philippine nutrition

Philippine Nutrition

Facts and Figures 2015

2015 Updating of the Nutritional Status of

Filipino Children and Other Population Groups

OVERVIEW

Food and Nutrition Research Institute

Department of Science and Technology

Bicutan, Taguig City, Metro Manila

December 2016

Philippine Nutrition Facts and Figures 2015

ISSN 2599-4425

This report provides an overview of the Updating of the Nutritional Status of Filipino Children and

Other Population Groups: Philippines, 2015 undertaken by the Department of Science and Technology-

Food and Nutrition Research Institute (DOST-FNRI).

Additional information about the survey may be obtained from the DOST-FNRI, DOST Compound,

Gen. Santos Avenue, Bicutan, Taguig City, Metro Manila, Philippines 1631.

Tel. Numbers.: (632) 837-20-71 local 2282/ 2296; 839-1846

Telefax: (632) 837-2934; 839-1843

E-mail: [email protected] [email protected]

Website: www.fnri.dost.gov.ph

Recommended Citation:

Department of Science and Technology - Food and Nutrition Research Institute (DOST-FNRI). 2016.

Philippine Nutrition Facts and Figures 2015: Updating of Nutritional Status of Filipino Children and

Other Population Groups Overview. FNRI Bldg., DOST Compound, Gen. Santos Avenue, Bicutan,

Taguig City, Metro Manila, Philippines.

The Philippine Nutrition Facts and Figures is published by the Department of Science and Technology-

Food and Nutrition Research Institute (DOST-FNRI).


TABLE OF CONTENTS

FOREWORD i

THE 2015 UPDATING SURVEY MANAGEMENT TEAM ii

ACKNOWLEDGMENTS iii

LIST OF ACRONYMS iv

LIST OF TABLES vii

LIST OF FIGURES ix

LIST OF APPENDICES x

MAP OF THE PHILIPPINES xi

DID YOU KNOW THAT... 1

1. INTRODUCTION

1.1 Background of the 2015 Updating Survey 19

1.2 Objectives of the Survey 20

1.3 Significance and Uses of the 2015 Updating Survey 20

1.4 Survey Components 23

2. METHODOLOGY

2.1 Sampling Design 27

2.2 Scope and Coverage 28

2.3 Survey Methods and Analyses 30

2.4 Survey Tools 43

2.5 Ethics Review 46

2.6 PSA Review and Approval 46

2.7 Preparatory Survey Activities 46

2.8 Actual Field Survey 50

2.9 Data Monitoring System 53

2.10 Data Processing and Statistical Analysis 54

2.11 Reporting and Dissemination 54

3. PROFILE OF RESPONDENTS

3.1 Demographic Characteristics of Individuals 57

3.2 Indigenous Peoples 61

3.3 Government Program Participation 62

4. SOCIOECONOMIC STATUS OF HOUSEHOLDS

4.1 Household Member Characteristics 64

4.2 Household Characteristics 66

4.3 Household Health and Sanitation 69

4.4 Household Possession 72

4.5 Wealth Quintile 73

5. REFERENCES 74

6. APPENDICES 76

i




FOREWORD

Since its birth in 1947, the Department of Science and Technology - Food and Nutrition

Research Institute (DOST- FNRI) has endeavored to fight malnutrition through accurate data, correct

information, and innovative technologies. Food and nutrition research is pertinent to the needs of

stakeholders who craft policies and implement programs and users who benefit from these policies and

programs.

With this in mind, I warmly welcome everyone who continuously supports all endeavors

towards improving the health and nutrition of all Filipinos in whatever form of undertaking.

Over the years, the NNS has evolved from a focused assessment of the Filipinos’ nutritional

status to include tracking progress towards the country’s commitment to “end malnutrition in all its

forms” as stipulated in the Millennium Development Goals, the Scaling-Up Nutrition Movement, and

now the Sustainable Development Goals.

The NNS is among the Department’s key services to the nation, wherein it provides data and

information for policies, program, and practice for both public and private sectors. Our food and

nutrition scientists’ dedication and commitment to the Department’s principles of excellence, relevance,

cooperation, and cost-effectiveness have made possible the timely release of these results despite all

natural and man-made struggles the survey personnel had to go through, such as typhoons, earthquakes,

and armed conflicts.

This monograph contains the overview of the components of the 2015 Updating of the

Nutritional Status of Filipino Children and Other Population Groups Survey which include the

Anthropometric Survey, Clinical and Health Survey, Dietary Survey, Food Security Survey,

Government Programs Participation Survey, Maternal Health and Nutrition and Infant and Young Child

Feeding Surveys and the Health-Related Millennium Development Goals Survey. It also presents the

sociodemogaphic and socioeconomic characteristics of the survey respondents.

This book has been compiled by the DOST-FNRI for the benefit of those who desire to obtain

scientific information on the 2015 Updating of the Nutritional Status of Filipino Children and Other

Population Groups. Through this, we hope to help address priority problems on malnutrition,

particularly undernutrition among our young ones and overnutrition among our older population. We

affirm that constant exposure to correct and accurate food and nutrition information is necessary

towards ending all forms of malnutrition.

All these are geared towards creating better lives for the Filipino people through science,

technology, and innovation (STI). May this book generate fresh ideas and perspectives that shall be

translated into practice for the betterment of the Filipino people’s nutrition and well-being.

MARIO V. CAPANZANA. Ph.D.

Director

ii Food and Nutrition Research Institute



THE 2015 UPDATING SURVEY MANAGEMENT TEAM

Mario V. Capanzana, PhD Project Director

Cecilia Cristina Santos-Acuin, MD, PhD

Project Leader

FINAL REPORT WRITERS

Charmaine A. Duante

Ma. Lynell M. Valdeabella-Maniego

Katrina G. Gomez, MD

Rovea Ernazelle G. Austria, RND

EDITORS

Mario V. Capanzana, PhD

Imelda Angeles-Agdeppa, PhD

COMPONENT STUDY LEADERS

Marina B. Vargas, PhD (Human Nutrition)

Dietary Component

Ma. Lilibeth P. Dasco, MSAN

Anthropometry Component

Mildred O. Guirindola, MPS-FNP

Maternal Health and Nutrition

and IYCF Component

Chona F. Patalen, MPH

Clinical and Health Component

Cristina G. Malabad, MSPH (Nutrition)

Food Security Component

Milagros C. Chavez

Government Programs Participation Component

(2012 to March 2016)

Charina A. Javier, MDE

Government Programs Participation Component

(April 2016 to present)

DATA MANAGEMENT

Charmaine A. Duante, MSc Epidemiology

(Public Health)

Head, Nutrition Statistics and Informatics Team

Glen Melvin P. Gironella

Senior Statistician and SES Component Head

Ma. Lynell M. Valdeabella-Maniego

Statistician

Eldridge B. Ferrer, MSAES

Statistician

Apple Joy D. Ducay

Statistician

Jeffrey Y. De Leon, MIT

Senior Programmer and Developer of e-DCS

Mae Ann S.A. Javier

Programmer and Developer of e-DCS

iii




ACKNOWLEDGMENTS

Grateful acknowledgment and appreciation are due to the following:

The Department of Health (DOH), Health Policy Development and Planning Bureau, and the DOST-

Philippine Council for Health Research and Development (DOST-PCHRD), through the 2015

Health Systems Research Management, for funding the project titled “Evaluation of the Attainment

of Health-Related Millennium Development Goals (MDGs)” integrated in the 2015 Updating

Survey;

The Philippine Society of Hypertension (PSH) and the Cardiology Unit and Pediatrics Unit of the

Philippine General Hospital (PGH) for sharing their expertise during the Blood Pressure

Certification Training;

The Philippine Statistics Authority (formerly National Statistics Office) for the technical assistance in

providing the list of sample housing units and sample households;

Ms. Benedicta A. Yabut, former Division Chief, and Mr. Percival A. Salting of the Demographic and

Social Statistics Division - Philippine Statistics Authority for their technical assistance during the

training and in the analysis of MDG indicators;

The Philippine Statistics Authority (PSA) Regional Offices (Regions VII, IX, XI) for their technical

assistance during the training of field researchers in the regions;

The Philippine Health Insurance Corporation or PhilHealth (Central Office and Regional Offices in

CAR, Regions VII, IX, XI) for the technical assistance during the training of field researchers; The

Department of Interior and Local Government (DILG), Local Government Units (LGUs), the

Governors, Mayors, Barangay Captains, and their constituents for providing direct assistance in the

field survey operations;

The National Nutrition Council of the Department of Health (NNC-DOH), through its Regional

Nutrition Program Coordinators (RNPCs) and Provincial/City and Municipal Nutrition Action

Officers (PNAOs/CNAOs and MNAOs), for sharing their untiring guidance and incessant support

during field data collection;

The Department of Science and Technology Regional Directors (RDs) and Provincial Science and

Technology Directors (PSTDs) for their support, especially during field data collection, training,

and pre-survey coordination in the regions/provinces;

The Centers for Health Development (CHDs) - Department of Health (DOH) through its Regional

Directors and the Provincial/City and Municipal Health Officers (PHOs/CHOs and MHOs) for their

assistance during field data collection;

Dr. Arturo Y. Pacificador, Jr., in his capacity as statistical consultant, for the technical guidance in

sampling design and computation of sampling weights;

The FNRI Finance and Administrative Division (FAD) for their invaluable assistance in the financial

aspect of the survey;

All 42,310 households and 161,577 individuals for their indispensable participation and utmost

cooperation in the survey; and

All FNRI technical and non-technical staff, local researchers, local survey aides, and numerous others

who have provided their inputs, involvement, and contribution to the fruition of the Updating of

Nutritional Status of Filipino Children and Other Population Groups: Philippines, 2015.

iv Food and Nutrition Research Institute



LIST OF ACRONYMS

AP As Purchased

AP_Ret As Purchased at Retail

AR Anthropometric Researcher

ARMM Autonomous Region in Muslim Mindanao

ATC Assistant Team Coordinator

BASULTA Basilan, Sulu, and Tawi-Tawi

BI Beginning Inventory

BMI Body Mass Index

CALABARZON Cavite, Laguna, Batangas, Rizal, and Quezon

CAR Cordillera Administrative Region

CCT Conditional Cash Transfer

CED Chronic Energy Deficiency

CGS Child Growth Standards

CNAO City Nutrition Action Officer

ComPack Complete Treatment Pack Program

CU Consumption Unit

DBP Diastolic Blood Pressure

DDS Dietary Diversity Score

DepEd Department of Education

DILG Department of Local Interior and Government

DOH Department of Health

DOST Department of Science and Technology

DR Dietary Researcher

DSWD Department of Social Welfare and Development

e-DCS Electronic Data Collection System

EA Enumeration Area

EAR Estimated Average Requirement

EBF Exclusive Breastfeeding

ECCD Early Childhood Care and Development

EI Ending Inventory

EO Executive Order

EPI Expanded Program on Immunization

FAO Food and Agriculture Organization

FCS Food Consumption Survey

FCT Food Composition Table

FDA Food and Drug Administration

FFQ Food Frequency Questionnaire

FIC Food Item Code

FNRI Food and Nutrition Research Institute

GP Government Program Participation

HC Hip Circumference

HDD Household Dietary Diversity

HDES Household Dietary Evaluation System

v




HFIAS Household Food Insecurity Access Scale

HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome

IERC Institutional Ethics Review Committee

IP Indigenous People

IRR Implementing Rules and Regulations

IT Information Technology

IYCF Infant and Young Child Feeding Practices

LBW Low Birth Weight

LCE Local Chief Executive

LFS Labor Force Survey

LGU Local Government Unit

LPG Liquefied Petroleum Gas

MAD Minimum Acceptable Diversity

MDD Minimum Dietary Diversity

MDG Millennium Development Goal

MMF Minimum Meal Frequency

MIMAROPA Occidental Mindoro, Oriental Mindoro, Marinduque, Romblon, and Palawan

MNAO Municipal Nutrition Action Officer

MNP Micronutrient Powder

MST Mobile Survey Team

MUAC Mid-upper Arm Circumference

NAMD Nutritional Assessment and Monitoring Division

NCD Noncommunicable Disease

NCHS National Center for Health Statistics

NCR National Capital Region

NEC Not Elsewhere Classified

NHIP National Health Insurance Program

NNC National Nutrition Council

NNS National Nutrition Survey

NSO National Statistics Office

PC Provincial Coordinator

PCA Principal Component Analysis

PCHRD Philippine Council for Health Research and Development

PDP Philippine Development Plan

PDRI Philippine Dietary Reference Intakes

PDS Personal Data Sheet

PhilHealth Philippine Health Insurance Corporation

PNAO Provincial Nutrition Action Officer

PPAN Philippine Plan of Action for Nutrition

PSA Philippine Statistics Authority

PSTD Provincial Science and Technology Director

PSU Primary Sampling Unit

RD Regional Director

REI Recommended Energy Intake

RENI Recommended Energy and Nutrient Intake

vi Food and Nutrition Research Institute



RNPC Regional Nutrition Program Coordinator

RST Regular Survey Team

SBP Systolic Blood Pressure

SD Standard deviation

SDG Sustainable Development Goals

SES Socioeconomic Survey

SHS Secondhand smoking

SMS Short messaging service

SNS Social networking sites

SOCCSKSARGEN South Cotabato, Cotabato City, North Cotabato, Sultan Kudarat, Sarangani,

and General Santos City

SPED Special Education

TC Team Coordinator

TL Team Leader

ToR Terms of Reference

UNICEF United Nations Children’s Fund

WB World Bank

WC Waist Circumference

WFP World Food Programme

WHO World Health Organization

WHR Waist-Hip Ratio

WI Wealth Index

WRA Women of Reproductive Age

vii




LIST OF TABLES

TABLE

NO. TITLE

PAGE

NO.

1 MDG health-related outcomes and their indicators: Updating Survey, 2015 26

2 Household level target, eligibility, and response rate: Philippines, 2015 28

3 Distribution of enumeration areas (EAs), sample households, and sample

individuals: Philippines, 2015

28

4 Eligible population and response and non-response rates per component:

Philippines, 2015

29

5 Equipment/tools and corresponding description for anthropometry data

collection

31

6 Age groups of WHO-Child Growth Standards (CGS) for infants and young

children, (0 to 60 months old) and WHO growth Reference 2007 for

school-age children and adolescents (61 to 228 months old), by index

32

7 Cut-off points used in classifying nutritional status of children, 0 to 19.0

years old (0 to 228 months)

32

8 Cut-off points used in classifying nutritional status of children, 0 to 5 years

old (0 to 60 months), based on BMI-for-age (WHO-CGS)

33

9 Cut-off points used in classifying nutritional status of children, 5.08 to 19.0

years old (61 to 228 months) based on BMI-for-age (2007 WHO Growth

Reference)

33

10 Cut-off points used in determining magnitude and severity of underweight

and stunting among children under five years old (0 to <60 months), as a

public health problem (WHO, 1995)

33

11 Cut-off points used in determining magnitude and severity of wasting

among children under five years old (<60 months), as a public health

problem (WHO, 1995)

33

12 Cut-off points used in classifying nutritional status of adults and lactating

mothers 19.0 years old and over (≥229 months) based on Body Mass Index

(NCHS/WHO, 1978)

33

13 Cut-off points used in classifying nutritional status of pregnant women

based on weight-for-height (Magbitang et al., 1988)

34

14 Classification and cut-off points for waist circumference and waist-hip

ratio, by sex

34

15 Blood pressure classification (JNC VII, 2003) 35

16 Operational definition of smoking status (WHO STEPS Surveillance

Manual) 35

17 Operational definition of smokeless smoking status 35

18 Operational definition of reported exposure to secondhand smoke (SHS) 35

19 Operational definition of alcohol consumption (WHO, 2014) 36

20 Operational definition of binge drinking (WHO, 2008) 36

21 Operational definition of insufficiently physically active (WHO STEPS

Surveillance Manual)

36

22 Operational definitions of selected dietary variables 38

23 HFIAS household food access scores 40

24 Categories of food insecurity (access) 41

viii Food and Nutrition Research Institute



TABLE

NO. TITLE

PAGE

NO.

25 List of booklets and forms used in the 2015 Updating Survey 43

26 2015 Updating Survey Regional Dissemination 56

27 Percent distribution of respondents, by age and sex: Philippines, 2015 57

28 Percent distribution of female respondents, by age group and physiological

status: Philippines, 2015

58

29 Percent distribution of respondents, 15 years old and above, by educational

attainment: Philippines, 2015

59

30 Percent distribution of respondents, 15 years old and above, by civil status

and sex: Philippines, 2015

59

31 Percent distribution of working respondents, 15 years and over, by type of

occupation and sex: Philippines, 2015

60

32 Percent distribution of population, 15 years and over by non-

working status and sex: Philippines, 2015

61

33 Proportion of Indigenous Peoples by region: Philippines, 2015 62

34 Proportion of households with at least one Philhealth principal member, by

region: Philippines, 2015

63

35 Proportion of households that are currently beneficiaries of CCT program:

Philippines, 2015

63

36 Percent distribution of highest educational attainment of household head,

by type of residence: Philippines, 2015

65

37 Percent distribution of occupation of household head, by type of residence:

Philippines, 2015

65

38 Percent distribution of households by type of household, type of dwelling

and number of bedrooms, by type of residence: Philippines, 2015

66

39 Percent distribution of households by tenure status of house and lot, by type

of residence: Philippines, 2015

67

40 Percent distribution of households by type of fuel used for cooking, by type


67

41 Percent distribution of households by presence of electricity and dwelling

materials, by type of residence: Philippines, 2015

68

42 Percent fistribution of households by sources of water for drinking,

cooking, and handwashing, by type of residence: Philippines, 2015

70

43 Percent distribution of households by treatment modalities prior to

drinking, by type of residence: Philippines, 2015

71

44 Percent distribution of households by sanitation facilities and waste

disposal practices, by type of residence: Philippines, 2015

71

45 Proportion of households by ownership of vehicles and appliances, by type


72

46 Percent distribution of households by wealth index, by type of residence

and region: Philippines, 2015

73

ix




LIST OF FIGURES

FIGURE

NO. TITLE

PAGE

NO.

