Publication: Mind Over Matter in the Philippines: A Study of Key Stakeholders' Perceptions of Childhood Stunting
Loading...
Date
2020-06
ISSN
Published
2020-06
Author(s)
Editor(s)
Abstract
Declines in rates of child stunting in the Philippines have decelerated, making it hard for the country to achieve its targets on nutritional outcomes. The knowledge base, beliefs, and practices of caregivers have been extensively researched, but little is known about how health workers and policy makers fare in comparison. The authors conduct qualitative interviews, striving to preclude bias as we capture these stakeholders’ views on factors that affect stunting, and go on to compare and contrast these perceptions. The authors subsequently investigate the importance of the different factors in detail through a large-scale quantitative survey with frontline health and nutrition workers. The findings suggest that while most workers’ knowledge and beliefs are consistent with accepted practices, important deviations from consensus views exist, and these are correlated with worse self-reported service delivery outcomes at local health centers. The findings suggest that in the Philippines any endeavor to further improve service delivery must take into consideration the beliefs of frontline workers.
Link to Data Set
Citation
“Sen, Iman; Mbuya, Nkosinathi; Demombynes, Gabriel; Gauri, Varun. 2020. Mind Over Matter in the Philippines: A Study of Key Stakeholders' Perceptions of Childhood Stunting. Health, Nutrition and Population Discussion Paper;. © World Bank. http://hdl.handle.net/10986/34377 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Related items
Showing items related by metadata.
Publication Undernutrition in the Philippines(Washington, DC: World Bank, 2021-04-30)For nearly 30 years, the rates of both wasting and stunting in the Philippines have been nearly flat. For 2019, the rate of stunting among children under five years of age (28.8 percent) was only slightly lower than in 2008 (32 percent)—the prevalence of underweight in 2019 was 19 percent and that of wasting was 6 percent. Based on the World Health Organization’s classification of undernutrition rates, the stunting prevalence of children in the Philippines is of “very high” public health significance. The Philippines’ 29 percent stunting rate places it fifth among countries in the East Asia and Pacific region, and among the top 10 countries globally. The Philippines’ high levels of childhood undernutrition can lead to a staggering loss of the country’s human and economic potential. The burden on the Philippines’ economy brought by childhood undernutrition was estimated at US$4.4 billion, or 1.5 percent of the country’s GDP, in 2015. Undernutrition robs Filipino children of their chance at a bright future. When viewed through the lens of the World Bank’s Human Capital Index (HCI), the country’s 2020 HCI score of 0.52 predicts that the future productivity of children born today will be 48 percent below what they might achieve if they were to enjoy complete education and full health. Undernutrition in the Philippines: Scale, Scope, and Opportunities for Nutrition Policy and Programming presents a comprehensive, analytical work on this topic. It provides evidence of why it is critical that the government of the Philippines prioritize tackling this persistent challenge. The report assesses the determinants and causes of childhood undernutrition and reviews current policies and programs directed at addressing this problem. Based on these analyses, the report provides recommendations of how national policies and programs can be strengthened to reduce the high rates of undernutrition in the country. It sets out to inform the debate on the causes and potential solutions of undernutrition while identifying high-priority policies and policy commitments for action.Publication Malnutrition in Afghanistan : Scale, Scope, Causes, and Potential Response(World Bank, 2011)This book has the potential to contribute to a reversing of this trend, whereby activities in not only the health sector but also in other sectors relevant to nutrition will gain increased support and prominence in national development planning. South Asia has by far the largest number of malnourished women and children, and no other region of the world has higher rates of malnutrition. Malnutrition in childhood is the biggest contributor to child mortality; a third of child deaths have malnutrition as an underlying cause. For the surviving children, malnutrition has lifelong implications because it severely reduces a child's ability to learn and to grow to his or her full potential. Malnutrition thus leads to less productive adults and weaker national economic performance. Therefore, the impact of malnutrition on a society's productivity and well being and a nation's long-term development is hard to underestimate. For the South Asia region of the World Bank, malnutrition is a key development priority, and in the coming years, the Bank intends to enhance dramatically its response to this challenge. As a first step, a series of country assessments such as this one are being carried out. These assessments will be used to reinforce the dialogue with governments and other development partners to scale up an evidence-based response against malnutrition. To succeed, we will need to address the problem comprehensively, which will require engaging several sectors. This assessment of malnutrition in Afghanistan lays out the