Maternal malnutrition, inequality drive stunting cycle

The Philippines remains caught in what experts described as an “intergenerational curse of malnutrition,” a crisis that threatens the country’s human capital and long-term development.

Despite economic growth, child stunting rates have barely improved, indicating that higher incomes alone cannot compensate for decades of weak investments in maternal and early childhood nutrition.

“Malnutrition in the Philippines is widespread and gut-wrenching,” said Dr. Valerie Gilbert Ulep, senior research fellow and program director of the Health Economics and Finance Program at the Philippine Institute for Development Studies (PIDS).

“[We are the] epicenter of chronic malnutrition in the region,” he added.

“We can only break the curse by making children a national priority; by acting with urgency, coordination, and accountability.”

Experts emphasized that the roots of stunting appear long before birth, reflecting chronic gaps in maternal nutrition and prenatal care.

Ulep said stunting is closely linked to maternal health and nutritional status.

“Shorter women are more likely to have smaller babies who grow up to be stunted adults themselves,” he explained.

He noted that undernourished mothers face a higher likelihood of delivering low-birth-weight infants who are more prone to stunting and developmental delays.

This biological link shows that malnutrition is not merely a food issue but a generational condition that worsens when interventions begin too late, beyond the critical window from conception to age 2.

Inequality, limited food access, and poor diets continue to deepen the crisis, experts said.

UNICEF Philippines Nutrition Manager Alice Nkoroi stressed that malnutrition disproportionately affects poor families and underserved regions.

“Children will basically eat rice with a snack that is high in salt or sugar,” she said.

“Obviously, this leads to all forms of malnutrition—not only stunting but also overweight and obesity in later years.”

PIDS senior research specialist Lyle Daryll Casas warned that Filipino families’ protein intake remains critically inadequate.

“This disparity may be attributed to escalating food costs relative to income levels,” he said.

He noted that the rising consumption of ultra-processed foods—driven by affordability, accessibility, and aggressive marketing—has entrenched poor dietary habits nationwide.

Experts also pointed out a persistent disconnect between available funds and the interventions that prevent stunting.

“The majority of our resources go to school feeding programs, but we continue to underprioritize cost-effective interventions during the first 1,000 days—when stunting can actually be prevented,” Ulep said.

He said nutrition spending should be properly tracked and tied to measurable outcomes.

Dr. Maria Asuncion Silvestre, founder of Kalusugan ng Mag-ina, Inc., agreed that many interventions begin too late.

“We target children that are already in the schools, where stunting is largely irreversible already,” she explained.

Silvestre called for realigning national strategy around maternal nutrition, exclusive breastfeeding, and early feeding support.

“We need breastfeeding counseling to optimize breastfeeding practices so that we can address the health inequities because of a lack of appropriate infant and young child feeding practices,” she said.

Department of Health Supervising Health Program Officer Jennilyn Ygaña acknowledged long-standing challenges in scaling and sustaining interventions.

“Over the past decades, we have had a lot of small-scale interventions that fail to scale up and are not actually sustained because most of the time these interventions are donor-driven,” she said.

She noted progress with the passage of the Universal Health Care Act and the First 1,000 Days Act, which provide a stronger framework for life-stage nutrition interventions.

“We are improving—we are able to reduce stunting—but not yet at the rate we expect,” she said.

“Still, we are moving toward that goal.”

Experts stressed that breaking the cycle of malnutrition requires sustained, convergent investments that support mothers and children during the first 1,000 days of life.

They said this includes ensuring access to prenatal care, nutritious food, breastfeeding support, clean water, and quality health services.

These insights were highlighted during the launch of “Raising the Bar: Understanding and Solving Chronic Malnutrition in the Philippines,” a book published by PIDS and UNICEF Philippines.

The book synthesizes five years of research on child nutrition and policy reforms and was launched on October 16 at Chardonnay by Astoria in Pasig City.

The recording is available at https://bit.ly/pidslive101625, and the book can be downloaded at https://bit.ly/RaisingtheBarBook.