1 Sampling design of the 2015 Updating of Nutritional Status of Filipino

Population (2015 Updating Survey)

27

2 Standard drink equivalents for different types of alcohol (WHO STEPS

Surveillance Manual)

36

3 Measuring tools used for food weighing and as visual aids for food recall 38

4 Booklets used as aid for the identification of food items consumed 38

5 Steps in processing and analysis of food consumption data 39

6 Screenshot of the log-in function of e-DCS 45

7 Screenshot of the main menu of e-DCS 45

8 Flowchart of the 2015 Updating Survey coordination 47

9 2015 Updating Survey Organizational Structure 48

10 Flow of data collection for anthropometry component 51

11 Flow of data collection for dietary survey 51

12 Flow of data collection for the 2015 Updating Survey 52

13 Screenshot of the Updating Survey 2015 Data Transmission Monitoring

System

53

x Food and Nutrition Research Institute



LIST OF APPENDICES

APPENDIX TITLE PAGE

NO.

A Sample Household Coverage 76

B Estimates of Sampling Error 77

C Profile of Sample Population by Response Status, Sex, Age, Type of

Residence and Wealth Quintile

81

D Ethical Clearance 85

E PSA Approval 86

F Informed Consent Forms 91

G Interview Guides - Household Membership and Information 96

H Regional DOST Officials 104

I NNC Regional Officials 108

J Organization Team and Composition 111

xi




MAP OF THE PHILIPPINES1

1 National Mapping and Resource Information Authority (2016)

xii




1




DID YOU KNOW THAT…

A. Anthropometry

Children, 0 to 59 months

Two (2) out of 10 (21.5%) children were underweight, with high prevalence among children

aged 4.00 to 4.99 years (24.7%).

Regions with high proportions of underweight children included MIMAROPA (31.8%),

Eastern Visayas (29.5%) and Bicol (28.4%).

Prevalence of underweight was observed to be significantly higher in 2015 at 21.5% than in

2013 at 20.0% (p-value = 0.001).

Three (3) out of 10 (33.4%) children were stunted.

More males (34.3%) were stunted than females (32.5%) (p-value = 0.009).

Stunting was prevalent in ARMM (45.2%), Eastern Visayas (41.7%), MIMAROPA (40.9%),

and Bicol (40.2%).

Stunting prevalence significantly increased from 30.3% in 2013 to 33.4% in 2015 (p-value =

0.0001).

Seven (7) out of 100 (7.1%) children were classified as wasted.

Regions with high proportions of wasted children were MIMAROPA (9.7%), Eastern Visayas

(8.4%), Bicol (8.2%), and ARMM (8.2%).

Prevalence of wasting slightly declined from 8.0% in 2013 to 7.1% in 2015, although the

difference was not statistically significant.

Four (4) out of 100 (3.9%) children were classified as overweight-for-height.

NCR (6.0%), Central Luzon (6.0%), and CALABARZON (5.0%) posted high proportions of

overweight children.

A significant decline in the prevalence of overweight children was observed in 2013 (5.1%)

relative to 2015 (3.9%) (p-value = 0.0001).

Children, 5.08 to 10.0 years

A significant increase in the proportion of underweight children was observed from 29.1% in

2013 to 31.2% in 2015 (p-value = 0.0165).

More boys (33.8%) were found to be underweight than girls (28.5%) (p-value = 0.0165).

High prevalence of underweight (35.6%) and stunting (36.6%) was noted in rural areas.

Anthropometric measurements are a ready measure of the nutritional status of an individual.

“Stunting” pertains to the presence of chronic malnutrition due to either energy deficiency or

repeated infections, while “wasting” is a measure of acute malnutrition. “Underweight” may be

due to either acute or chronic malnutrition. Meanwhile, “overweight” is an indicator of

overnutrition and a risk factor of non-communicable diseases.

2




Regions with high proportions of underweight children included MIMAROPA (42.2%),

Eastern Visayas (39.9%), Bicol (38.9%), and Western Visayas (38.9%).

A higher prevalence of stunting was noted in 2015 (31.1%) than in 2013 (29.9%) but the

difference was not statistically significant.

High prevalence of stunting was noted in ARMM (44.0%), Eastern Visayas (41.7%), and

MIMAROPA (39.3%).

Wasting barely decreased from 8.6% in 2013 to 8.4% in 2015.

Regions with high prevalence of wasting were MIMAROPA (11.8%), Bicol (10.9%), and

Western Visayas (10.0%).

The proportion of overweight children aged 5 to 10 years slightly decreased from 9.1% in 2013

to 8.6% in 2015, but the decrease was not significant (p-value = 0.0940).

Regions noted to have a high proportion of overweight/obese children were NCR (17.9%),

Central Luzon (12.5%), and CALABARZON (11.3%).

More overweight/obese children were found in urban (13.0%) than in rural areas (5.1%) (p-

value = 0.001).

Adolescents, 10.08 to 19.0 years old

The mean height and weight of adolescents had increased from 148.0 cm to 148.4 cm and from

40.4 kg to 41.0 kg, respectively.

A high proportion of adolescents was found to be stunted (31.9%) or wasted (12.5%).

Nine (9) out of 100 (9.2%) adolescents were overweight/obese.

Stunting was prevalent among adolescents 16 to 19 years old (33.5%), with more males affected

(33.3%) than females (30.4%) (p-value = 0.001).

A higher proportion of stunted adolescents resided in rural areas (36.1%) than in urban areas

(27.3) (p-value = 0.001) and belonged to the poorest wealth quintile (49.4%).

Wasting affected about 14.0% of adolescents aged 10 to 13 years.

Overweight and obesity were noted to be prevalent among the 10 to 12 age group at 10.8%, as

well as those from urban areas (12.4%) and among the richest quintile (21.1%).

Among regions, NCR had the highest prevalence of overweight and obesity at 16.1%.

Adults, 20 years and over

One (1) out of 10 adults (10.3%) was chronic energy deficient.

Chronic energy deficiency was significantly more prevalent in rural (11.0%) than in urban areas

(9.5%) (p-value < 0.0000), as well as among those in the poorest wealth quintile (14.9%).

Prevalence of chronic energy deficiency was highest in Western Visayas (14.0%).

3




Android type of obesity, as measured by high waist circumference (WC) and high waist-hip

ratio (WHR) among female adults was 18.5% and 57.9%, respectively, and among male adults

at 3.0% and 7.1%, respectively.

Pregnant Women and Lactating Mothers

The proportion of nutritionally at-risk pregnant women had decreased by 3.7 percentage points

over the past ten years.

In 2015, about one-fourth (24.7%) of pregnant women were nutritionally at-risk.

Being nutritionally at-risk was prevalent among pregnant women at the younger age group of

below 20 years (39.7%), among those at the poorest quintile (30%) and among those residing

urban areas (25.2%) .

Regions with a high proportion of nutritionally at-risk pregnant women were MIMAROPA

(35.1%), Western Visayas (32.1%), and Zamboanga Peninsula (29.1%).

One (1) out of 10 (13.6%) lactating mothers were found to be underweight or chronically energy

deficient while two (2) out of 10 (22.4%) were overweight and obese.

The prevalence of overweight and obesity among lactating mothers had increased from 21.7%

in 2013 to 22.4% in 2015, but the difference was not statistically significant.

Birth Weight of Young Children, 0 to 5.9 years old

Nine (9) out of 10 (89.9%) birth deliveries were attended by a skilled birth attendant (i.e.,

doctor/nurse/midwife).

Eight (8) out of 10 (82.6%) births were delivered in a health facility.

The mean birth weight of young children was 3,001.8 grams.

Based on both birth records and recall by mothers, one (1) out of 10 children (14.0%) were born

with low birth weight (LBW).

There were more LBW babies among girls (14.9%) than boys (13.2%) (p-value = 0.0052).

Regions with a high proportion of LBW babies were MIMAROPA (16.4%), Western Visayas

(16.3%), and Zamboanga Peninsula (16.1%).

4




B. Clinical and Health

Adolescents, 10.0 to 19.9 years old

Adolescents 10 to 19.9 years had a mean systolic blood pressure (SBP) of 99.5 mmHg and a

mean diastolic blood pressure (DBP) of 64.5 mmHg.

Current smoking among adolescents 10 to 19.9 years old was significantly more common

among boys (9.4%) than girls (1.4%) (p-value = 0.001).

The proportion of smokers was highest among those in the 18.0 to 19.9 age group at 17.1%.

The regions with a high proportion of current smokers among adolescents were NCR (9.7%),

Western Visayas (7.0%), and Davao Region (6.4%).

Four (4) out of 10 (44.0%) adolescents were exposed to secondhand smoke inside their homes

at least once a week, while six (6) out of 10 adolescents (61.6%) were exposed to secondhand

smoke outside their homes (i.e. transport terminals, eating places, and the neighborhood).

There was a decline on the proportion of adolescents who drink alcoholic beverages from 21.7%

in 2008, to 18.6% in 2013, and to 14.9% in 2015.

The proportion of boys who currently drink alcoholic beverages (19.6%) were significantly

higher than that of girls (10.1%) (p-value = 0.001).

Alcohol drinking among adolescents was common in urban areas (18.8%), among those

belonging to the rich quintile (19.7%), and among those residing in the NCR (28.4%).

Adults, 20.0 years and over

The overall mean SBP for adults, 20 years and over, was 119.5 mmHg, with significantly higher

mean SBP noted among adult males at 122.3 mmHg than adult females at 117.2 mmHg (p-

value = 0.001).

A significant increase in the prevalence of elevated blood pressure among adults was observed

for both sexes, from 22.3% in 2013 to 23.9% in 2015 (p-value = 0.001).

The prevalence of elevated blood pressure was noted to be high among males (27.5%), urban

dwellers (25.2%), and those belonging to the rich (26.1%) and richest wealth quintiles (26.0%).

The prevalence of elevated blood pressure was high in Central Luzon (27.4%), CAR (26.5%),

and Bicol (26.2%).

According to the World Health Organization (WHO), two-thirds (67%) of the total deaths in the

Philippines in 2012 were caused by non-communicable diseases. Of these deaths, one-third (33.0%)

were diseases of the heart and vascular system. Non-communicable diseases or chronic diseases tend

to be of long duration, resulting from a combination of genetic, physiological, environmental, and

behavioral factors (WHO, 2014). The modifiable risk factors for NCDs are lifestyle-related

behaviors, including smoking, alcohol consumption, physical inactivity, and unhealthy diet.

5




Two (2) out of 10 adults (23.3%) were current smokers and one (1) out of 10 adults (13.0%)

were former smokers. Results showed significant decrease in the proportion of current smokers

from 25.4% in 2013 to 23.3% in 2015 (p-value = 0.001).

Six (6) out of 10 adults (63.7%) were never smokers. There was a significant increase in the

proportion of never smokers, from 59.2% in 2013 to 63.7% in 2015 (p-value = 0.001).

Regions with a high proportion of current smokers among adults included NCR (27.5%),

Western Visayas (25.8%), Cagayan Valley (24.9%), and Central Luzon (24.9%).

Four (4) out of 10 adults (39.7%) were exposed to secondhand smoke inside their homes at

least once a week, while seven (7) out of 10 (68.9%) were exposed to secondhand smoke outside

their homes.

Prevalence of current smokeless smoking among adults was 2.4%. It was noted to be common

among male adults (3.4%), rural dwellers (4.0%), those in the poorest wealth quintile (6.7%),

and in CAR (21.8%).

The proportion of adults who drink alcoholic beverages significantly decreased from 48.2% in

2013 to 44.9% in 2015 (p-value = 0.001).

There were significantly more males (69.1%) currently drinking alcoholic beverages than

females (24.3%) (p-value = 0.001).

The proportion of binge drinkers among currently drinking adults slightly decreased from

56.2% in 2013 to 55.2% in 2015, but the difference was not statistically significant (p-value =

0.304).

About six (6) out of 10 (58.8%) males and four (4) out of 10 (41.9%) females were binge

drinkers.

Four (4) out of 10 (42.5%) adults were insufficiently physically active.

Three (3) out of 10 males (30.1%) and more than half (52.9%) of females were insufficiently

physically active.

6




C. Dietary

The typical Filipino diet remained to be a rice-vegetable-fish combination.

Processed meats were highly consumed by urban households while rural households preferred

processed fish such as canned sardines and dried fish. Furthermore, consumption of processed

food was found to increase with wealth status.

More than half of households met the estimated average requirement (EAR) for protein (59.6%)

and niacin (85.1%). The proportion of households meeting the EAR for other nutrients ranged

from 20.0% to 33.2%. Calcium (16.0%) and iron (9.2%) registered the lowest proportion of the

population meeting the EAR.

Nearly one-third (32.2%) of households had at least one member who took meals or snacks

outside of home.

Eating out was observed to be highest among households in the rich (39.6%) and richest

(44.9%) quintiles, among those in urban areas (40.8%), and among those residing in NCR

(60.5%).

The daily household food cost in the Philippines was Ᵽ 262.87. The biggest share of cost was

spent on fish, meat, and poultry (Ᵽ 91.98), followed by cereal and cereal products (Ᵽ 83.99)

and vegetables (Ᵽ 24.38).

The total daily household plate waste was 62 grams which was composed of vegetables (5

grams), rice (43 grams), fish and fish products (6 grams), and meat and meat products (1 gram).

These were either discarded or fed to pets by the household, resulting to a total equivalent loss

of 172 kilocalories per day.

Among food groups, the highest amount of plate waste was composed of mainly rice and rice

products (43 grams) and was observed to be high among rural households (53 grams).

.

The Dietary Survey or Food Consumption Survey (FCS) component of the NNS provides a direct

measure of food consumption at the household level. It determines the actual food intake and

adequacy of energy and nutrient intake of Filipino households using the food weighing technique.

Dietary patterns are indicative of emerging concerns that are of public health significance in terms

of inadequacy and excess consumption.

7




D. Government Nutrition and Health Programs Participation

Eight (8) out of 10 (85.3%) households were aware of the Pantawid Pamilyang Pilipino

Program (4Ps).

Among regions, SOCCSKSARGEN (92.9%), Northern Mindanao (92.7%), and Eastern

Visayas (92.2%) had a high proportion of households that were aware of 4Ps.

Among eligible households, more than one-fourth (26.0%) were beneficiaries of the 4Ps.

Eight (8) out of 10 (77.1%) households had at least one PhilHealth principal member.

Moreover, the region with highest proportion of households with at least one PhilHealth

principal member was Caraga (84.1%) while the lowest was ARMM (52.0%).

Four (4) out of 10 meal planners (38.2%) had always read product labels. About 10% of those

who check product labels read nutrition facts.

One (1) in every 2 children aged 0 to 71 months old (50.7%) underwent newborn screening.

The regions with the highest proportion of children 0 to 71 months who underwent newborn

screening were CAR (88.5%), Ilocos (83.3%), and NCR (78.7%), while the lowest was ARMM

(21.7%).

Six (6) out of 10 (64.4%) children aged 0 to 24 months were fully immunized before their first

birthday.

Seven (7) out of 10 (70.6%) children aged 12 to 71 months received Vitamin A supplements.

Among regions, a high proportion of children aged 12 to 71 months with Vitamin A

supplementation was found in Eastern Visayas (87.4%), Western Visayas (84.8%), and

Northern Mindanao (83.0%).

The proportion of children aged 6 to 59 months that were reported to have ever taken iron

supplements was 17.2%.

Among mothers who were aware of the Micronutrient Powder (MNP), less than half (47.9%)

of their children aged 6 to 23 months have tried the product.

Only 13.5% of children 0 to 71 months old who got sick (57.1%), have consulted for treatment

and were prescribed with medication, reported to have received enough medications under the

ComPack Program.

Six (6) out of 10 (58.1%) children aged 12 to 71 months old, and seven (7) out of 10 (72.9%)

children 6 to 12 years of age participated in the deworming program.

The Government Program Participation Component tracked the participation of the target population

on programs such as the health and nutrition program included in the Philippine Development Plan

(PDP) 2011-2016 and Philippine Plan of Action for Nutrition (PPAN) 2011-2016. At the household

and individual levels, government programs were crafted to address the country’s health and

nutrition-related problems. As such, it is essential to obtain information on the extent of participation

to these programs for policy-decision and intervention formulation or review.

8




Among schoolchildren 6 to 12 years of age, seven (7) out of 10 (72.4%) participated in the

school gardening program.

Only 4.8% of adults who got sick (48.1%), have consulted with a health facility, and was

prescribed medication reported to have received enough medicines under the ComPack

program.

9




E. Socioeconomic Status

Household Member Characteristics

About 27% of respondents 15 years and over had at least elementary schooling and 11.4%

graduated from college.

Nearly one-fourth (23.8%) of respondents 15 years and over worked in the agriculture, forestry,

or fishery sectors.

At least 14% of respondents in rural areas and 17% of those in urban areas were engaged in

elementary occupations such as unskilled labor.

About 6.7% of respondents in rural areas and 13% in urban areas were employed as

professionals.

The smallest group of employed individuals in both rural and urban areas was those employed

in the armed forces.

Household Characteristics

Six (6) out of 10 (63.8%) Filipino households were single-family households.