scale, scope, and causes of the problem. The assessment also indicates key elements of a potential response.Publication Immunization in Developing Countries : Its Political and Organizational Determinants(World Bank, Washington, DC, 2002-01)The authors use cross-national social, political, economic, and institutional data to explain why some countries have stronger immunization programs than others, as measured by diphtheria-tetanus-pertussis (DTP) and measles vaccine coverage rates and the adoption of the hepatitis B vaccine. After reveiwing the existing literature on demand- and supply-side side factors that affect immunization programs, the authors find that the elements that most affect immunization programs in low- and middle-income countries involve broad changes in the global policy environment and contact with international agencies. Democracies tend to have lower coverage rates than autocracies, perhaps because bureaucratic elites have an affinity for immunization programs and are granted more autonomy in autocracies, althought this effect is not visible in low-income countries. The authors also find that the quality of a nation's institutions and its level of development are strongly related to immunization rate coverage and vaccine adoption, and that coverage rates are in general more a function of supply-side than demand effects. there is no evidence that epidemics or polio eradication campaigns affect immunization rates one way or another, or that average immunization rates increase following outbreaks of diphtheria, pertussis, or measles.Publication Qualitative Study on Nutrition- and Health-Related Knowledge Attitudes and Practices in Four High Stunting Regions of Lao PDR(World Bank, Washington, DC, 2020-09)Despite the Lao People’s Democratic Republic (Lao PDR)’s significant economic growth over the last decade, poor nutritional outcomes remain a concern. Rates of malnutrition are particularly high in remote, rural, and upland areas. Redressing these high rates of malnutrition is critical in reversing inequalities in mortality and ill-health throughout people’s lives. This report presents the results of a qualitative study to investigate the knowledge, attitudes, and practices related to maternal and child health and nutrition in local communities in four provinces of Lao PDR with high levels of childhood undernutrition. While study participants were aware of the importance and benefits of antenatal care, facility-based birthing, and postnatal care, they also reported significant barriers to accessing these services. These barriers included poor road conditions and lack of transportation, long distances to health facilities, language difficulties, and lack of spousal support. With regard to infant and young child feeding, many mothers were aware of the benefits of colostrum for the first 24 hours and exclusive breastfeeding for the first six months of life and tried to put this into practice. However, some ethnic minority women stated that at times it was hard to prevent grandmothers from giving the infant water or a little chewed rice. There were mixed results when it came to growth monitoring of children. Even though mothers did participate in growth monitoring and promotion activities, most did not fully understand the reasons behind those activities. Access to clean water and appropriate sanitation facilities depended on location, but few families had access to safe water. While messages regarding handwashing and desisting from open defecation were well known in most villages, poverty and lack of support for providing safe and sustainable sanitation systems diminished the ability of many families to practice safe hygienic practices.Publication Malnutrition in Timor-Leste(World Bank, Washington, DC, 2017-04-01)This report presents the findings of nutrition assessment, gap analysis, and donor mapping exercise in the Democratic Republic of Timor-Leste (RDTL). Timor-Leste, though as a young and fragile state, has the preconditions for successful development. However, persistent high levels of malnutrition threaten to impede efforts to reduce poverty, capitalize on gains in human and skills development, increase productivity, and stimulate economic growth. Though progress has been in other areas of human development, malnutrition – particularly maternal and Child undernutrition – is the single greatest contributor to premature death and disability in the country and presents an unparalleled development challenge. In 2013, over half (50.2 percent) of all children under-five were stunted in their physical and cognitive development. Timor-Leste has the third highest stunting prevalence in the world, higher than all other g7+ countries and a significant outlier relative to its level of economic development. In 2013, nearly one in three (63.2 percent) children (6-59 months) and 2 in 5 women age 14-60 (39.5 percent) were anemic. Although the country is no longer in an emergency situation, the prevalence of wasting (11 percent) – an indicator of acute malnutrition and a prominent risk factor for child mortality – exceeds the WHO threshold for high public health significance, with emergency levels of wasting experienced in Covalima and Oecusse districts. Overweight prevalence is low relative to global averages, but has risen more than five-fold among adult women over the past decade. Though Timor-Leste does not yet suffer from the double burden of malnutrition, it will soon emerge if the problem continues unaddressed.
