregnant women from 26.6 to 28.4. Table 15. Percentage distribution of pregnant women by weight-for-height classification: Philippines, 1998, 2003 and 2005 Year Total Subjects 1998 Percentage Distribution Nutritionally at-risk < P 95 Not Nutritionally at-risk > P 95 2,880 30.7 69.3 2003 594 26.6 73.4 2005 360 28.4 71.6 • • Underweight pregnant women are more likely to deliver low birth weight babies, who in turn become vulnerable to undernutrition, poor health and delayed psychosocial development. The results, therefore, present a challenge to nutrition planners and program implementers to strengthen programs for pregnant women to sustain the reduction of undernutrition among young children. 1.7.2 Lactating Mothers • • body_june20.pmd Among the lactating mothers, 66 in every 100 have normal weight, 14 are underweight and 20 are overweight for their height. Between 1998 and 2005, overweight prevalence had increased by 6.2 percentage points from 13.6 to 19.8 or a yearly increase of 0.89 percentage point. 19 2/20/2008, 9:00 AM FACTS & FIGURES 20 Table 16. Percentage distribution of lactating mothers by nutritional status: Philippines, 1998, 2003 and 2005 Year Nutritional Status Total Subjects Underweight Normal Overweight 1998 2,990 13.2 73.3 13.6 2003 1,201 11.7 70.7 17.6 2005 989 13.9 66.3 19.8 2. AT THE REGIONAL LEVEL 2.1 Preschool-age Children (0 to 5 Years) • NCR is the only region that has much lower prevalence of underweight zero to five year-old children as compared to the national estimate (16.2 vs. 24.6). • ARMM, on the other hand, has the highest underweight prevalence with 38.0 percent compared to the national estimate. Prevalence rates of the other regions ranged from 19.7 percent (Central Luzon) to 35.8 percent (MIMAROPA). • Based on the cut-off used by NSO, those regions with coefficient of variation (CV) less than 15 percent are reliable estimates for the region. • For underweight prevalence, almost all regions except CAR (23.0), Cagayan Valley (17.2) and SOCCKSARGEN (15.0) have CVs less than 15 percent, which indicate that the estimates are reliable for these regions. body_june20.pmd 20 2/20/2008, 9:00 AM FACTS & FIGURES Table 17. Estimates of the proportion of underweight among 0 to 5 yearold children, standard error, confidence interval, margin of error and coefficient of variation by region: Philippines, 2005 Sample Size Standard Error • NCR 3,560 391 24.6 16.2 0.8 2.3 • CAR 125 17.5 4.0 9.6 25.5 7.9 23.0 • Ilocos 226 28.5 3.4 21.8 35.1 6.6 11.8 • Cagayan Valley 139 17.9 3.1 11.9 24.0 6.1 17.2 • Central Luzon 295 19.7 2.3 15.2 24.2 4.5 11.6 • CALABARZON 335 20.5 2.5 15.6 25.5 4.9 12.2 • MIMAROPA 151 35.8 5.2 25.6 46.1 10.3 14.6 • Bicol 248 26.4 3.0 20.4 32.4 6.0 11.5 • Western Visayas 237 28.3 3.0 22.4 34.2 5.9 10.6 • Central Visayas 229 27.0 3.9 19.4 34.6 7.6 14.3 • Eastern Visayas 240 32.1 3.4 25.4 38.8 6.7 10.6 • Zamboanga Peninsula 149 33.9 5.0 24.1 43.6 9.7 14.6 • Northern Mindanao 146 25.4 3.0 19.6 31.2 5.8 11.6 • Davao 181 23.1 3.3 16.6 29.7 6.6 14.5 • SOCCSKSARGEN 184 27.8 4.2 19.6 36.0 8.2 15.0 • Caraga 168 24.3 3.1 18.3 30.4 6.1 12.7 • ARMM 116 38.0 5.2 27.7 48.2 10.3 13.8 Region Philippines • • body_june20.pmd 95 Percent Confidence Interval LL UL Percent Underweight 22.9 11.6 26.2 20.7 Margin Percent of Error CV 1.6 4.6 3.4 14.3 For the estimates of the prevalence of underheight among zero to five yearold children, all regions except CAR and Davao region have CVs less than 15 percent (17.4 and 16.7, respectively), hence, considered reliable. Central Luzon has the estimate of underheight that is much below the national estimate (19.3 vs. 26.3) while Zamboanga Peninsula (37.4 vs. 26.3) and SOCCSKSARGEN (40.5 vs. 26.3) have estimates that are way above the national prevalence. 