Nine (9) out of 10 households (90.3%) reported to reside in a single-house type of dwelling.

About three (3) out of 10 households had one bedroom (28.0%) and about four (4) out of 10

had two bedrooms (36.8%).

Up to 82% of households owned their dwellings and 59% of households also owned the lots

where their dwellings were situated.

Majority of households (86%) used galvanized iron or aluminum roofing. Less than half (49%)

of households had dwellings with concrete/brick/stone walls and 52% had plain cement floors.

Almost 90% of households had electricity.

Nine (9) out of 10 households (94%) used improved water sources, with less than one-third

(31.7%) using bottled water for drinking. Water used for cooking and handwashing was

commonly piped into dwellings. The most commonly used non-improved sources for drinking,

cooking, and handwashing were unprotected springs and dug wells.

Boiling was the method used by about 16% of households as water treatment prior to drinking.

About nine (9) out of 10 (87.2%) households reported to have water-sealed toilets.

Majority of households (78.1%) had exclusive ownership and use of toilet facilities.

Waste segregation was practiced by 60% of households.

Socioeconomic status (SES) is an important determinant for identifiying inequalities and needs

within a population group. Actual income, a direct measure for SES, is not feasible to be determined

during actual data collection; thus, Wealth Index (WI) may be employed as a proxy indicator of

income. WI is determined using household assets and housing characteristics to categorize

households into wealth quintiles.

10




Nearly half (47.9%) of households nationwide had their garbage regularly collected from their

dwellings, the practice being more common in urban areas (76.9%).

In rural areas, burning garbage was still the preferred means of disposal, practiced by more than

half (52.3%) of households.

Household Assets and Wealth Index

More than one-third (34.2%) of households had motorcycles.

Seven (7) out of 10 households owned televisions (74.8%) and basic cellphones (74.0%).

Four (4) out of 10 households owned a refrigerator or freezer (39.4%) and a stove or range

(36.8%).

In rural areas, about one-third (32.0%) of households fell under the poorest wealth quintile and

31.0% of households in urban areas were classified under the richest quintile.

The regions with the most households under the richest quintile included NCR (37.2%),

CALABARZON (31.1%), and Central Luzon (31.1%).

Up to 70% of households in ARMM fell under the poorest quintile.

11




F. Food Security

One-third of households (33.9%) were food secure.

A high proportion of food secure households was located in CALABARZON (44.4%) and

Central Luzon (43.3%).

Up to 21.9% of households in the Philippines were severely food insecure, with the highest

prevalence observed in ARMM (44.5%).

Households attained a mean Dietary Diversity Score (DDS) of 9.4.

The regions with the highest DDS were Cagayan Valley and Central Luzon, both with 9.8. The

region with the lowest score was ARMM at 7.8.

The most commonly consumed food groups, as far as DDS was concerned, were cereals and

cereal products such as rice and grains (99.8%) followed by vegetables (97.8%) and spices and

condiments (95.8%). The least consumed food groups were milk and milk products (50.9%),

white tubers and roots (48.4%), and legumes and nuts (39.7%).

In terms of Food Consumption Scores (FCS), cereal products and grains were consumed by

99% of households, followed by meat and fish (98.8%) and vegetables (97.9%). Pulses were

the least consumed group at 39.7%.

Most households in the Philippines had an “acceptable” food consumption rating, except in

ARMM where up to 22.6% of households had “borderline” food consumption and 6.5% had

“poor” food consumption based on the Food Consumption Score developed by the World Food

Programme.

The food security survey measures a household’s access to safe, sufficient, and nutritious food using

an experience-based scale (Household Food Insecurity Access Scale or HFIAS). It also includes

measurements of diversity of diet, as this is an important component of food security.

12




G. Maternal Health and Nutrition

One-fourth (24.7%) of the population of pregnant women were nutritionally at-risk.

More than one-third of pregnant women in MIMAROPA (35.1%) were nutritionally at-risk.

One (1) out of 10 lactating mothers (13.6%) were underweight/chronically energy deficient

while two (2) out of 10 (22.4%) were overweight/obese.

Regions with high proportions of chronically energy deficient lactating mothers were

MIMAROPA (18.4%), Ilocos Region (18.3%), Western Visayas (17.9%), and Central Luzon

(17.8%).

The prevalence of overweight/obesity was high in NCR (30.7%), CAR (30.7%), Northern

Mindanao (28.4%), and Caraga (25.1%).

Among women who were neither pregnant nor lactating but had children aged 0 to 36 months

old, one (1) out of 10 (10.8%) were found to have chronic energy deficiency, while three (3)

out of 10 (27.7%) were overweight/obese.

Nine (9) out of 10 pregnant mothers (95.3%) had at least one prenatal checkup during their

previous/current pregnancy.

Seven (7) out of 10 mothers (69.5%) had their first prenatal checkup within the first trimester

of their previous/current pregnancy.

The most frequently stated reason for having prenatal checkups was ‘to have a healthy

pregnancy’ (69%), followed by ‘to avoid pregnancy complications’ (46.9%).

Eight (8) out of ten (84.5%) Filipino mothers had taken any form of vitamin supplements.

The most frequently taken supplement was iron (86.9%), both as a single supplement or in

combination with folic acid or other vitamins.

Folic acid supplements were taken by one-fourth of mothers (25.5%) during their previous/

current pregnancy.

Hypertension was the most frequently reported complication during the mothers’

previous/current pregnancy (20.2%), followed by diabetes (5.9%) and asthma (3.8%).

Nine (9) out of 100 teenage mothers (8.7%) and seven (7) out of 100 adult mothers (6.9%)

reported having night blindness.

In 2015, the World Health Organization (WHO) recorded a maternal mortality ratio of 114 per

100,000 livebirths in the Philippines. Clearly, the MDG target of reducing Maternal Mortality Rate

(MMR) by 75 percent to 52 per 100,000 livebirths by 2015 was not met. Now, the country adopted

the Sustainable Development Goals, which is a continuation and expansion of the MDGs. One of

the targets of SDG 3 is to reduce global MMR to less than 70 per 100,000 livebirths by 2030.

The Maternal Health and Nutrition component of the NNS is an opportune survey activity to gather

evidence-based data on factors influencing maternal health and nutrition and to formulate or

redefine policies and implement programs for the improvement of maternal health and nutrition.

13




Self-reported night blindness was 12.5% among mothers with six or more children.

Self-reported night blindness ranged from 6.0% to 6.9% among mothers with five or fewer

children.

Eight (8) out of 10 (78.0%) mothers delivered their children in health facilities while two (2)

out of 10 (21.7%) delivered in their homes.

The most common reason cited for not delivering at a health facility was the cost of delivery in

a health facility (34.3%).

Eight (8) out of 10 (83.4%) birth deliveries were attended by a skilled birth professional (i.e.,

doctor/nurse/midwife).

Traditional birth attendants assisted in 15.4% of birth deliveries, showing an increase from

9.4% in 2013.

Nine (9) out of 10 (88.6%) mothers delivered their babies normally, while 11.4% delivered via

caesarian section.

The proportion of normal deliveries was highest in ARMM (96.7%) and caesarian deliveries

were most common in Central Luzon (22.8%).

Nine (9) out of 10 (89.8%) mothers intended to breastfeed their children. Meanwhile, 6.1%

planned to give a mix of breastmilk and formula, while 3.6% planned to give solely milk

formula.

Two-thirds of mothers (66.5%) deemed breastfeeding as the most nutritious feeding practice.

Almost half (49.9%) of mothers had correct knowledge on the duration of exclusive

breastfeeding.

Two-thirds (66.2%) of mothers had correct knowledge on the proper timing of introduction of

complementary food.

More than half (56.6%) of mothers had maternity leave.

On the average, mothers had 2.2 months of maternity leave. Mothers who were self-employed

or working in a family business enjoyed longer maternity leave at 2.5 months.

Nine (9) out of 10 mothers (97.9%) deemed child immunization as important.

Less than half (45.5%) of mothers stated that the prevention of life-threatening disease was

their reason for availing of immunization for their children.

In the event of an illness, more than half (54.5%) of mothers reported to have self-medicated

with over-the-counter drugs, 15.4% consulted public health facilities and 11.3% visited private

facilities.

Nine (9) out of 10 mothers reported washing their hands regularly before handling food (89.7%)

and eight (8) out of 10 (84.9%) after attending to a child who defecated.

14




H. Infant and Young Child Feeding

The mean duration of exclusive breastfeeding (EBF) among infants was 4.2 months,

approximately two (2) months short of the recommended six (6) months.

Regions with duration closest to the six-month recommendation were CAR (5.0 months),

ARMM (4.7 months), and MIMAROPA (4.7 months). On the other hand, regions with shorter

duration of EBF were Northern Mindanao (3.9 months), NCR (4.0 months), and

CALABARZON (4.0 months).

Less than half (48.8%) of infants aged 0 to 5 months were exclusively breastfed. This is lower

than the 2013 estimate of 52.3%; however, the decline was not statistically significant.

Regions with high proportions of exclusive breastfeeding among children were MIMAROPA

(74.0%), CAR (72.1%), Davao (64.4%), and Bicol (64.1%).

The proportion of children who were initiated to breastfeeding within one hour after delivery

decreased from 77.1% in 2013 to 65.1% in 2015.

Regions with high proportions of infants initiated to breastfeeding within one hour after

delivery were Eastern Visayas (78.1%), Davao (75.8%), Northern Mindanao (74.4%), and

Zamboanga Peninsula (74.2%).

The proportion of children who were continuously breastfed at the age of one was 53.2%.

The highest proportion of children with continued breastfeeding at year 1 was recorded in

MIMAROPA (76.4%), which increased from 54.1% in 2013 (p-value = 0.0783). The lowest

proportion of children with continued breastfeeding was observed in NCR (39.1%), which also

increased from 28.3% in 2013 (p-value = 0.1323).

At year 2, the highest proportion of children with continued breastfeeding was seen in Western

Visayas (45.2%) and the lowest in Caraga (24.2%).

The average overall duration of breastfeeding, regardless of exclusivity, was 8.3 months, still

three times lower than the recommended duration of 24 months by WHO.

The prevalence of bottle feeding had increased significantly from 48.8% in 2013 to 52.3% in

2015 (p-value = 0.0003).

The highest proportion of bottle-fed children were those aged 10 to 11 months (56.7%).

Up to 80.3% of children were introduced to complementary food at the age of 6 to 8 months.

Commercial baby food was the most frequently introduced first food for children (42.9%),

Three (3) out of 10 children aged 6 to 23 months (29.2%) met the Minimum Dietary Diversity

(MDD), signifying an almost twofold increase from 15.5% in 2013 (p-value < 0.0000). This

Optimal infant and young child feeding practices are important in reducing malnutrition that may

result in wasting and stunting. The incidence of infections, delays in growth and development, and

the irreversible consequences of stunting, may be averted through appropriate nutrition and feeding.

15




age group consumed grains, roots, and tubers (100%), followed by meats (82.7%) and milk

and milk products (80.8%). Legumes were the least consumed food group (11.7%).

Overall, nine (9) out of 10 (91.7%) children met the Minimum Meal Frequency (MMF) of food

other than breastmilk that were consumed daily.

Up to 94.8% of children in NCR and only 85.3% of children in ARMM met the Minimum Meal

Frequency.

The Minimum Acceptable Diet (MAD) summarizes both the MDD and MFF. In 2015 only

18.6% of children aged 6 to 23 months met the MAD.

16




I. MDG Health –Related Outcomes

MDG 1C: Eradicate extreme poverty and hunger

Target: Halve, between 1990 and 2015, the proportion of people who suffer from hunger

Indicators: 1.8) prevalence of underweight children under five years of age, 1.9a) percent of

household with per capita energy less than 100% adequacy

Two (2) out of ten (21.5%) children under five years of age were underweight, with a high

prevalence among children aged 4.00 to 4.99 years (24.7%). The target reduction to 13.6%

prevalence was not met.

The proportion of households with per capita energy less than 100% adequacy was 69.0%,

higher than the 37.1% target.

MDG 4A: Reduce child mortality

Target: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate

Indicators: 4.1) Under-five mortality rate, 4.2) infant mortality rate; neonatal mortality rate,

and 4.3) proportion of 1-year-old children immunized against measles; fully immunized

children (FIC) rate

The under-five mortality rate (U5R)2 and infant mortality rate (IMR)2 was 27 deaths and 21

deaths per 1,000 live births, respectively. Only the target for under-five mortality rate was met.

Eight (8) out of 10 (79.0%) one-year-old children were immunized against measles, not meeting

the 100% target. Six (6) out of 10 (61.9%) children 12 to 23 months old were fully immunized.

2 These are not official results.

The Millennium Development Goals (MDGs) are formulated as the world’s time-bound and

quantified targets aimed at addressing the different facets of extreme poverty, i.e., income poverty,

hunger, disease, lack of adequate shelter, and exclusion; while promoting gender equality, education,

environmental sustainability, and the reinforcement of basic human rights, the right of each human

to health, education, shelter, and security. The Philippines, together with other nations, signed the

Millennium Declaration in 2000, committing the country to the achievement of the Millennium

Development Goals (MDGs). There are eight MDGs, six of which have health-related indicators.

These include MDG 1: eradicate extreme hunger and poverty; MDG 4: reduce child mortality; MDG

5: improve maternal health; MDG 6: combat HIV/AIDS, malaria and other diseases; MDG 7C:

reduction of the proportion of the population without sustainable access to safe drinking water and

basic sanitation by half; and MDG 8E: provide access to affordable essential drugs in developing

countries.

17




MDG 5: Improve maternal health

5.A. Target: Reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio

Indicators: 5.1) maternal mortality ratio, 5.2) proportion of births attended by skilled health

personnel (proportion of births delivered in a health facility)

5.B. Target: Achieve, by 2015, universal access to reproductive health

Indicators: 5.3) Contraceptive prevalence rate, 5.4) Adolescent birth rate, 5.5a) Antenatal care

coverage (at least one visit), 5.5b) Antenatal care coverage (at least four visits), 5.6) unmet need

for family planning

Maternal mortality ratio (MMR)2 was reduced to 149 deaths per 100,000 live births from 209

deaths in 1993. Despite this improvement, the Philippines failed to meet the target of 52

maternal deaths per 100,000 live births.

Eight (8) out of 10 (77.7%) birth deliveries were attended by a skilled birth personnel (i.e.,

doctor, nurse or midwife) and seven (7) out of 10 (69.8%) births were delivered in a health

facility.

The contraceptive prevalence rate (CPR) was 42.8% for any method and 35.7% for any modern

method.

Contrary to the target of zero adolescent birth rate (ABR), an increase from 6.5% in 1993 to

9.9% in 2015 was observed.

Nine (9) out of 10 mothers had at least one prenatal visit.

Three-fourths (75.8%) of mothers had at least four preanatal visits.

Two (2) out of 10 (21.3%) currently-married women 15 to 49 years old were regarded to have

unmet need for family planning.

MDG 6: Combat HIV/AIDS, Malaria, and Other Diseases

6.A Target/s:a) have halted by 2015 and begun to reverse the spread of HIV/AIDS

Indicator/s: 6.3) proportion of population aged 15-24 years with comprehensive correct

knowledge of HIV/AIDS

6.C Target/s:a) have halted by 2015 and begun to reverse the incidence of malaria and other

major diseases

Indicator/s: a) knowledge and attitude towards tuberculosis

One (1) out of 10 (15.9%) individuals 15.0 to 24.9 years had comprehensive correct knowledge

of HIV/AIDS.

More than 90% of the respondents has heard of TB and believed that it can be cured; however,

only 12.9% of Filipinos knew it is caused by bacteria (Mycobacterium tuberculosis) and almost

60% believed that it is transmitted by sharing utensils. Knowledge and attitudes towards

tuberculosis are not direct MDG indicators, but these are considered contributors in achieving

the MDG target.

2 These are not official results.

18




MDG 7: Ensure environmental sustainability

Target/s:a) halve, by 2015, the proportion of the population without sustainable access to safe

drinking water and basic sanitation

Indicator/s: 7.7a) proportion of households with access to safe water supply, 7.8a) proportion

of families with sanitary toilet facility

Nine (9) out of 10 (94.5%) households had access to safe water supply.

The overall proportion of households with improved sanitation facility was 86.3%.

MDG 7 target C has already been achieved in 2008, seven years before the set deadline in 2015.

The only MDG achieved in 2015 by the Philippines and other countries is the reduction of the

proportion of people without sustainable access to safe drinking water and basic sanitation by

half.

PhilHealth Awareness, Membership and Utilization

PhilHealth membership among household members 15 years and over increased from 37.7%

percent in 2008 to 67.6% in 2015. Awareness of PhilHealth was also high at 95.5%. Utilization

of PhilHealth benefits showed that 56.8% availed PhilHealth services for in-patient care while

77.6% availed it for out-patient care.

19




1. INTRODUCTION

1.1 Background of the 2015 Updating Survey3

The Food and Nutrition Research Institute of the Department of Science and Technology

(DOST-FNRI), as the premier research and development institution of the government, is mandated to

define and update the Philippine citizenry’s food and nutrition situation, including the nutritional status

of Filipino children and other nutritionally-vulnerable groups, through the conduct of National Nutrition

Surveys (NNS) every five years and the Updating Survey as follow-up survey in the intervening years.

The Updating Survey 2015 titled “2015 Updating of the Nutritional Status of Filipino Children and

Other Population Groups” is the sixth in the series of Updating Surveys.