Users also downloaded
Showing related downloaded files
Publication World Development Report 2019(Washington, DC: World Bank, 2019)Work is constantly reshaped by technological progress. New ways of production are adopted, markets expand, and societies evolve. But some changes provoke more attention than others, in part due to the vast uncertainty involved in making predictions about the future. The 2019 World Development Report will study how the nature of work is changing as a result of advances in technology today. Technological progress disrupts existing systems. A new social contract is needed to smooth the transition and guard against rising inequality. Significant investments in human capital throughout a person’s lifecycle are vital to this effort. If workers are to stay competitive against machines they need to train or retool existing skills. A social protection system that includes a minimum basic level of protection for workers and citizens can complement new forms of employment. Improved private sector policies to encourage startup activity and competition can help countries compete in the digital age. Governments also need to ensure that firms pay their fair share of taxes, in part to fund this new social contract. The 2019 World Development Report presents an analysis of these issues based upon the available evidence.Publication Ten Steps to a Results-Based Monitoring and Evaluation System : A Handbook for Development Practitioners(Washington, DC: World Bank, 2004)An effective state is essential to achieving socio-economic and sustainable development. With the advent of globalization, there are growing pressures on governments and organizations around the world to be more responsive to the demands of internal and external stakeholders for good governance, accountability and transparency, greater development effectiveness, and delivery of tangible results. Governments, parliaments, citizens, the private sector, Non-governmental Organizations (NGOs), civil society, international organizations, and donors are among the stakeholders interested in better performance. As demands for greater accountability and real results have increased, there is an attendant need for enhanced results-based monitoring and evaluation of policies, programs, and projects. This handbook provides a comprehensive ten-step model that will help guide development practitioners through the process of designing and building a results-based monitoring and evaluation system. These steps begin with a 'readiness assessment' and take the practitioner through the design, management, and importantly, the sustainability of such systems. The handbook describes each step in detail, the tasks needed to complete each one, and the tools available to help along the way.Publication Supporting Youth at Risk(World Bank, Washington, DC, 2008)The World Bank has produced this policy Toolkit in response to a growing demand from our government clients and partners for advice on how to create and implement effective policies for at-risk youth. The author has highlighted 22 policies (six core policies, nine promising policies, and seven general policies) that have been effective in addressing the following five key risk areas for young people around the world: (i) youth unemployment, underemployment, and lack of formal sector employment; (ii) early school leaving; (iii) risky sexual behavior leading to early childbearing and HIV/AIDS; (iv) crime and violence; and (v) substance abuse. The objective of this Toolkit is to serve as a practical guide for policy makers in middle-income countries as well as professionals working within the area of youth development on how to develop and implement an effective policy portfolio to foster healthy and positive youth development.Publication The Power of Survey Design : A User's Guide for Managing Surveys, Interpreting Results, and Influencing Respondents(Washington, DC: World Bank, 2006)The vast majority of data used for economic research, analysis, and policy design comes from surveys-surveys of households, firms, schools, hospitals, and market participants, and, the accuracy of the estimate will depend on how well the survey is done. This innovative book is both a 'how-to' go about carrying out high-quality surveys, especially in the challenging environment of developing countries, and a 'user's guide' for anyone who uses statistical data. Reading this book will provide data users with a wealth of insight into what kinds of problems, or biases to look for in different data sources, based on the underlying survey approaches that were used to generate the data. In that sense the book is an invaluable 'skeptics guide to data'. Yet, the broad storyline of the book is something that should be absorbed by statistical data users. The book will teach and show how difficult it often is to obtain reliable estimates of important social and economic facts, and, therefore encourages you to approach all estimates with sensible caution.Publication Zimbabwe(World Bank, Washington, DC, 2019-03-01)This report presents an assessment of Zimbabwe’s agriculture sector disaster risk and management capacity. The findings indicate that Zimbabwe is highly exposed to agricultural risks and has limited capacity to manage risk at various levels. The report shows that disaster-related shocks along Zimbabwe’s agricultural supply chains directly translate to volatility in agricultural GDP. Such shocks have a substantial impact on economic growth, food security, and fiscal balance. When catastrophic disasters occur, the economy absorbs the shocks, without benefiting from any instruments that transfer the risk to markets and coping ability. The increasing prevalence of ‘shock recovery-shock’ cycles impairs Zimbabwe’s ability to plan and pursue a sustainable development path. The findings presented here confirm that it is highly pertinent for Zimbabwe to strengthen the capacity to manage risk at various levels, from the smallholder farmer, to other participants along the supply chain, to consumers (who require a reliable, safe food supply), and ultimately to the government to manage natural disasters. The assessment provides the following evidence on sources of risks and plausible risk management solutions. It is our hope that the report contributes to action by the Government of Zimbabwe to adopt a proactive and integrated risk management strategy appropriate to the current structure of the agricultural sector.