21 2/20/2008, 9:00 AM 21 FACTS & FIGURES 22 Table 18. Estimates of the proportion of underheight among 0 to 5 year-old children, standard error, confidence interval, margin of error and coefficient of variation by region: Philippines, 2005 Sample Size Region Philippines body_june20.pmd Percent Underheight Standard Error 95 Percent Confidence Interval LL UL Margin of Error Percent CV 3,560 26.3 0.8 24.7 27.9 1.6 3.0 • NCR 391 21.4 2.3 16.9 25.9 4.5 10.7 • CAR 125 27.6 4.8 18.2 37.0 9.4 17.4 • Ilocos 226 21.4 3.0 15.5 27.3 5.9 14.1 • Cagayan Valley 139 23.0 2.8 17.5 28.5 5.5 12.2 • Central Luzon 295 19.3 2.4 14.5 24.0 4.8 12.6 • CALABARZON 335 21.0 2.4 16.2 25.7 4.7 11.5 • MIMAROPA 151 33.6 4.2 25.3 41.9 8.3 12.6 • Bicol 248 22.7 3.1 16.6 28.7 6.1 13.6 • Western Visayas 237 29.0 3.2 22.7 35.4 6.4 11.2 • Central Visayas 229 29.9 2.6 24.8 35.1 5.2 8.8 • Eastern Visayas 240 34.4 3.3 27.9 40.9 6.5 9.6 • Zamboanga Peninsula 149 37.4 3.2 31.0 43.8 6.4 8.7 • Northern Mindanao 146 29.2 4.3 20.8 37.7 8.4 14.7 • Davao 181 27.4 4.6 18.4 36.4 9.0 16.7 • SOCCSKSARGEN 184 40.5 3.6 33.5 47.5 7.0 8.8 • CARAGA 168 27.0 4.0 19.1 34.8 7.8 14.8 • ARMM 116 36.1 5.0 26.3 46.0 9.8 13.8 22 2/20/2008, 9:00 AM FACTS & FIGURES 2.2 School-age children (6 to 10 Years) • For the prevalence of underweight among school-age children six to 10 years old, the regions with reliable estimates (CVs less than 15 percent) are Ilocos (26.4 percent), Central Luzon (22.6 percent), CALABARZON (21.2 percent), MIMAROPA (30.1 percent), Bicol (22.0 percent), Western Visayas (30 percent), Central Visayas (23.7 percent), Eastern Visayas (32.2 percent, SOCCSKSARGEN (31.1 percent) and CARAGA (20.4 percent). • For the underweight prevalence, NCR, Cagayan Valley and Northern Mindanao have estimates that are much below the national figure (14.1 to 14.7 vs. 22.8). • On the other hand, Eastern Visayas and SOCCSKSARGEN have higher estimates (32.2 and 31.1, respectively vs. 22.8) than that of the national figure. Table 19. Estimates of the proportion of underweight among 6 to 10 yearold children, standard error, confidence interval, margin of error and coefficient of variation by region: Philippines, 2005 body_june20.pmd Region Sample Size Percent Underweight Standard Error Philippines • NCR • CAR • Ilocos • Cagayan Valley • Central Luzon • CALABARZON • MIMAROPA • Bicol • Western Visayas • Central Visayas • Eastern Visayas • Zamboanga Peninsula • Northern Mindanao • Davao • SOCCSKSARGEN • CARAGA • ARMM 3,264 316 113 182 148 261 304 158 223 220 255 227 125 151 164 166 155 96 22.8 14.1 16.2 26.4 14.1 22.6 21.2 30.1 22.0 30.0 23.7 32.2 35.2 14.7 17.2 31.1 20.4 23.5 0.8 2.5 3.9 3.4 3.0 2.6 2.4 3.8 3.1 3.4 3.0 3.8 5.9 2.2 3.8 3.2 3.0 5.0 23 95 Percent Confidence Interval LL UL 21.2 9.2 8.5 19.6 8.3 17.4 16.5 22.6 15.8 23.2 17.8 24.8 23.7 10.4 9.8 24.7 14.5 13.6 24.4 18.9 23.9 33.1 19.9 27.7 26.0 37.7 28.1 36.8 29.6 39.7 46.7 19.1 24.7 37.5 26.3 33.3 Margin of Error Percent CV 1.6 4.8 7.7 6.8 5.8 5.1 4.7 7.6 6.2 6.8 5.9 7.4 11.5 4.3 7.4 6.4 5.9 9.8 3.6 17.5 24.0 13.0 20.9 11.5 11.4 12.8 14.3 11.5 12.7 11.7 16.7 15.0 22.0 10.4 14.7 21.3 2/20/2008, 9:00 AM 23 FACTS & FIGURES 24 • Underheight prevalence rates indicate that the regions of Eastern Visayas, Zamboanga Peninsula and SOCCSKSARGEN have higher