The Updating Survey, along with the NNS, is a designated statistical activity that generates

critical data on food, nutrition, and health status of the population to aid in decision making of both

government and private sectors (Executive Order 352). This mandate was given in due recognition to

the wealth of relevant information generated from nationwide nutrition surveys that the FNRI regularly

undertakes in adherence to its first mandate (Executive Order 128).

The Updating Survey is a simple and rapid nutritional assessment carried out in-between a more

comprehensive NNS to periodically monitor the nutrition situation of the country. This 2015 Survey is

more significant as the results will provide the end line data in gauging the country’s progress towards

achieving the Millennium Development Goals (MDGs), which include, among others, the eradication

of hunger and reduction of child mortality. In addition, data from this year’s Updating Survey will also

establish the benchmark/baseline measures for the Sustainable Development Goals (SDGs) and will

serve as basis for the World Bank’s Country Program for the Philippines.

Through the years, since the First NNS in 1978 and up to the present, the DOST-FNRI has been

committed in providing accurate and reliable nutrition data for food and nutrition policies and program

development. The NNS and the Updating Surveys continue to evolve to meet the growing needs of its

stakeholders, and to respond to the new and emerging health and nutrition problems by integrating other

relevant nutrition and health variables.

The 2015 Updating Survey shall generate critical data on Anthropometry, Clinical and Health,

Dietary Consumption (Household Level), Socioeconomic Status, Food Security, Government Program

Participation, Maternal Health and Nutrition, Infant and Young Child Feeding Practices, and MDG

Health-Related Outcomes.

3 2015 Updating of the Nutritional Status of Filipino Children and Other Population Groups

20




1.2 Objectives of the Survey

As mandated by the Government, the primary purpose of the 2015 Updating Survey is to

provide a continuous flow of updated information on the nutritional status of Filipino children and other

population groups for appropriate formulation and modification of food and nutrition policies and

interventions at the national down to the provincial levels. A related objective is the conduct of research

on survey data to address health- and nutrition-related problems of the country.

The 2015 Updating Survey, specifically aims:

- To determine the prevalence of under- and overnutrition among all population groups

using prescribed techniques;

- To determine and monitor the changes in infant and young child feeding practices among

children, 0 to 23 months old;

- To determine the participation of households in nutrition and other related programs;

- To determine the maternal health and nutritional status;

- To assess the food security status of Filipino households;

- To determine the prevalence of selected risk factors of non-communicable diseases, such

as hypertension, smoking and alcoholism among children, adolescents and adults, physical

inactivity, and unhealthy diet;

- To determine the usage and awareness of health and food/dietary supplements among

adults;

- To determine and assess the household and per capita food and nutrient intake and

adequacy

- To determine the socioeconomic and demographic characteristics of households and

members; and

- To determine the endline results for the attainment of health-related Millennium

Development Goals (MDGs)

1.3 Significance and Uses of 2015 Updating Survey

The food and nutrition statistics obtained by the NNS and Updating Survey serve as bases for

formulating, drafting, and implementing legislation and programs for improving health, particularly of

households and populations identified as nutritionally-vulnerable groups. The Philippine Food

Fortification Act of 2000 (RA 1872), National Policies on Infants and Young Children (AO No. 2005

0014), Anti-Hunger Mitigation Program (EO 616), and Sin Tax Law (RA 10351) are among the laws

and policies that relied on results of previous NNSs and Updating Surveys.

21




In addition to the usual data collected during NNSs, the 2015 Updating Survey results may also

help track the country’s attainment of the health-related MDGs, which concluded in 2015. The MDGs

consist of eight goals, 18 targets, and 48 indicators. The 2015 Updating Survey contributes to tracking

the achievement of the MDGs by charting the country’s progress on the improvement of nutrition

among Filipino children; decrease in the number of Filipinos suffering from hunger; improvement of

maternal health through universal access to reproductive health; HIV/AIDS and TB awareness; access

to safe water and sanitation facilities; and utilization and coverage of health insurance. Moreover, the

results can also serve as baseline for Sustainable Development Goals (SDGs) 2 and 3 using selected

indicators collected during the survey and as vital inputs for plans of action for nutrition and health.

Through the Surveys, the authorities that draft, devote resources to, and implement policies and

programs to improve the lives of the Filipino people are provided objective measures regarding the state

of food security of Filipino households, and the nutritional status and well-being of Filipino children,

women, and other nutritionally-vulnerable population groups.

Among others, Updating Survey data have been utilized in the following manner:

- As inputs to the legislative and executive branches of the government, which need to be

provided with regular, timely, and relevant nutrition updates and nutrition program impacts

vital in redefining strategies and formulating human and social development policies and

national development programs geared at achieving food security and improved nutrition;

for efficient and effective implementation of nutrition and nutrition-related programs; for

surveillance and monitoring purposes and as source of sound technical data and factual

document on the nutrition situation analysis of the country;

- Setting of the Philippine Desirable Dietary Patterns, which have guided the formulation of

the country’s food production targets and plans; for trend analysis and monitoring of food

consumption; and projection studies on food demand and nutrient intake;

- Identification of specific nutritional deficiencies and estimation of the magnitude of

malnutrition; for targeting population groups that need public health assistance; and for

program implementation (e.g., Sangkap Pinoy Seal Program and Garantisadong Pambata,

among others);

- Identification of target regions and provinces, and the number of at-risk children, women,

and other population groups, for nutrition as well as other social and economic development

programs (e.g. LAKASS provinces, Food Assistance Programs, Micronutrient

Supplementation Programs);

22




- Estimation of poverty threshold and poverty statistics from the nutritional point of view

across different regions of the country; for comparison of the country’s food balance sheet

versus food consumption patterns and nutrient intake; and for linkage with other related

social and economic statistics;

- Crafting of the ASIN (RA 8172) and Food Fortification (RA 8976) laws and the respective

Implementing Rules and Regulations (IRRs), including the identification of priority

fortifiable food or staples and the setting of fortification levels for various fortifiable food

commodities;

- For food formulation, product development, and market feasibility studies of food

industries;

- For use as educational materials or text in nutrition and related courses, and as support

document in research thesis and dissertations for the academe, faculty, and students;

- Development of the Nutritional Guidelines for Filipinos, Recommended Energy and

Nutrient Intake (RENI), Pinggang Pinoy, and the Non-Communicable Disease Guidelines

Control Programs of the Department of Health;

- Development of the Sin Tax Reform Act of 2012;

- Development of messages for nutrition and health education;

- For use by individual researchers and workers in the medical and paramedical field, such

as physicians, nutritionists-dietitians, auxiliary workers, and the like for pinpointing

malnutrition problems and specific nutrition deficiencies, as basic reference in modifying

and improving diets;

- Basis for health measures of the government; and

- Intercountry comparisons of data on the basis of validated tools and instruments (interview

guides) that were aligned to global standards

Furthermore, international and foreign organizations such as the United Nations Children Fund

(UNICEF), World Health Organization (WHO), Food and Agriculture Organization (FAO), United

States Agency for International Development (USAID), World Bank (WB), and Helen Keller

International (HKI) continually avail of and extensively use the survey results to monitor the

international nutrition situation and to plan country development projects with nutrition-related

objectives.

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1.4 Survey Components

The 2015 Updating Survey is divided into nine (9) components, namely: Anthropometry,

Clinical and Health, Dietary, Socioeconomic, Food Security, Government Nutrition and Health

Programs Participation, Maternal Health and Nutrition, Infant and Young Child Feeding (IYCF), and

MDG Health-Related Outcomes.

Data on household food consumption, as part of the dietary component, socioeconomic status,

food security, and government nutrition and health programs participation, were collected and analyzed

at the household level. Meanwhile, data for anthropometry, clinical and health, government nutrition

and health programs participation, IYCF and maternal health and nutrition components and MDG-

related health outcomes were obtained on the individual level.

1.4.1. Anthropometry

Anthropometry is a key component in assessing the nutritional status of children and adults

(Simko & Cowell, 1995). An individual’s anthropometric data reflects his/her general health and

nutritional status, as well as predict performance, health, and survival. Trends in growth and community

statistics are also tracked using anthropometry.

This component assesses the nutritional status of all population groups by determining the

prevalence of underweight, underheight, thinness, overweight and obesity, high waist circumference,

high waist-hip ratio, and low birth weight.

1.4.2. Clinical and Health

The clinical and health component assesses the prevalence of risk factors of non-communicable

diseases, including physical risk factors such as hypertension and behavioral risk factors such as

cigarette smoking, alcohol drinking and physical inactivity. Furthermore, it determines the awareness

on and usage of health and food/dietary supplements.

The clinical and health component of the NNS and Updating Survey has evolved from focusing

on clinical signs of nutritional deficiencies (vitamin A, iron, and iodine deficiency disorders) to the

integration of the epidemiology of lifestyle-related diseases (android obesity, hypertension, diabetes,

dyslipidemia, etc.). Findings were being correlated with data from other NNS and Updating Survey

components, such as sociodemographic, anthropometry, and dietary components, to provide a more

definitive assessment of the emerging problem of non-communicable diseases (NCDs). This component

has been supported by the Department of Health (DOH) and other medical specialty associations.

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1.4.3. Dietary

The dietary component measures food and nutrient intake at the household level. It provides

information on the quantities of food consumed, wherein the nutritive value of the diet and the adequacy

of intake can be derived. This is considered an indirect method of assessing the nutritional status of a

population (Gibson, 2005). The dietary survey aims to present dietary patterns of the population and

identify public health concerns related to inadequate and excessive consumption. Moreover, this

component presents food intake in relation to national demographic and socioeconomic differences in

the country.

1.4.4. Socioeconomic

This module contains household membership and demographic information. This information

determines the interview guides to be used according to age group or physiological state.

In the survey, the living conditions of the households were described using indicators such as

type and tenure of dwelling unit, presence and type of utilities in the household, and ownership of

appliances and vehicles. Meanwhile, household health and sanitation were characterized by toilet

facility, sources of water for drinking, cooking and handwashing, and garbage disposal methods and

practices. Other socioeconomic status indicators include educational and occupational information of

household heads.

1.4.5. Food Security

This component is focused on the food security status of households, which is defined by food

access, dietary diversity, frequency of food consumption, and food availability.

The Food and Agriculture Organization (FAO) defines food security as the state “when all

people, at all times, have physical and economic access to sufficient, safe, and nutritious food that meets

their dietary needs and food preferences for an active and healthy life” (FAO, 1996). Household food

access is defined as the ability to acquire sufficient quality and quantity of food to meet the nutritional

requirements of all household members to live productive lives.

1.4.6. Government Nutrition and Health Program Participation

The Government Nutrition and Health Program Participation component assesses the

participation of households, as well as individuals, in selected nutrition and health-related programs

implemented by government. The 2015 Updating of Nutrition Survey focused on the awareness and

participation of households in the Pantawid Pamilyang Pilipino Program (4Ps).

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At the individual level, this component collects data related to various age groups. Individuals

aged 0 to 71 months were assessed in terms of availing programs on newborn screening, the Expanded

Program on Immunization (EPI), micronutrient powder (MNP) use, deworming, vitamin A

supplementation, and incidence of diarrhea. For children 6 to 12 years old, data on deworming was

gathered. Participation in the Complete Treatment Pack Program (ComPack) program, meanwhile, was

gathered for children 0 to 71 months old, as well as for the 18.0 and above age group. Data on PhilHealth

Awareness and Client Satisfaction of household members 15 years old and above were also obtained.

1.4.7. Maternal Health and Nutrition

Improvement of maternal and child health is an international agenda, as stipulated in MDGs 5

and 6. Yet in the Philippines, eight women die every day4, which is equivalent to one woman dying

every three hours, because of pregnancy-related causes and childbirth.

This component collects data on maternal and child health, as well as mothers’ health-seeking

behavior and practices. These include prenatal care and postnatal care practices, breastfeeding and

complementary feeding practices, child immunization, practices during illness, hygienic practices, and

childcare. Data on the qualitative assessment of the mother’s dietary intake was also gathered.

1.4.8. Infant and Young Child Feeding

Infant and young child feeding (IYCF) practices have an indispensable impact on the nutritional

status, growth and development, and health and survival of infants and young children. Poor feeding

practices in the first two years of a child’s life could lead to malnutrition, severe illnesses and

irreversible consequences of stunted growth and developmental delays.

Data from this component, as well as comparisons with data from previous NNSs and Updating

Surveys, forms the basis for policies, plans, and programs on infant and young child feeding. This is in

line with the jointly developed guidelines of the WHO and UNICEF to achieve the child’s optimal

growth and development by promoting appropriate infant and young child feeding practices, such as

exclusive breastfeeding and provision of appropriate complementary food (WHO & UNICEF 2003).

All children, 0 to 23 months old, from the selected households were taken as subjects, with the

primary caregiver serving as the respondent for the interview. Moreover, this survey component updates

information on the feeding practices, such as breastfeeding and complementary feeding, of Filipino

children aged 0 to 23 months and related factors affecting feeding practices.

4Based on the WHO, UNICEF, UNFPA, The World Bank, and the United Nations Population Division Maternal Mortaltiy Estimation Inter-Agency Group estimate of about 3000 maternal deaths per year (2013)

26




1.4.9. MDG Health-Related Outcomes

In September 2000, members of the United Nations (UN), which include the Philippines, signed

the Millennium Declaration, committing the country to the achievement of the Millennium

Development Goals (MDGs).

The Department of Health (DOH), as the government’s lead agency for health, is in-charge of

the attainment of the health-related MDGs 1, 4, 5, 6 and 7. MDG 1 aims to eradicate extreme poverty

and hunger, as indicated by the reduction by half of underweight prevalence in children under-five and

reduction of households with per capita energy less than 100% adequacy. MDG 4 targets the reduction

of under-five child and infant mortality by two-thirds. Meanwhile, the objective of MDG 5 is to improve

maternal health as indicated by a three-fourth reduction in maternal mortality. MDG 6 aims to halt or

reverse HIV/AIDS, malaria, and other diseases while MDG 7 is devoted to ensuring environmental

sustainability as indicated by reducing the lack of access to safe drinking water and basic sanitation by

half.

Table 1 summarizes the goals and indicators derived from the results of the 2015 Updating

Survey for this component.

Table 1. MDG health-related outcomes and their indicators: Updating Survey, 2015

MILLENNIUM DEVELOPMENT GOAL OUTCOMES

GOAL INDICATOR

1 Eradicate extreme poverty and

hunger

Prevalence of underweight children under five years of age

Proportion of households with per capita energy less than 100% adequacy

4 Reduce child mortality

Infant mortality rate

Under-five mortality rate

Fully Immunized Children (FIC) rate

Proportion of one-year old children immunized against measles

5 Improve maternal health

Maternal Mortality Ratio (MMR)

Proportion of births attended by skilled health personnel

Proportion of births delivered in facility

Contraceptive Prevalence Rate (CPR)

Adolescent Birth Rate

Antenatal care coverage of at least 1 and 4 visits

Unmet need for family planning

6 Combat HIV/AIDS and other

diseases

Proportion of population aged 15 to 24 years with corresponding correct

knowledge of HIV/AIDS

Knowledge and attitude towards tuberculosis

7 Ensure environmental

sustainability

Proportion of households with access to safe water supply

Proportion of households with sanitary toilet facility

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2. METHODOLOGY

2.1 Sampling Design

The 2015 Updating of Nutritional Status of Filipino Children and Other Population Groups

(2015 Updating Survey) utilized the 2003 Master Sample developed by the Philippine Statistics

Authority (PSA) (formerly the National Statistics Office (NSO)). The survey employed a stratified

three-stage sampling design (Figure 1). The first stage involved the selection of Primary Sampling Units

(PSUs). Each PSU was composed of one barangay or a combination of contiguous barangays with at

least 500 households per sampling unit. Enumeration Areas (EAs) were identified within each PSU,

with each EA comprising of 150 to 200 households. Households were then randomly selected from

each EA during the third and final stage. A household, the ultimate sampling unit (Barcenas, 2004), is

defined as “a group of persons who may be related or not, who sleep in the same dwelling unit and

have common arrangements for the preparation and consumption of food.”5 Eligible members of the

sampled households were included in the survey. The list of sample households was updated through

the 2015 Labor Force Survey (LFS).

This survey used four replicates of the Master Sample to obtain the national, regional, and

provincial estimates for the following components: measurements of anthropometry, blood pressure

and interview schedule-based information. For the dietary component, one replicate was used to obtain

national as well as regional estimates.

5Manual of Instructions, 2015 Updating of Nutritional Status of Filipino Population, Philippines, 2015

4 replicates from the NSO Master Sample which utilized 100% of the Updated/ Refreshed 2015 Listing of Households

Figure 1. Sampling design of the 2015 Updating of Nutritional Status of Filipino Population (2015 Updating Survey)

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2.2 Scope and Coverage

The 2015 Updating Survey was divided into three (3) phases. The first leg was conducted in

NCR from July to August 2015. The second leg, which covered areas in Luzon, was conducted from

August to September 2015. Areas in the Visayas, Mindanao, and BASULTA (Basilan, Sulu, and Tawi-

Tawi) were covered in the final leg from September to November 2015.

From the target households on the PSA list (LFS, 2015), 91% were eligible for interview. The

overall response rate was 87.8%. Response rates among households were 87.8% for Luzon, 91.3% for

Visayas, and 85.7% for Mindanao (Table 2).

Table 2. Household level target, eligibility, and response rate: Philippines, 2015

Results Philippines Luzon Visayas Mindanao

Target Households (PSA list)

52,815 27,364 10,067 15,384

Eligible 48,178 24,976 9,137 14,065

% Eligibility 91.2 91.3 90.8 91.4

Response (actual) 42,310 21,921 8,342 12,047

% Response 87.8 87.8 91.3 85.7

The 2015 Updating Survey covered all 17 regions and 80 provinces of the country (Appendix

A). Batanes was excluded because of unsafe travel conditions during the survey period, which coincided

with the typhoon season. Table 3 shows the survey coverage in terms of enumeration areas and actual

number of households and individuals.

Overall, there were 3,347 identified enumeration areas. A total of 42,310 sample households

and 161,577 individuals were covered (Table 3).

Table 3. Distribution of enumeration areas (EAs), sample households, and sample individuals: Philippines, 2015

Region Enumeration Areas Households Individuals

Philippines 3,347 42,310 161,577 NCR 564 3,526 14,037 CAR 134 1,752 6,212 Ilocos 168 2,411 9,524 Cagayan Valley 146 2,328 8,770 Central Luzon 251 3,499 13,141 CALABARZON 318 4,376 15,991 MIMAROPA 139 1,339 5,126 Bicol Region 169 2,690 11,541 Western Visayas 203 3,179 11,612 Central Visayas 203 2,677 10,281 Eastern Visayas 143 2,486 9,926 Zamboanga Peninsula 153 1,750 6,507 Northern Mindanao 164 2,184 7,438 Davao 176 2,239 8,255 SOCCSKSARGEN 160 2,200 8,265 ARMM 117 1,744 7,499 Caraga 139 1,930 7,452

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At the individual level, the response rate for all components ranged from 70.8% to 96.9%. For

the anthropometric component, overall response rate was 89.1%. Majority of the components recorded

at least 80% response rate except for the 15.0 years old and above age group of the HIV/AIDS

Awareness of Filipinos component, which only obtained 70.8% response. At least 82% of households

responded to components with household-level data collection.

The profile of the sample population by response status, age, sex, type of residence and wealth

quintile is presented in Appendix C.

Table 4. Eligible population and response and non-response rates per component: Philippines, 2015

Component Eligiblea Responseb Non-Responsec

INDIVIDUALS n n % n %

Anthropometry

ALL 181,384 161,577 89.1 19,807 10.9

0-60 months (0-5.0 years old) 18,641 17,202 92.3 1,439 7.7

61-120 months (5.08-10.0 years old) 21,880 20,173 92.2 1,707 7.8

10.08-19.9 years old 42,717 35,206 82.4 7,511 17.6

20.0 -59.9 years old 73,547 66,880 90.9 6,667 9.1

60.0 y.o. and above 18,874 16,613 88.0 2,261 12.0

Pregnant 1,585 1,493 94.2 92 5.8

Lactating 4,137 4,010 96.9 127 3.1

Birth Weight of 0-71 months old children 22,329 20,303 90.9 2,026 9.1

Health and Nutrition of Adults and Other Members

Blood Pressure

3.0-9.9 years old 29,849 27,066 90.7 2,783 9.3

10.0-19.9 years old 43,764 36,067 82.4 7,697 17.6

20 years old & over 97,808 88,976 91.0 8,832 9.0

Smoking, Alcohol*

10-19.9 years old 11,199 9,266 82.7 1,933 17.3

20 years old & over 24,866 21,969 88.3 2,897 11.7

Physical Activity 18.0 years old and above 26,722 21,934 82.1 4,788 17.9

Awareness on Food and Health Supplement 27,064 23,232 85.8 3,832 14.2

Government Program Participation

0-71 months 21,201 20,233 95.4 968 4.6

6-12 years old 31,696 28,989 91.5 2,707 8.5

PhilHealth (15 years old and above) 118,354 99,686 84.2 18,668 15.8

Infant and Young Child Feeding (0-23 months) 6,653 6,142 92.3 511 7.7

Maternal Health and Nutrition 9,399 8,568 91.2 831 8.8

MDG Health-Related Outcomes

Women of Reproductive Age (15.0-49.0 years old) 42,123 35,781 84.9 6,342 15.1

HIV/AIDS Awareness of Filipinos 15.0 years old and

above 9,397 6,649 70.8 2,748 29.2

Tuberculosis Awareness of Filipinos 15.0 years old and

above 30,212 25,697 85.1 4,515 14.9

HOUSEHOLDS

Dietary* 12,115 9,930 82.0 2,185 18.0

Food Security 48,178 41,282 85.7 6,896 14.3

Government Program Participation

PhilHealth Membership 48,178 40,642 84.4 7,536 15.6

Socioeconomic 48,178 41,972 87.1 6,206 12.9 ainterview status: completed, partially completed, not at home, refused, respondent incapacitated, missing data bactual covered households/ individuals: completed and partially completed interviews cactual uncovered individuals: respondent not at home, refused, respondent incapacitated *used one replicate only

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2.3 Survey Methods and Analyses

2.3.1 Anthropometry

Method of Data Collection

The weight and height/recumbent length of all household members were measured. Standard

anthropometric techniques were followed. Waist and hip circumference were measured among subjects

10 years old and above, with the exclusion of pregnant women.

The weight of all eligible household members was measured

using a digital double window weighing scale with 150 to 200-kilogram

capacity. In order to weigh children below two years of age or those not

able to stand independently, each child was weighed together with the

mother or caregiver or any adult companion. To obtain the weight of the

child in this case, the weight of the mother or caregiver or any adult

companion without the child was subtracted from the combined weight

of the child with the mother/caregiver/adult companion. Weight was

recorded to the nearest 0.1 kilograms.

The standing height of subjects two years and above was measured using

a stadiometer. A medical plastic infantometer was used to measure

recumbent length of respondents less than two years of age. Height/length

was recorded to the nearest 0.1 centimeters.

Waist circumference (WC), hip circumference (HC), and mid-

upper arm circumferences (MUAC) were measured using a non-

stretchable tape measure.

All measurements were taken twice for verification.

Equipment and tools used for anthropometry data collection are presented in Table 5.

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Table 5. Equipment/tools and corresponding description for anthropometry data collection

Equipment/ Tools

Description Illustration

Calibration/ Test weight

(Häfner M1)

This is a 5-kilogram metal weight used to calibrate the platform beam balance at the beginning of each weighing activity. Each regular subteam (RST) and mobile subteam (MST) had one unit calibration/test weight.

Digital Double Window Weighing Scale (SECA® 874)

The platform beam balance is a 150 or 200-kilogram capacity scale used to measure the weight of the survey participants. One unit was provided to each RST and MST.

Stadiometer

(SECA® 213)

This is used to measure the height (stature) of subjects 2 years and above. One stadiometer was provided to each RST and MST.

Medical Plastic Infantometer (SECA® 417)

This is a plastic board used to measure the recumbent length of subjects 0 to 23 months old (<2 years old). Each RST and MST was provided with one (1) unit of infantometer.

Non-Stretchable Tape Measure (SECA® 203)

One (1) circumference tape was provided to each RST and MST. The tape was used to measure waist, hip, and mid-upper arm circumferences.

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Assessment of Nutritional Status

The nutritional status of children, 0 to 5 years of age, based on weight and height measurements,

was assessed using the World Health Organization Growth Standards (WHO-CGS). The WHO Growth

Reference 2007 was used to assess the nutritional status of children and adolescents from ages 5.08 to

19.0 (61 to 228 months) (Table 6).

Data was analyzed using two software packages, namely: WHO Anthro 3.3.2 for children 0 to 60

months old and WHO Anthro Plus 1.0.3 for children and adolescents 61 to 228 months old.

Table 6. Age groups of the WHO-Child Growth Standards (CGS) for infants and young

children, (0 to 60 months old) and WHO Growth Reference 2007 for school-age children and adolescents (61 to 228 months old), by index

Indicators WHO Child Growth Standards WHO Growth Reference 2007

Weight-for-age 0-60 months

(0-5.0y) 61-120 months

(5 y & 1mo-10.0y)

Length/Height-for-age 0-60 months

(0-5.0y) 61-228 months

(5y & 1mo-19.0y)

Weight-for-length/height 0-60 months

(0-5.0y) None

BMI-for age 0-60 months

(0-5.0y) 61-228 months

(5y & 1mo-19.0y)

The summary of cut-off points used for the classification of the nutritional status of children is

presented in Tables 7 to 9.

Table 7. Cut-off points used in classifying nutritional status of children, 0 to 19.0 years (0-228 months)

Indicator/Nutritional Status Cut-off Points

Weight-for-age*

Underweight <-2SD

Normal -2SD to +2SD

Above Normal ≥2SD

Length/Height-for-age

Underheight/Stunting <-2SD

Normal -2SD to +2SD

Above average/tall ≥2SD

Weight-for-length/height**

Thin/Wasting <-2SD

Normal -2SD to +2SD

Overweight ≥2SD

NEC ***

* Only for older children and adolescents 10 to 19 y (121-228 months)

** Only for children 0-5 years (0-60 months) *** NEC (Not Elsewhere Classified) – those whose

heights are beyond the limits of the weight-for-height tables

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Table 8. Cut-off points used in classifying nutritional status of children, 0 to 5 years old

(0 to 60 months), based on BMI-for-age (WHO-CGS)

Nutritional Status Cut-off Points

Severe wasting/thinness <-3SD Wasting/thinness <-2SD to -3SD Normal -2SD to +2SD Overweight >+2SD to +3SD Obesity >+3SD

Table 9. Cut-off points used in classifying nutritional status of children, 5.08 to 19.0 years old (61 to 228 months) based on BMI-for-age (2007 WHO Growth Reference)

Nutritional Status Cut-off Points

Severe thinness <-3SD Thinness <-2SD to -3SD Normal -2SD to +1SD Overweight >+1SD (equivalent to BMI 25 kg/m2 at 19 yrs) Obesity >+2SD (equivalent to BMI 30 kg/m2 at 19 yrs)

The cut-off points used to determine the magnitude and severity of underweight, stunting, and

wasting as a public health problem among under-five children are presented in Tables 10 and 11.

Table 10. Cut-off points used in determining magnitude and severity of underweight and stunting among children under-five years old (0 to <60 months) as a public health problem (WHO, 1995)

Magnitude and Severity Prevalence Category for

Underweight Prevalence Category for

Stunting

Low <10% <20% Medium 10-19% 20-29% High 20-29% 30-39% Very High >30% >40%

Table 11. Cut-off points used in determining magnitude and severity of wasting among children under five years old (<60 months), as a public health problem (WHO, 1995)

Magnitude and Severity Prevalence Category for

Wasting

Acceptable <5% Poor 5-9% Serious 10-14% Critical >15%

The nutritional status of adults and lactating women 19.0 years old and over was assessed using

Body Mass Index, with cut off points defined in 1978 by NCHS/WHO (Table 12).

Table 12. Cut-off points used in classifying nutritional status of adults and lactating

mothers 19.0 years old and over (≥228 months) based on Body Mass Index (NCHS/WHO, 1978)

Classification Cut-off Points

Chronic Energy Deficiency <18.5 Normal 18.5 to 24.99 Overweight 25.0 to 29.99 Obesity >30.0

34




The Philippine reference for weight-for-height index developed by Magbitang et al. (1988) was

used to assess the nutritional status of pregnant women (Table 13). A pregnant woman whose weight

falls below the 95th percentile is classified as nutritionally at-risk.

Table 13. Cut-off points used in classifying nutritional status of pregnant women based on weight-for-height (Magbitang et al., 1988)

Classification Cut-off Points

Nutritionally at-risk < 95th percentile

Not nutritionally at-risk ≥ 95th percentile

Table 14 presents the cut-off points used to classify the waist circumference (WC) and waist-

hip ratio (WHR) of male and female adults.

Table 14. Classification and cut-off points for waist circumference and waist-hip ratio, by sex

Sex Waist

Circumference (cm) Classification Waist-Hip Ratio

Male <90 Low <0.9 90-101 Normal 0.9 to 0.99 ≥102 High ≥1.0

Female <80 Low <0.8 80-87 Normal 0.8 to 0.84

≥88 High ≥0.85

2.3.2 Clinical and Health


A face-to-face interview was conducted to obtain information about lifestyle-related behaviors,

such as smoking and alcohol consumption behavior, usage of health supplements, food frequency, and

physical activity.

Blood pressure was measured using an A&D

UM-101A non-mercurial sphygmomanometer and

KaweTM dual stethoscope, following standard

procedures. By definition, blood pressure is the

pressure produced by the heart’s pumping action as

well as the capacity of blood vessels transporting blood

throughout the body. It is expressed using two

numerical values. The first number indicates the

systolic pressure while the second indicates the diastolic pressure.

Each blood pressure measurement was taken twice. The cut-off points for blood pressure

classification are shown in Table 15.

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Table 15. Blood pressure classification (JNC VII, 2003)

Classification Systolic BP (SBP)

(mmHg)

Diastolic BP (DBP)

(mmHg)

Normal <120 and <80

High Normal 120-129 or 80-84 Pre-hypertension 130-139 or 85-89 Hypertension >140 or >90

Lifestyle-related variables such as smoking, smokeless smoking, reported exposure to

secondhand smoke, alcohol consumption, binge drinking and physical inactivity were operationally

defined using WHO guidelines shown in Tables 16 to 21. These variables are considered modifiable

risk factors for non-communicable diseases (NCDs), alternatively known as lifestyle-related diseases.

Table 16. Operational definition of smoking6 status (WHO STEPS Surveillance Manual)

Smoking Status Definition

Current smokers Those who smoke during the time of the survey either on a “daily” (at least one cigarette a day) or on a regular/occasional smoking basis or those who do not smoke daily but who smoke at least weekly or those who smoke less often than weekly.

Former smokers Those who have ever smoked in the past year prior to survey whether in a daily basis or an aggregate lifetime consumption of at least 100 cigarettes but not daily.

Never smokers Those individuals who have never smoked at all

Table 17. Operational definition of smokeless smoking7 status

Smokeless Smoking

Status Definition

Current smokeless smokers

Those who consume smokeless tobacco products either by chewing or other means during the time of the survey either on a “daily” or on a regular/occasional smoking basis or those who do not consume daily but who consume at least weekly or those who consume less often than weekly.

Former smokeless smokers

Those who have ever consumed smokeless tobacco products in the past year prior to survey

Never smokeless smokers

Those individuals who have never consumed smokeless tobacco products at all

Table 18. Operational definition of reported exposure to secondhand smoke (SHS)

Place of reported

exposure to SHS Definition

At home Number of days the respondent was exposed to secondhand smoke at home in the past seven (7) days

Outside Home Number of days the respondent was exposed to secondhand smoke in closed areas in the workplace (in the building, work area or a specific office) in the past seven (7) days

6Smoking: commercial/ manufactured cigarettes, hand-rolled cigarettes, pipes full of tobacco, cigars/cheroots/cigarillos 7Smokeless smoking: snuff, chewing tobacco, betel

36




Table 19. Operational definition of alcohol consumption (WHO, 2014)

Alcohol Consumption

Status Definition

Lifetime abstainers People who have never consumed alcohol

Former drinkers People who have previously consumed alcohol, but have not done so in the previous 12-month period

Current drinkers People who were currently consuming alcohol during the survey period

Table 20. Operational definition of binge drinking (WHO, 2008)

Binge Drinking Status Definition

For males Drinking five (5) or more standard drinks in a row

For females Drinking four (4) or more standard drinks in a row

1 standard drink =

Note: net alcohol content of a standard drink is approximately 10g of ethanol.

Figure 2. Standard drink equivalents for different types of alcohol (WHO STEPS Surveillance Manual)

Figure 2 illustrates the definition of the equivalent of one (1) standard drink for different types

of alcohol.

Table 21. Operational definition of insufficiently physically active individuals (WHO STEPS Surveillance Manual)

Definition

A person not meeting any of the following criteria is considered as physically inactive or insufficiently physically active and therefore at risk of chronic disease: - 3 or more days of vigorous intensity activity of at least 20 minutes per day; OR - 5 or more days of moderate intensity activity or walking of at least 30 minutes per day

37




2.3.3 Dietary


Food consumption at the household level was measured by

one- day food weighing, food inventory, and food recall. A digital

dietary balance (Sartorious AZ 4101TM) was used to weigh the food

items in the households. Standard food weighing procedures and

techniques were followed. All food items prepared and cooked in the

households throughout the day (breakfast, lunch,

supper, in between snacks) were weighed in their

raw form (pre-cooked state) and cooked state. Plate wastes, food given-out, and

leftovers were also weighed. The resulting measurements were then subtracted

from the initial cooked food weight in order to obtain the actual weight of food

items consumed.

A food inventory was also employed. Non-

perishable food items that may be used anytime of the

day such as coffee, sugar, salt, cooking oil, and other

condiments were weighed at the beginning and end

of the food weighing day.

In addition, face-to-face interviews were conducted

using a 24-hour food recall interview guide to account for

food items eaten outside the home by a household member.

The kind of food and quantity consumed were recorded to

complete the household’s intake for the day. For validation

purposes, sample weighing of similar food items eaten

outside the home was done.

To ensure accuracy of recalled items in their cooked states, the quantities of food items were

expressed in terms of common household measurements. These include cups, tablespoons, and counts

by number of pieces of food eaten or by size. The tools utilized include measuring cups for solid and

liquid food items, tablespoons and teaspoons, plastic circles of different sizes, matchboxes, ruler, and

the Visuals of Foods booklet to aid the respondent in the estimation of consumed food items (Figure 3).

Sartorious AZ 4101TM

38




Figure 3. Measuring tools used for food weighing and as visual aids for food recall

Analysis of Dietary Data

Table 22 summarizes the operational definitions of dietary data variables.