prevalence rates as compared with the national estimate (44.6, 50.1 and 45.6, respectively vs. 32.1). • NCR, on the other hand, has an estimate that is much below the national figure (20.7 vs. 32.1). Table 20. Estimates of the proportion of underheight among 6 to 10 yearold children, standard error, confidence interval, margin of error and coefficient of variation by region: Philippines, 2005 Region Philippines body_june20.pmd 95 Percent Confidence Interval Sample Size Percent Underheight Standard Error Margin of Error Percent CV LL UL 32.1 20.7 1.0 2.5 30.1 15.8 34.1 25.5 2.0 4.9 3.1 12.0 16.2 • NCR 3,264 316 • CAR 113 35.8 5.8 24.4 47.3 11.4 • Ilocos 182 27.5 2.7 22.1 32.9 5.4 9.9 • Cagayan Valley 148 24.3 4.0 16.4 32.2 7.9 16.6 • Central Luzon 261 24.1 3.5 17.2 30.9 6.8 14.5 • CALABARZON 304 24.5 3.1 18.5 30.6 6.0 12.5 • MIMAROPA 158 42.1 4.4 33.4 50.8 8.7 10.5 • Bicol 223 33.4 4.3 24.9 41.9 8.5 13.0 • Western Visayas 220 36.9 4.0 29.1 44.6 7.8 10.7 • Central Visayas 255 36.9 3.7 29.7 44.1 7.2 10.0 • Eastern Visayas 227 44.6 3.9 36.9 52.2 7.7 8.7 • Zamboanga Peninsula 125 50.1 6.5 37.3 62.9 12.8 13.0 • Northern Mindanao 151 30.9 3.8 23.5 38.4 7.5 12.3 • Davao 164 33.8 4.0 25.9 41.6 7.8 11.8 • SOCCSKSARGEN 166 45.6 3.9 38.0 53.2 7.6 8.5 • CARAGA 155 41.2 5.6 30.1 52.3 11.1 13.7 • ARMM 96 40.0 6.1 28.1 51.9 11.9 15.2 24 2/20/2008, 9:00 AM FACTS & FIGURES Iodized Salt Survey 1. AWARENESS AND USAGE OF IODIZED SALT • 83.4 percent of sample households (5,344) are aware of iodized salt • 49.2 percent of all survey households claimed to be users of iodized salt during the survey • Among those who are aware of iodized salt (or from the 83.4 percent who are aware), more than one-half or 59.0 percent claimed to be users of iodized salt. Other results revealed that: • The most common sources of information on iodized salt are from health personnel and the television • Grocery/supermarket/drugstore and market/’talipapa’ are the common market source of iodized salt • According to households, iodized salt is usually used as table salt and for cooking • Households’ perception on the cost of iodized salt is just right and the most common packaging is in package with label body_june20.pmd 25 2/20/2008, 9:00 AM 25 FACTS & FIGURES 26 Table 21.Results of iodized salt survey: Philippines, 2003 and 2005 Information /Data Percent of Households 2003 2005 79.5 83.4 Aware of iodized salt Reported users of iodized salt during survey • All survey households • All households aware of iodized salt Sources of information on iodized salt* • TV • Radio • Print media • IEC materials / billboards / posters / food labels • Health personnel / LGU • Relatives / friends / neighbors • School / seminar / meeting • Others Market source of iodized salt • Sari-sari store • Market / ‘Talipapa’ • Grocery / supermarket / drugstore • Health center / hospital / school • Other sources (ambulant vendors, salt plant) • Given / free • No data How iodized salt is used • Table salt as ‘sawsawan’ • Cooking • Both table salt and cooking • Others • No data Perception on the cost of iodized salt • Cheap • Just right • Expensive • Others (given / free / no idea) • No data Type of iodized salt packaging bought by /given to households • ‘Takal’ • In package with label • In package without label • No data 38.1 47.9 49.2 59.0 - 41.5 13.7 4.1 8.4 54.1 14.5 4.2 1.3 19.2 28.8 38.6 9.1 4.2 19.0 32.5 35.6 10.1 1.2 1.5 0.1 - 1.8 39.2 58.8 0.1 0.1 18.9 65.6 15.2 10.6 64.9 23.0 1.3 0.2 - 22.1 50.1 27.7 0.1 * multiple response body_june20.pmd 