Table 22. Operational definitions of selected dietary variables

Variable Definition

As Purchased (AP) Form of food as sold in the market or picked from the garden, and includes peelings, bones, shells, and other inedible parts

As Purchased at Retail (AP_Ret)

Form of food in which processed food are converted to a form that can be utilized by the agricultural sector

Per Capita Food/ Nutrient Intake

Average amount of food and nutrient eaten by each member of the sample population, without consideration of age, sex, and physiological status; computed by diving the total weight consumed over the consumption unit

Consumption Unit (CU) A factor used for obtaining the per capita intake of the household taking into account all necessary adjustments for meals missed and meals shared by visitors during the survey period

Leftovers Food items, cooked or raw, weighed during the survey period, which can still be eaten usually after the survey period

Plate-waste Edible portions of food that are left on the dining table or on the plates after the family has finished eating and are usually given to household pets or discarded.

Given-out The amount of food, cooked or raw, previously weighed for household consumption, but is given away to other persons of other families outside the households

Figure 4. Booklets used as aid for the identification of food items consumed

The Food Composition Library is used as reference for the Food Item Code (FIC) of each food

item and its corresponding energy and nutrient content. Different booklets were used as guides for the

dietary researchers in the identification of food consumed (Figure 4). One is the Compilation of Food

Substitutes and Translation of Local Foods in the Philippines, which is a compilation of food items

arranged sequentially into food groups with their corresponding English and local names. This is used

for food items consumed that were not found in the Food Composition Library or whose names are of

a different vernacular. Also included in the list were food items used as substitute based on the

description provided by the respondent.

39




The processing and analysis of food consumption data are summarized in Figure 5.

Figure 5. Steps in processing and analysis of food consumption data

Field editing, office editing, and validation of food intake data were employed to ensure

accuracy and completeness. The Household Dietary Evaluation System (HDES) was used to assess the

energy and nutrient intake for each household. This includes the computation of food intake, which

involved the conversion of cooked food items into raw, as purchased (AP) form. An online database of

the Philippine Food Composition Table (FCT) was utilized for the computation of energy and nutrient

intakes. Estimates of the energy and nutrient content of the diet of households were compared with the

nutritional requirements stipulated in the Philippine Dietary Reference Intakes (PDRI, 2015). Energy

intake was compared with the Recommended Energy Intake (REI) of the PDRI while nutrient intake

was compared with the Estimated Average Requirement (EAR), also indicated in the PDRI.

2.3.4 Sociodemographic and Socioeconomic


Data on sociodemographic and socioeconomic

variables were gathered using face-to-face interview and

actual observation. Data on age, civil status, physiological

status, educational attainment, occupation, and

employment were obtained for the sociodemographic

characteristics. For the socioeconomic status,

characteristics of household members, household

characteristics, household health and sanitation, and

household possession and wealth index were gathered. The interview guides for this component is

presented in Appendix G.

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2.3.5 Food Security


Data for the food security component were

collected via face-to-face interview. Two sets of

interview guides were used to assess food insecurity –

the Household Food Insecurity Access Scale (HFIAS)

and the Household Dietary Diversity (HDD). The

HFIAS included nine (9) occurrence questions based on

a 30-day recall period, followed up by probing on the

frequency of conditions experienced by the household. The HDD asked about the frequency of

consumption of 16 food groups and the most commonly consumed food item per group on a 7-day

recall period. The criteria for inclusion were the following: a) food items prepared and consumed inside

the home; b) prepared in the home or consumed outside; c) purchased or gathered outside and consumed

in the home. Excluded were food items both purchased and consumed outside the home.

Analysis of Food Security Data

The HFIAS provides information on the prevalence and magnitude of food insecurity at the

household level. Table 23 shows the standard procedure for scoring. The range of the total HFIAS score

for each household could be from 0 (food security) to 27 (maximum food insecurity). The higher the

score, the more food insecurity the household experienced8.

Table 23. HFIAS household food access scores

Frequency of Occurrence Scoring (points)

Never occurred (0 times) 0 Rarely (1-2 times) 1

Sometimes (3-10 times) 2

Often (>10 times) 3

The Household Food Insecurity Access Scale is divided into four (4) levels: food secure, mildly

food insecure, moderately food insecure, and severely food insecure (Table 24). The level of food

insecurity of the household increases with higher severity and higher frequency of occurrence.

8Coates, Swindale, & Bilinsky, 2007

41




Table 24. Categories of food insecurity (access)9

Situation(s) experienced in the past month

Frequency

Rarely 1-2x

Sometimes 3-10x

Often >10x

1. Worry about food 2. Unable to eat preferred food 3. Eat just a few kinds of food 4. Eat food they really do not want to eat 5. Eat a smaller meal 6. Eat fewer meals a day 7. No food of any kind in the household 8. Go to sleep hungry 9. Go a whole day and night without eating

Legend Food Secure Mildly Moderately Severely

The interview guide for Household Dietary Diversity10 (HDD) provides a better understanding

of the access of households to various food items, as well as the quality of food items in terms of

diversity and food frequency using the Food Consumption Score11 (FCS) developed by the World Food

Program (WFP).

Twelve (12) food groups were used to measure the diversity of food consumed by the

household. These food groups are: a) cereals, b) white tubers and roots, c) vegetables, d) fruits, e) meat

and poultry, f) eggs, g) fish and other seafood, h) legumes, nuts, and seeds, i) milk and milk products,

j) oils and fats, k) sugar and honey and l) beverages, spices and condiments.

A higher diet diversity score implies a more varied diet and a higher probability that a wider

array of nutrients was consumed.

2.3.6 Government Nutrition and Health Programs Participation


Face-to-face interviews were conducted to

collect data for the government program (GP)

participation component. Responses were verified

using secondary data sources such as immunization/

Early Childhood Care and Development (ECCD)

cards, baby books, birth certificates, and PhilHealth

membership and Senior Citizen identification cards.

9 Household Food Insecurity Access Scale Indicator Guide, v.3 10Food and Agriculture Organization, 2010 11World Food Programme, 2008

42




2.3.7 Maternal Health and Nutrition


Data were obtained via face-to-face

interviews. Biological mothers of children aged 0 to

36 months (whether pregnant, lactating, or neither

pregnant nor lactating (NP/NL)), and all currently

pregnant women (regardless of number of previous

pregnancies) were eligible respondents for the

module. A one-day qualitative assessment of the

mother’s food intake was also conducted using 24-

hour food recall.

2.3.8 Infant and Young Child Feeding


IYCF data was collected through face-to-face

interview. Mothers or caregivers were also asked for a

one-day qualitative 24-hour food recall for children

aged 0 to 36 months.

2.3.9 MDG Health-Related Outcomes


MDG health-related data were collected

through face-to-face interview. Information relevant

to the accomplishment of selected MDGs, such as

maternal and child mortality rates, reproductive

health, family planning, and knowledge and attitudes

on tuberculosis, AIDS, and HIV, were included in the

2015 Updating Survey. Eligible respondents included women of reproductive age, or those between 15

to 49 years old. Interviews regarding knowledge and attitudes on tuberculosis, AIDS, and HIV were

conducted with both sexes aged 15 and above as respondents.

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2.4 Survey Tools

2.4.1 Interview Schedule

The 2015 Updating Survey Interview Schedules consisted of nine (9) booklets and were

translated from English to Filipino.

The booklets and forms are summarized in Table 25.

Table 25. List of booklets and forms used in the 2015 Updating Survey

BOOKLET /FORM NO.

FORM TITLE

Booklet 1 Household Membership, Anthropometric and BP Measurements

F1.1 Household Membership and Demographic Information

F2.1 Anthropometric Measurements of All Household Members

F5.1 Blood Pressure Measurement of 3 Years Old and Above

Booklet 2 Household Questionnaire

F1.2 Household and Other Demographic Information

F1.3 Participation of Households in Conditional Cash Transfer or Pantawid Pamilyang Pilipino Program

F1.4 Knowledge and Practice of Meal Planners in Reading Product Labels of Packaged Foods and Beverages

F1.5 Household Food Security

F1.6 Household Food Security Radimer Cornell

F1.7 Household Dietary Diversity and Food Frequency

Booklet 3 Mothers with Health-Seeking Behaviors and Practices (All Mothers with Children < 36 Months, Pregnant Women and Lactating Mothers)

F3.1 Maternal Health and Nutrition of Mothers with Youngest Child, 0-36 Months and Pregnant Women

F3.2 Qualitative Assessment of Mother's Dietary Intake (All Mothers 0-36 Months, Pregnant and Lactating)

Booklet 4 Children, 0 to 23 Months (0 to <2 Years Old)

F4.1 Birth Weight of Children, 0-71 Months

F4.2 Government Program Participation of Children, 0-71 Months

F4.3 Infant and Young Child Feeding Practices of 0-23 Months

F4.4 24-Hour Food Recall

F4.5 Checklist of Food and Liquid Intake

F4.7 Participation of Individuals in Complete Treatment Pack (ComPack) Program

F6.1 PhilHealth Awareness and Client Satisfaction

Booklet 5 Children, 24 to 71 Months (2-5 Years Old)

F4.1 Birth Weight of Children, 0-71 Months

F4.2 Government Program Participation of Children, 0-71 Months



Booklet 6 Children, 6 to 12 Years Old

F4.6 Government Program Participation of Children, 6-12 Years Old

F5.1 Blood Pressure Questionnaire

F5.2 Smoking and Alcohol Consumption


44




Cont. Table 25. List of booklets and forms used in the 2015 Updating Survey

BOOKLET /FORM NO.

FORM TITLE

Booklet 7 Adolescents, 13 to 17 Years Old

F5.2 Smoking and Alcohol Consumption of 10 Years Old and Above


F6.2 Maternal Mortality Questionnaire for All Female Members of the Household, 15-49 years old

F6.3 Reproductive History Questionnaire for All Female Members of the Household, 15-49 years old

F6.4 Contraceptive Use and Unmet Need for Family Planning of Women 13-49 Years Old

F6.5 Knowledge of HIV/AIDS of 15-24 Years Old

F6.6 Knowledge and Attitude Towards Tuberculosis of 15 Years and Above

Booklet 8 Adult, 18 years old and above


F5.1 History of Raised Blood Pressure of 18 years old and Above

F5.2 Smoking and Alcohol Consumption

F5.3 Awareness and Usage of Health/Food/Dietary Supplements (Adults, 20 Years and Over)

F5.4 Physical Activity and FFQ

F5.5 Self-administered Food Frequency Questionnaire (FFQ) of 18 Years Old and Above

F5.5 Taste Preferences of 18 Years Old and Above

F6.1 National Health Insurance Program (NHIP)/PhilHealth Coverage and Support Value

F6.2 Maternal Mortality Questionnaire for All Female Members of the Household, 15-49 years old

F6.3 Reproductive History Questionnaire for All Female Members of the Household, 15-49 years old

F6.4 Contraceptive Use and Unmet Need for Family Planning of Women 15-49 Years Old

F6.5 Knowledge of HIV/AIDS of 15-24 Years Old

F6.6 Knowledge and Attitude Towards Tuberculosis of 15 Years and Above

Booklet 9 Household Food Consumption

F9.1 Household Membership – Dietary

F9.2 Household Food Inventory

F9.3 Household Food Record

2.4.2 Electronic Data Collection System (e-DCS)

The electronic Data Collection System or e-DCS is a

browser-based data collection system developed for the 2015

Updating Survey. The primary objective of the e-DCS was to

facilitate data collection, editing, and transmission of data. Each

team leader and each researcher was given one netbook to access

this system.

For this survey, computer-based interview schedules

replaced the traditional pen and paper interview guides. However, for certain components such as

anthropometry, blood pressure, food weighing, and food recall, data were recorded using the pen-and-

paper method prior to data entry in the e-DCS.

The e-DCS system was designed to minimize data entry errors. It was also used to transmit data

electronically from the survey area to the central database in the FNRI office for immediate data

cleaning and validation to facilitate prompt release of results.

45




Each researcher was given a username and password to access the e-DCS (Figure 6). After

logging in to the system, the user is shown five functions in the main menu window, which are: a)

Collect, b) Review, c) Backup, d) Transmission, and e) Submit (Figure 7).

Using the Collect function, the researcher may begin or complete an interview, as well as review

previously collected data. The Review function enables the researchers to further review the collected

data and mark any items for missing and incomplete answers. Data collected by each researcher and

team leader (TL) is saved in the system and then duplicate copies are generated by saving the data to

the official USB flash drive and memory card using the Backup Function. Meanwhile, the Transmission

option allows the researcher and the TL to choose and attach the field-edited data file to be sent to the

central database at FNRI. Finally, the Submit button allows for the final transmission or the actual

sending of the field-edited data file to the central database at FNRI via the internet.

Figure 7. Screenshot of main menu of e-DCS

Figure 6. Screenshot of the log-in function of e-DCS

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2.5 Ethics Review

The project proposal titled “Updating of Nutritional Status of Filipino Children and Other

Population Groups: Philippines, 2015” was submitted to the FNRI Institutional Ethics Review

Committee (FNRI-IERC) for clearance on July 10, 2015 which was approved on July 20, 2015

(Appendix D).

Prior to inclusion in the survey, respondents signed informed consent forms to affirm their

voluntary participation in the study. The forms also served to inform the respondents on the purpose of

the survey and the manner by which data would be collected, as well as assurance to the participants

that confidentiality would be maintained.

The participation of each respondent was strictly voluntary and they were permitted to withdraw

their participation at any time without any penalty or consequence.

2.6 PSA Review and Approval

The 2015 Updating Survey Questionnaires were submitted to PSA for review and approval.

The forms were reviewed by Ms. Maria Fe M. Talento, Division Chief of Statistical Policies and

Programs Division, and subsequently recommended for approval by Ms. Regina S. Reyes, Interim

Assistant National Statistician of Standards Services on July 15, 2015. Ms. Josie B. Perez, Deputy

National Statistician of the Censuses and Technical Coordination Office provided the PSA approval

number and expiration date for the above-mentioned project (Appendix E).

2.7 Preparatory Survey Activities

Organization

The 2015 Updating Survey was conducted by the Institute from July 20 to November 28, 2015.

It was primarily funded by the Philippine Government, with additional financial assistance from the

Department of Health and the Philippine Council for Health Research and Development.

Prior to actual data collection, several preparatory activities were conducted. A stakeholders’

meeting was conducted on September 23, 2014 at Crowne Plaza Manila Galleria, Ortigas Center to

present the plans and preparations for the 2015 Updating Survey, as well as to request inputs or

suggestions and lobby for support and possible collaborations. The meeting was initiated by the

Nutritional Assessment and Monitoring Division (NAMD) of DOST-FNRI. Participants included

representatives from government agencies, international organizations, private sectors, and other

stakeholders.

47




Pre-survey conferences were held to gather firsthand information on the actual condition of

survey areas and to brief and discuss with local chief executives (LCEs) the survey objectives,

procedures, and methods. Logistics, such as assistance and support for accommodation and

transportation arrangements of the survey teams, hiring of local survey aides, and clearance of the peace

and order situation and security measures, were also discussed and arranged. Figure 8 summarizes the

flow of the 2015 Updating Survey coordination activities.

Figure 8. Flowchart of the 2015 Updating Survey coordination

As part of the regional coordination, FNRI

representatives discussed the 2015 Updating Survey with the

DOST Regional Director, the Provincial Science and

Technology Directors (PSTDs), as well as the Regional

Nutrition Program Coordinator (RNPC), and the Provincial

Nutrition Officers (PNAO). Provincial Coordinators (PCs)

were identified and the Terms of Reference (ToR) were

signed. Information and letters for the LCEs, as well as pre-

survey notes, were endorsed to the PC for subsequent distribution to the City/Municipal Nutrition

Action Officers (C/MNAOs).

Meet with the DOST Regional Director and PSTDs in the morning, RNPC and PNAOs in the

afternoon to discuss 2015 Updating Survey Identify PCs and signing of TOR Endorse pre-survey notes and information and letters to PC for distribution to C/MNAOs Sets a date for the provincial meeting with the c/MNAOs

FNRI TC coordinates/ follows-up with the PCs/PNAO through phone/ cellphone

PC/ C/MNAOs and FNRI TC to meet for a briefing and discussion of survey needs Collect and validate Pre-survey notes and information Establish communication scheme

FNRI TC and Team Leaders assigned to follow-up through phone/cell phone

C/MNAOs to meet with Barangay Officials of survey areas for a briefing of the survey and

endorse the needs of the survey team FNRI TC and Team Leaders assigned to follow-up through phone/ cell phone

FNRI Coordinator

Provincial

Coordination

(1 day)

C/MNAO to coordinate

with barangay officials

After 1 week

Regional

Coordination

(1 day)

48




The PC/C/MNAOs and the FNRI Team Coordinator met for a briefing and discussion of survey

needs, as well as to arrange a communication scheme for ease of coordination between FNRI and the

C/MNAOs. The C/MNAOs were tasked to coordinate with and subsequently endorse the needs of the

survey team to a Barangay Focal Person, which is usually the Barangay Chairman or the Kagawad on

Health.

Figure 9 illustrates the organizational structure of the 2015 Updating Survey.

Figure 9. 2015 Updating Survey Organizational Structure

The 2015 Updating Survey was headed by the FNRI Director (Figure 10). The Project Leader

was the Chief Science Research Specialist of NAMD, assisted by the Head of Operations and Head of

Data Management. Administrative and technical aspects of the survey were managed by the Head of

Operation, while data processing and analysis were handled by the Head of Data Management. Six (6)

major teams headed by the Team Coordinators (TCs) worked under the supervision of the Heads of

Operation and Data Management. Each big team headed by the TC was divided and supervised by two

(2) Assistant Team Coordinators (ATC). Each ATC handled ten (10) subteams. Seven (7) of these

subteams were composed of one Team Leader (TL), two Dietary Researchers (DR), and two

Anthropometric Researchers (AR) each, collectively called as the Regular Subteam (RST). The

remaining three (3) subteams were composed of one TL each and two ARs each, which was called

Mobile Subteam (MST).

PROJECT DIRECTOR

ASST. PROJECT LEADER/ OPERATIONS MANAGER

ASST. PROJECT LEADER/ DATA MANAGER

TEAM COORDINATOR (TC)

IT Staff

TEAM LEADERS (7)

ARs (2 per subteam)

PROJECT LEADER

ASSISTANT TEAM COORDINATOR (ATC) 1

TEAM LEADERS (3)

ARs (2 per subteam) & DRs (2 per subteam)

TEAM LEADERS (7)

ARs (2 per subteam)

ASSISTANT TEAM COORDINATOR (ATC) 2

TEAM LEADERS (3)

ARs (2 per subteam) & DRs (2 per subteam)

49




More than 400 personnel comprised the 2015 Updating Survey team (Appendix J). In total,

six (6) big teams composed of 20 subteams worked for the survey. Six (6) subteams were composed

of one (1) TL, two (2) DRs and two (2) ARs. The remaining 14 subteams were comprised of one

(1) TL and two (2) ARs.

Personnel were hired based on qualifications (i.e., academic achievement, work experience,

and trainings attended). They underwent and passed extensive training courses given by the Institute.

All DRs and ARs were well-trained Nutritionists-Dietitians and Nurses and Allied Health

Professionals, respectively.

Pre-testing of Interview Schedule and Electronic Data Collection System

Pre-testing of the interview schedule was conducted in a series of visits at Barangay San

Antonio, Parañaque in November 2014. The interview guides were pretested to assess functionality of

the instrument, accuracy and precision of data collected, and to identify possible improvements.

Suggestions for improvement and feedback were relayed by the survey team to the team coordinators.

After deliberation and approval of corrections, changes were relayed to the e-DCS team for input to the

system.

Field Practicum

A field practicum was conducted in Mendez, Cavite from December 2 to 6, 2014. This was

done to test interview guides, assess the movement of the teams and workload distributions among team

members, and evaluate feasibility of planned field operations, including assigned workload of the

researchers in terms of household coverage per day.

Pooling, Training and Hiring of Field Personnel

The qualification standards for potential field personnel varied depending on the Survey

component. Graduates of Bachelor of Science (BS) in Nutrition and Dietetics/BS Nutrition were

preferred for potential team leaders and anthropometric and dietary researchers. Job postings for the

position were coursed through the FNRI official website, online job-finding sites, and social networking

sites (SNS). Previous Updating Survey researchers were also notified via short messaging service

(SMS). Interested applicants were required to submit a Personal Data Sheet (PDS) and take a qualifying

examination. Qualified applicants based on the examination results were selected to undergo voluntary

trainings. Not all applicants who underwent training were accepted as field researchers.

Trainings of the team leaders were held in three batches at the DOST-FNRI in Bicutan, Taguig

City Training Room. The first batch of prospective TLs underwent training from April 15, 2015 to May

11, 2015, the second batch from April 20, 2015 to May 18, 2015, and the last batch from April 17, 2015

to May 25, 2015. The trainings all took place at the training room of NAMD-FNRI.

50




Trainings for Anthropometric Researchers in Metro Manila and selected provincial areas were

simultaneously held between May 11 to July 13, 2015 at FNRI in Bicutan, Taguig City and selected

training sites in Baguio City, Cebu City, and Zamboanga City. On the other hand, the training for dietary

component team leaders was held from June 3 to 9, 2015 at NAMD-FNRI. The three batches of dietary

training were held from June 15 to July 9, 2015 at FNRI-Bicutan, Taguig City and Zamboanga City.

The training program included lecture-demonstrations, diagnostic tests and quizzes, group work

(role-playing and presentation), a one-day practicum, and a Blood Pressure Certification Class,

specifically for Local Researchers. The culmination of the training was a one-day field practicum held

at selected barangays in Bicutan, Taguig City. Each trainee was expected to apply the knowledge, skills,

techniques, and attitudes they learned during the training while surveying a single household. Trainees

who passed the evaluation were hired as field researchers.

2.8 Actual Field Survey

Upon arrival at the province or municipality,

the team pays a courtesy call to local officials in order

to announce the entry of the research teams into the

areas, as well as to adhere to courtesy protocols.

The first day of data collection was allotted

for briefing of the local aides on their responsibilities

and obligations, as well as the remuneration scheme for the services rendered and the locations of

households. Survey objectives, methods, and procedures were

explained to the heads of each household drawn from the

sample. Consent was obtained in writing from the study

participants prior to actual data collection. The Informed

Consent Form (Appendix F) contains all the components of the

2015 Updating Survey and the detailed data collection

procedures to be carried out with the study participants. Non-

disclosure of information on the corresponding identity of the subject was also indicated in the consent

form which was translated to Tagalog, Ilocano, Bisaya and Waray.

After locating the households and acquiring informed consent, household membership data

were collected by the anthropometric researcher. The researcher then transmitted the household

membership form to the other researchers to determine eligible respondents for their respective

components. Figures 10 and 11 show the flow of data collection for the anthropometry and dietary

components.

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Figure 10. Flow of data collection for anthropometry component

The ARs collected weight, height, waist, and hip measurements of each household member as

well as blood pressure measurements. They also conducted the interviews on the following components:

household information, GP Participation, IYCF, Maternal Health and Nutrition, and Food Security. The

ARs also facilitated interviews on smoking and alcohol consumption, physical activity, and Food

Frequency Questionnaire (FFQ).

Figure 11. Flow of data collection for dietary survey

The DRs was assigned for food weighing and 24-hour food recall, conducted on two separate

days.

The TLs, meanwhile, was tasked to coordinate with officials, review, edit, consolidate and

create back-up for the data collected, and transmit data to the central office.

• Location • Getting informed consent • Interview Form 1.1 (Booklet 1) • Encode Form 1.1

• Get measurements • Interview: HH Forms • Interview: Individual Forms • Give incentive

Editing/ Transmission

Transfer to next area/ TRAVEL

Day 1 House-to-house

Day 2 Assembly

Day 3 House Visits

• Location • Getting informed consent • Copy names of HH

members in Dietary Forms

Household Food Weighing • Conduct of Beginning Inventory (BI) • Weighing of food items before meal

planner codes • Weigh plate waste/ leftover • Conduct of Ending Inventory (EI)

Editing and Encoding of Forms and Transmission

Transfer to next area/ TRAVEL

Day 1 House-to-house

Day 2 onwards

Individual Food Recall Conduct • Food Recall eaten outside by HH members for

snacks and major meals, and visitors shared on major meals

• Sample weighing of recalled food items not found in List of Standard Weights and Measures

52




The flow of data collection for the 2015 Updating Survey is illustrated in Figure 12.

Figure 12. Flow of data collection for the 2015 Updating Survey

53




As previously mentioned, the big teams were subdivided into two (2) types – regular subteam

(RST) and mobile subteam (MST). Both RST and MST stayed on the survey area for an average of 5

and 3 days, respectively, depending on the number of sample households. This period allowed the field

staff to accomplish their assigned duties and to make sure that all data needed are collected, checked

and edited, and transmitted to the Office before leaving the area.

While on-field, the survey team is on an “on-call” basis, which means that the staff is on hand

for work in the survey area (i.e., assembly area, survey headquarter, or at the household’s residence).

The standard 8-hour per day working hours does not apply in the field since work will depend primarily

on the availability of sample households for interview and measurement. For this reason, “standby

time” (which arises due to the lack of respondents or other operating circumstances beyond the

personnel’s control) was considered paid working hours, provided that these will be used for editing,

checking of accomplished forms, and/or other work related to the survey.

2.9 Data Monitoring System

Data transmitted to FNRI central database by the field researchers were monitored using the

Updating Survey 2015 Data Transmission Monitoring System. This is a web application designed to

monitor the data collection and transmission of the 2015 Updating Survey, as well as to report the

household coverage status per enumeration area. The target and actual number of households covered

and the date of termination of data collection per enumeration area were reflected in the system and

tagged with the corresponding name of the team, subteam, and team leader.

The Updating Survey 2015 Data Transmission Monitoring System featured a data filer, which

is helpful in making selections be viewed and reported by the system (Figure 13).

Figure 13. Screenshot of the Updating Survey 2015 Data Transmission Monitoring System

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2.10 Data Processing and Statistical Analysis

Cleaning and validation of data immediately started upon receipt of transmitted data in the

central database. This was applicable to all interview-based modules.

Measurements for height, weight, waist and hip circumferences, mid-upper arm circumference,

and blood pressure were validated by manually checking a printed copy of the encoded measurements

against the manually recorded values in the hard copy of the interview guide. Several rounds of

alternating manual and machine validations were done until desired consistency and completeness of

data were achieved.

The dietary component was recorded using the pen-and-paper method. The team leaders pre-

edited the dietary forms in the field for both the food weighing and the 24-hour food recall. A more

thorough editing of the forms was done in the central office prior to data encoding by hired dietary

encoders. Proof lists of the encoded data were checked for errors and consistency as part of several

rounds of alternating manual and machine validation. Necessary corrections were encoded in the

program until data were completely cleaned and validated.

Sampling weights were adjusted for non-response and were post-stratified based on the

population obtained from the Philippine Statistics Authority (PSA) (Appendix B). Stata version 12 was

used to generate descriptive statistics including mean, median and percentage, range, confidence

intervals, design effect, and coefficient of variation.

2.11 Reporting and Dissemination

The initial results of the 2015 Updating Survey were released during the 3rd National Nutrition

Summit titled “MDGs by 2015: Did Juan Hit the Targets” held at the Crowne Plaza Manila Galleria,

Ortigas Center on February 16, 2016. Results relevant to selected MDG indicators were presented to

representatives from national line agencies and non-government organizations, as well as international

and development partners. Another presentation was held during the 42nd FNRI Seminar Series, with

the theme: "The Millennium Development Goals (MDGs), how did the Philippines perform?", held on

July 4, 2016 at the Crowne Plaza Manila Galleria, Ortigas Center. Here, the results were presented to a

wider, more diverse set of audience that included nutritionist-dietitians, nutrition action officers, food

industry professionals, food technologists, barangay nutrition scholars and health workers, local

government health workers, and students.

55




The FNRI, in partnership with DOST

Regional Offices (Appendix H) and the National

Nutrition Council of the Department of Health

(NNC-DOH) (Appendix I), organized post-survey

conferences and seminars to disseminate survey

results at the regional and provincial levels. Results

dissemination meetings at the regional level were

scheduled from July 2016 to October 2016 (Table

26).

The results of the 2015 Updating Survey

were also presented to government agencies during

strategic planning, as well as during conferences,

food and nutrition stakeholders meetings, and other

venues, as requested by different agencies.

Attendees of the dissemination meetings

included regional and provincial planners from all

sectors, including policy-making, health and

nutrition, agriculture, labor and development, researchers, academe, media, nutrition advocates, and

other stakeholders. During the forum, participants were clustered by province or by organization (for

private partners) and tasked to come up with policy statements and recommendations appropriate for

their respective local government units in order to solve the problems that may have emerged from the

2015 Updating Survey results.

Presentations were open to public access via the internet through the FNRI and NNC websites,

among others.

56




Table 26. 2015 Updating Survey Regional Dissemination

Region Date

(2016) No. of

Participants Venue

NCR July 26 76 DOST-FNRI

CALABARZON July 28 104 DOST-FNRI

ARMM August 16 78 Alnor Hotel and Convention Center, Cotabato City

SOCCSKSARGEN August 18 75 The Farm @ Carpenter Hill, Koronadal City

Central Luzon August 23 128 King’s Royale Hotel and Resort, Pampanga

Bicol Region August 25 109 Hotel Venezia, Legazpi City

Cagayan Valley August 31 94 Hotel Carmelita, Tuguegarao City

MIMAROPA September 5 105 Sikatuna Beach Hotel, San Jose, Occidental Mindoro

Ilocos September 6 76 Oasis Country Resort San Fernando City, La Union

MIMAROPA September 7 60 Training Center, Provincial Capitol, Mamburao, Occidental Mindoro

CAR September 8 72 Eurotel, Baguio City

Eastern Visayas September 13 100 Ritz Tower de Leyte, Tacloban City

Central Visayas September 15 48 Montebello Villa, Cebu City

Western Visayas September 20 74 Amigo Terrace Hotel, Iloilo City

Negros Island Region September 23 54 Check Inn Pension Arcade, Dumaguete City

Zamboanga Peninsula and BASULTA

October 4 79 Garden Orchid Hotel, Zamboanga City

Davao October 6 132 Grand Regal Hotel, Davao City

Palawan October 13 51 Empire Suites Hotel, Puerto Prinsesa

MIMAROPA October 19 62 Bayview Park Hotel, Roxas Boulevard, Manila

Caraga October 25 101 Balanghai Hotel, Butuan City

Northern Mindanao October 27 102 Marianne Suites, Cagayan De Oro City

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3. PROFILE OF RESPONDENTS

3.1. Demographic Characteristics of Individuals

Age and Sex

Age and sex are important demographic characteristics of a population, as these pinpoint groups

that are at risk of nutritional and health problems. Of the 161,577 respondents, 78,262 were males and

83,315 were females.

Table 27 shows the distribution of the respondents by age and sex. Adults 20 years and over

made up the majority at 54.6%. Approximately 45% were below 20 years old. About one-third (32.2%)

were school children, 5.08 to 10.00 years old and adolescents, 10.08 to 19 years of age. Infants and

preschoolers, 0 to 60 months old, accounted for 13.2% of the respondents.

Table 27. Percent distribution of respondents, by age and sex: Philippines, 2015

Age Group All Males Females

n % n % n %

Philippines 161,577 100.0 78,262 48.3 83,315 51.7

0-5 years old 17,202 13.2 8,880 14.1 8,322 12.5

0-5m 1,354 7.9 694 7.9 660 8.0

6-11m 1,697 10.0 889 10.1 808 10.0

12-23m 3,033 17.9 1,505 17.2 1,528 18.7

24-35m 3,253 19.1 1,678 19.2 1,575 19.0

36-47m 3,607 21.0 1,893 21.4 1,714 20.6

48-60m 4,258 24.0 2,221 24.3 2,037 23.7

5.08-10 years old 20,173 12.2 10,337 12.8 9,836 11.5

5.08-5.9 y 3,426 17.2 1,799 17.6 1,627 16.7

6.0-6.99 y 4,025 20.1 2,076 20.4 1,949 19.7

7.0-7.99 y 4,275 21.3 2,171 21.0 2,104 21.6

8.0-8.99 y 4,042 20.0 2,073 20.0 1,969 20.1

9.0-10.0 y 4,405 21.5 2,218 21.1 2,187 21.9

10.08-19 years old 35,750 20.0 18,346 21.2 17,404 18.9

10.08-12.99 y 12,105 33.0 6,143 33.2 5,962 32.8

13.0-15.99 y 12,093 33.2 6,219 33.5 5,874 33.0

16.0-17.99 y 6,237 18.1 3,262 18.0 2,975 18.1

18.0-19.99 y 5,315 15.7 2,722 15.3 2,593 16.1

20 years old and over 88,452 54.6 40,699 51.9 47,753 57.1

20.0-29.99 y 19,094 25.7 9,292 26.2 9,802 25.3

30.0-39.99 y 17,591 23.3 7,943 22.9 9,648 23.5

40.0-49.99 y 18,757 20.6 8,830 20.9 9,927 20.3

50.0-59.99 16,397 15.8 7,563 16.0 8,834 15.5

60.0-69.99 y 10,375 9.4 4,672 9.4 5,703 9.4

> 70.0 y 6,238 5.3 2,399 4.6 3,839 6.0

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Physiologic Status of Female Respondents

The physiologic status of female respondents in a population is important in identifying females

who, due to being either pregnant or lactating, are vulnerable in terms of health and nutrition. It is

important to take steps to reduce maternal mortality and morbidity, as well as associated infant mortality

and morbidity.

Nine (9) out of 10 women (92.9%) in the younger age group of 15 to 19 years were neither

pregnant nor lactating (NP/NL). More women above the age of 20 were pregnant or lactating compared

to their younger counterparts. In the older age group of women 20 years and over, there were about

thrice as many lactating mothers (8.6%) compared to pregnant mothers (3.0%).

Among women of reproductive age 15 to 49 years old, one-fifth (21.3%) were of young

reproductive age, between 15 to 20 years old. For women of advanced maternal age, 12.5% were

between 41 and 45 years old, while 9.2% were between 46 of 49 years old (Table 28).

Table 28. Percent distribution of female respondents, by age group and physiological status: Philippines, 2015

Physiological Status n %

15-19 years old 7,450 100.0

NP/NL* 6,910 92.9

Pregnant 233 3.1

Lactating 307 4.0

20 years old and above 47,753 100.0

NP/NL 42,791 88.3

Pregnant 1,261 3.0

Lactating 3,701 8.6

Women of Reproductive Age (15-49) 36,827 0.0

15-20y 8,597 21.3

21-25y 5,056 15.2

26-30y 4,496 14.1

31-35y 4,728 14.3

36-40y 5,033 13.3

41-45y 5,000 12.5

46-49y 3,917 9.2

*non-pregnant/ non-lactating

Educational Attainment

The educational attainment of a population affects not only the socioeconomic status but also

the population’s capability to plan and participate in health interventions. It is also important in making

sound health decisions and practicing proper health-seeking behaviors.