26 2/20/2008, 9:00 AM FACTS & FIGURES 2. IODINE TESTING 2.1 Using Rapid Test Kit • • • • Using the rapid test kit, results revealed that 75.4 percent (as compared to 56.4 in 2003) of the total household salts tested had positive reaction to potassium iodate. The 24.1 percent of the total households have salt negative to the test, i.e the salt either had no detectable iodine as potassium iodate, or had iodine but in potassium iodide form, or was confirmed to be ordinary non-iodized salt. Among households who claimed using iodized salt, only 88.7 percent had positive reaction indicating that iodine in salt is in the form of potassium iodate. The remaining 11.0 percent, probably had iodine but in iodide form or even with iodine but in very low undetectable level. Table 22. Household salt testing results using the Rapid Test Kit (RTK): Philippines, 2005 Data/Information Number Positive Negative No available salt No data Percent of all sampled household salts by reaction to potassium iodate solution 5,345 75.4 24.1 0.3 0.3 Percent of households who claimed to be using iodized salt by reaction to potassium iodate solution 2,598 88.7 11.0 0.1 0.2 2.2. Using the WYD Iodine Checker Machine • • • • body_june20.pmd Majority of the household salts (65.1 percent) was iodized, that is, five and above ppm. Only 44.5 percent of salt samples were found to have iodine at > 15ppm. About 20.6 percent of salt samples were found to have 5-14.9 ppm of iodine at the household level. In addition, 35 percent of household salts have no iodine content at all in their salt (0-4.9 ppm). 27 2/20/2008, 9:00 AM 27 FACTS & FIGURES 28 Table 23. Percentage distribution of households by iodine levels in salt using the WYD Iodine checker: Philippines, 2005 Iodine Levels (ppm) Number 0 to 4.9 5.0 to 9.9 10.0 to 14.9 15.0 to 29.9 30.0 to 39.9 40.0 to 59.9 > 60.0 Total • Percent 1,009 328 329 675 220 213 261 34.9 10.3 10.3 21.0 7.2 7.1 9.2 3,035 100.0 The minimum and maximum iodine level content in sample salts analyzed are zero and 445 ppm, respectively. • Median value of iodine in salt is 12.00 ppm. Table 24.Mean, median, standard deviation, minimum and maximum iodine content of salt using the WYD Iodine checker: Philippines, 2005 Iodine Levels Number Minimum Maximum (ppm) body_june20.pmd Mean Median Standard Deviation 0 to 4.9 1,009 0.00 4.00 1.16 0.80 1.10 5.0 to 9.9 328 5.00 9.00 7.00 7.00 1.50 10.0 to 14.9 329 10.00 14.00 12.02 12.00 1.43 15.0 to 29.9 675 15.00 29.00 21.13 21.00 4.13 30.0 to 39.9 220 30.00 39.00 34.31 34.00 2.83 40.0 to 59.9 213 40.00 59.00 48.11 48.00 5.56 > 60.0 261 60.00 445.00 89.95 89.00 30.21 Total 3,035 0.00 445.00 20.95 12.00 27.53 28 2/20/2008, 9:00 AM FACTS & FIGURES • • 29 There were 18.3 percent of the household salts that positively reacted to RTK but has no iodine content when analyzed by the WYD Iodine Checker machine. On the other hand, there were 81.8 percent of household salts that were correctly identified by RTK test to have iodine, the levels of which ranged from 5.0 to >60 ppm. • In addition, those 56.2 percent, which tested positive from RTK, had sufficient to high iodine content. Table 25. Percentage distribution of households by iodine levels and by RTK: Philippines, 2005 Iodine Levels (ppm) Number Positive to RTK 1,006 18.3 5.0 to 9.9 326 12.6 10.0 to 14.9 329 13.0 15.0 to 29.9 674 26.5 30.0 to 39.9 220 9.4 40.0 to 59.9 210 8.8 > 60.0 258 11.5 3,023 100.0 0 to 4.9 TOTAL body_june20.pmd 29 2/20/2008, 9:00 AM
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