Among respondents 15 years and over, 2.0% were recorded to have not completed any grade

level (Table 29). One (1) out of 10 of respondents (13.8%) had at least reached elementary while 12.8%

graduated from elementary. High school graduates accounted for 25.3% of the respondents. Meanwhile,

less than 7% were vocational undergraduates and graduates, and only 11.4% were college graduates.

59




In general, more females finished high school (26.3%) than males (24.1%) (p-value= 0.0001).

Likewise, there were more female college graduates (13.4%) than males (9.1%) (p-value = 0.0001). A

slightly higher proportion of vocational graduates was observed among males (5.4%) than among

females (4.6%) (p-value = 0.2113).

Table 29. Percent distribution of respondents, 15 years old and above, by educational attainment and sex: Philippines, 2015

Education All Males Females

n % n % n %

No Grade Completed 2,392 2.0 1,078 2.0 1,314 2.0

Elementary Undergraduate 16,400 13.8 8,983 16.4 7,417 11.5

Elementary Graduate 14,984 12.8 6,934 13.0 8,050 12.7

HS Undergraduate 18,779 17.8 9,196 18.5 9,583 17.2

HS Graduate 24,445 25.3 11,040 24.1 13,405 26.3

Vocational Undergraduate 1,249 1.4 639 1.5 610 1.3

Vocational Graduate 4,646 5.0 2,358 5.4 2,288 4.6

College Undergraduate 10,059 10.6 4,524 10.1 5,535 10.9

College Graduate 10,993 11.4 4,015 9.1 6,978 13.4

Civil Status

Determining the civil status of individuals figures in facilitating the planning of health and

social interventions, as well as in identifying psychosocial stressors unique to situations such as

separation or bereavement.

About half of the respondents 15 years and over (49.4%) were married, about one-third (32.1%)

were single, and 10.4% were in a live-in arrangement. The remaining 8% where widows/widowers and

separated/annulled/divorced (Table 30). More male respondents (37.8%) than females (27.1%) reported

single civil status, while more female respondents (50.4%) than males (48.3%) were married.

Table 30. Percent distribution of respondents, 15 years old and above, by civil status and sex:

Philippines, 2015

Civil Status All Males Females

n % n % n %

Single 31,540 32.1 17,700 37.8 13,840 27.1

Married 53,180 49.4 24,600 48.3 28,580 50.4

Widow/Widower 7,751 6.1 1,544 2.7 6,207 9.0

Separated/Annulled/Divorced 2,100 2.1 851 1.8 1,249 2.4

Live-in 9,384 10.4 4,076 9.4 5,308 11.2

60




Occupation and Employment

Occupations and employment status are not only socioeconomic markers but can also point to

possible health hazards and concerns within the population.

Overall, about one-fourth (23.8%) of respondents were working in the agriculture, forestry, or

fishery sectors. Moreover, 17.5% were laborers and unskilled workers, 15.8% were services and sales

workers, and 10.1% belonged to the group of government officials, corporate executives, managers and

related occupations (Table 31).

Female-dominated occupations included work in government and corporate offices (17.3%), as

professionals (9.8%), as technicians and associate professionals (6.1%), clerical support (8.7%), and

service and sales (25.3%). Meanwhile, occupations in the agricultural, forestry, and fishery sectors

(32.5%), labor and unskilled work (17.7%), plant and machine operations and assembly (13.5%), and

craft and related trades (11.1%) were male-dominated.

Table 31. Percent distribution of working respondents, 15 years and over, by type of occupation and sex: Philippines, 2015

Occupation All Males Females

n % n % n %

Special Occupations (AFP personnel, unclassified jobs)

39 0.1 39 0.1 0 0.0

Officials of Government and Special Interest Organizations, Corporate Executives, Managers, Managing Proprietors and Supervisors

5,434 10.1 1,953 5.8 3,481 17.3

Professional 2,654 5.3 804 2.7 1,850 9.8 Technicians and Associate

Professionals 2,046 4.5 987 3.6 1,059 6.1

Clerks 2,217 5.0 776 2.8 1,441 8.7 Service Workers and Shop

and Market Sales Workers 7,825 15.8 3,015 10.2 4,810 25.3

Farmers, Forestry Workers and Fishermen

15,545 23.8 13,121 32.5 2,424 9.1

Craft and Related Trades Workers

4,474 9.0 3,473 11.1 1,001 5.4

Plant and Machine Operators and Assemblers

4,340 8.9 4,167 13.5 173 1.1

Elementary Occupation: Laborers and Unskilled Workers

9,142 17.5 5,809 17.7 3,333 17.2

Work Status of Individuals

Identifying the status of non-employed individuals is important in identifying and anticipating

the needs and concerns of the dependent members of the community. While for a good number of the

population unemployment is a transient state, others will no longer be able to return to productive

employment, such as pensioners.

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Among the non-working population (Table 32), three (3) out of 10 respondents (30.6%) had no

occupation. About one-fourth (24.6%) were students and four (4) out of 10 (40.6%) were housekeepers.

Pensioners accounted for 4.3% of the non-working population.

More males (47.6%) than females (23.7%) had no occupation, and more females (55.9%) than

males (2.4%) were housekeepers. About two (2) out of 10 females (17.3%) and four (4) out of ten male

respondents (42.7%) were students.

Table 32. Percent distribution of population, 15 years and over by non-working status and sex: Philippines, 2015

Non-working status All Males Females

n % n % n %

No occupation 14,614 30.6 6,630 47.6 7,984 23.7

Housekeeper 20,378 40.6 344 2.4 20,034 55.9

Student 12,422 24.6 6,314 42.7 6,108 17.3

Pensioner 2,550 4.3 1,180 7.4 1,370 3.1

3.2. Indigenous Peoples

The Philippine Statistics Authority (PSA) defines Indigenous Peoples (IPs) as

“a group of people or homogenous societies identified by self-ascription and ascription by others,

who have continuously lived as organized community on communally bounded and defined territory,

and who have, under claims of ownership since time immemorial, occupied, possessed customs,

tradition and other distinctive cultural traits, or who have, through resistance to political, social,

and cultural inroads of colonization, non-indigenous religions and culture, become historically

differentiated from the majority of Filipinos” (Philippine Statistics Authority, 2017).

There are an estimated 14 to 17 million indigenous peoples (IPs)12 in the country belonging to

110 ethno-linguistic groups. Cariño (2012) reports that no accurate figures on the population of

indigenous peoples exist because no formal census has been done.

Due to the remoteness of their settlements, IPs are considered among the poorest and most

disadvantaged group in the country and characteristically have little access to basic health services. This

is evidenced by high illiteracy and unemployment rates and poverty incidence, as well as increased

likelihood of high prevalence of morbidity, mortality, and malnutrition.

In the 2015 NNS, the categorization of IPs was based on self-report of ethnicity. The parent

members of the households were asked about their ethnicity. Subsequently, children were categorized

as IPs if at least one the following conditions were met: a) both biological parents are IPs, b) one of the

12 (United Nations Development Programme, 2013)

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biological parents is an IP, c) one biological grandparent is an IP. A household was considered an IP

household if at least one (1) member is an IP.

Four (4) out of 100 (4.4%) respondents identified themselves as a member of an IP group.

Regions with more than 10% IP respondents included CAR (48.8%), Zamboanga Peninsula (14.7%),

ARMM (13.9%), Davao (11.8%), SOCCSKSARGEN (11.8%), and Cagayan Valley (11.0%) (Table

33).

Table 33. Proportion of Indigenous Peoples by region: Philippines, 2015

Region n IPs

Philippines 161,577 4.4

NCR 14,037 0.2

CAR 6,212 48.8

Ilocos 9,524 1.6

Cagayan Valley 8,770 11.0

Central Luzon 13,141 0.3

CALABARZON 15,991 0.1

MIMAROPA 5,126 9.7

Bicol 11,541 0.2

Western Visayas 11,612 2.8

Central Visayas 10,281 0.1

Eastern Visayas 9,926 1.8

Zamboanga Peninsula 6,507 14.7

Northern Mindanao 7,438 6.0

Davao 8,255 11.8

SOCCSKSARGEN 8,265 11.8

ARMM 7,499 13.9

Caraga 7,452 5.6

3.3 Government Program Participation

3.3.1 PhilHealth

The National Health Insurance Program administered by the Philippine Health Insurance

Corporation (PhilHealth) is mandated to provide health insurance coverage to all Filipinos and ensure

affordable, acceptable, available, and accessible health care services.

Table 34 shows the proportion of households with at least one Philhealth principal member,

according to region. Results showed that about eight (8) in 10 households (77.1%) in the country have

at least one Philhealth principal member. Regions with at least 80% of households having a principal

member included Caraga (84.1%), Northern Mindanao (82.7%), Davao (82.0%), Western Visayas

(81.7), CAR (81.3%), Zamboanga Peninsula (81.0%), and Ilocos (80.9%).

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Table 34. Proportion of households with at least one Philhealth

principal member, by region: Philippines, 2015

Region n %

Philippines 31,498 77.1 NCR 2,382 73.3 CAR 1,363 81.3 Ilocos 1,878 80.9 Cagayan Valley 1,670 74.1 Central Luzon 2,579 77.0 CALABARZON 3,218 78.0 MIMAROPA 994 79.5 Bicol Region 2,011 76.9 Western Visayas 2,557 81.7 Central Visayas 1,956 78.0 Eastern Visayas 1,843 77.2 Zamboanga Peninsula 1,362 81.0 Northern Mindanao 1,711 82.7 Davao 1,800 82.0 SOCCSKSARGEN 1,676 78.0 ARMM 914 52.0 Caraga 1,584 84.1

3.3.2 Pantawid Pamilyang Pilipino Program (4Ps)

The Pantawid Pamilyang Pilipino Program (4Ps) is a human development program of the

national government that invests in the health and education of poor households, particularly children

aged 0 to 18 years. It is implemented through the Department of Social Welfare and Development

(DSWD), with partner agencies including the Department of Education (DepEd), Department of Health

(DOH), and the Department of Interior and Local Government (DILG) in coordination with Local

Government Units (LGUs). This program provides conditional cash grants to beneficiaries upon

compliance with their co-responsibilities.

Results of the 2015 Updating Survey showed that 26% of households with pregnant members

and with members 18 years and below, were current recipients of the 4Ps (Table 35).

Table 35. Proportion of households that are current beneficiaries of 4Ps: Philippines, 2015

Region n %

Philippines 8,833 26.0 NCR 373 14.7 CAR 344 25.6 Ilocos 457 25.7 Cagayan Valley 324 18.3 Central Luzon 379 15.0 CALABARZON 507 15.8 MIMAROPA 349 34.8 Bicol 894 42.3 Western Visayas 634 27.9 Central Visayas 406 22.8 Eastern Visayas 743 39.2 Zamboanga Peninsula 597 45.2 Northern Mindanao 541 34.6 Davao 483 27.2 SOCCSKSARGEN 530 29.7 ARMM 706 44.6 Caraga 566 38.4

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4. SOCIOECONOMIC STATUS OF HOUSEHOLDS

In the absence of income and expenditure data, household surveys in the Philippines usually

utilize asset-based wealth index to disaggregate survey results. The 2008 and 2013 National

Demographic and Health Surveys of the Philippine Statistics Authority and the 2011 Updating of the

Nutritional Status of the Filipino Children and Other Population Groups and 2013 8th National

Nutrition Survey used wealth index in disaggregating survey results. Wealth index was computed using

principal component analysis (PCA) based on household assets, household characteristics, access to

utilities, and infrastructure variables.

The variables collected for household information were the following: type of dwelling unit,

tenure status of the house, tenure status of the lot, type of roof, type of wall, type of floor, number of

bedrooms, type of fuel used, transport utilities used (bicycle, motorcycle, car/jeep/van, tractor, caritela,

boat), presence of electricity in the household, functioning appliances (computer/laptop/tablet,

telephone, cellphone/smartphone, television, radio/cassette recorder, VCD/DVD Player, camera/video

camera, refrigerator/freezer, stove/range/microwave oven, blender/food processor, electric generator,

air-conditioner, washing machine, electric fan, sewing machine, piano/organ, and wall clock).

Other household information collected included the presence of household help, type of

drinking water, main source of water for cooking and hand washing, type of toilet facility used, and

type of garbage disposal method of the household.

4.1 Household Member Characteristics

The educational attainment of the head of a given household affects not only the employment

and economic resources of the household head, but also has a bearing on the household’s capacity to

participate in community activities and engage in health-seeking behavior.

Overall, most household heads in the survey were high school graduates (21.9%) and

elementary undergraduates (21.0%). In rural communities, household heads were mostly elementary

undergraduates (28.5%) and graduates (21.6%). Most household heads in urban areas were high school

graduates (25.9%); while 14.3% were college graduates, and 10.4% were college undergraduates (Table

36).

65




Table 36. Percent distribution of highest educational attainment of household head, by

type of residence: Philippines, 2015

Educational Attainment

of Household Head

All Urban Rural

n % n % n %

No Grade Completed 1,110 2.8 173 1.0 937 4.4

Elementary Undergraduate 8,195 21.0 2,022 12.8 6,173 28.5

Elementary Graduate 6,760 17.6 2,075 13.2 4,685 21.6

HS Undergraduate 4,678 13.6 1,986 14.1 2,692 13.1

HS Graduate 7,125 21.9 3,481 25.9 3,644 18.3

Vocational Undergraduate 371 1.2 227 1.8 144 0.7

Vocational Graduate 1,566 5.0 874 6.6 692 3.5

College Undergraduate 2,306 7.2 1,405 10.4 901 4.3

College Graduate 3,252 9.7 2,097 14.3 1,155 5.5

The occupation of a family’s household head determines not only the quantity of economic

resources available to the household, but also has a bearing on the stability of household income.

Occupations that are highly reliant on the physical environment, such as those in farms and fisheries,

are more likely to be affected or disrupted by natural and man-made calamities. Other occupations may

also pose inherent health risks or hazards, particularly those involving manual work or exposure to

dangerous chemicals or weaponry. On a larger scale, the nature of employment within a community is

one measure of urbanization and development in the area.

One-third of household heads (33.8%) were found to be agricultural, forestry, and fishery

workers. In rural areas, majority of household heads were farmers, forestry workers, and fishermen

(52.4%) and laborers and unskilled workers (13.8%). Meanwhile, most household heads in urban areas

were laborers and unskilled workers (17.2%), plant and machine operators and assemblers (17.1%),

service workers and shop and market sales workers (15.0%), and craft and related trades workers

(14.1%) (Table 37).

Table 37. Percent distribution of occupation of household head, by type of residence: Philippines, 2015

Occupation of Household Head All Urban Rural

n % n % n %

Special Occupations (AFP personnel, unclassified jobs)

26 0.1 15 0.2 11 0.1

Officials of Government and Special Interest Organizations, Corporate Executives, Managers, Managing Proprietors and Supervisors

2,485 9.2 1,359 12.5 1,126 6.5

Professional 631 2.4 390 3.6 241 1.4 Technicians and Associate Professionals 708 3.1 499 5.4 209 1.3 Clerks 554 2.3 371 3.9 183 1.1 Service Workers and Shop and Market

Sales Workers 2,607 10.4 1,491 15.0 1,116 6.6

Farmers, Forestry Workers and Fishermen 10,758 33.8 1,447 10.9 9,311 52.4 Craft and Related Trades Workers 2,703 10.8 1,383 14.1 1,320 8.0 Plant and Machine Operators and

Assemblers 3,041 12.5 1,683 17.1 1,358 8.8

Elementary Occupation: Laborers and Unskilled Workers

4,089 15.4 1,768 17.2 2,321 13.8

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4.2 Household Characteristics

Determining the composition of households and types of dwellings is important in planning

interventions as well as in assessing crowding and need for relocation.

Throughout the country, six (6) out of 10 (63.8%) households were composed of single families.

On the other hand, four (4) out of 10 (36.2%) were composed of extended families, with this scenario

more common in urban (39.1%) than in rural areas (33.5%) (p-value < 0.0000).

With regard to the types of dwellings, majority of households nationwide lived in single houses,

which is true for 96.8% of households in rural areas and 83.6% in urban areas. In urban areas, up to 8%

of households dwelt in multi-unit residences and another 7.5% in duplexes. These household setups

were relatively uncommon in rural areas.

Crowding of members in the household may compromise the health status of one or all

members of the household. A good indicator to determine the extent of crowding is the number of

rooms used for sleeping.

One (1) out of 10 households in urban (13.7%) and rural (15.6%) areas had no bedrooms. About

three (3) out of 10 households (28.0%) nationwide had only one bedroom and four (4) out of 10 (36.8%)

had two bedrooms. About one-fourth (24.6%) of urban households and 16.5% of rural households had

three or more bedrooms.

Table 38. Percent distribution of households by type of household, type of dwelling and number of bedrooms, by type of residence: Philippines, 2015

Household Characteristics All Urban Rural

n % n % n %

Type of Household (n = 42,310)

Single 27,156 63.8 10,181 60.9 16,338 66.5

Extended family 15,154 36.2 6,912 39.1 8,242 33.5

Type of Dwelling (n = 41,972)

Single house 38,642 90.3 15,067 83.6 23,575 96.8

Duplex 1,732 4.8 1,205 7.5 527 2.1

Multi-unit residential 1,455 4.5 1,222 8.2 233 1.0

Commercial/industrial/ agriculture

78 0.2 66 0.4 12 0.05

Institutional living quarter 22 0.05 11 0.1 11 0.05

Other housing unit 43 0.13 32 0.2 11 0.04

Number of bedrooms (n = 41,972)

None 5,964 14.7 2,276 13.7 3,688 15.6

One 11,645 28.0 4,706 27.5 6,939 28.6

Two 15,780 36.8 6,123 34.2 9,657 39.3

Three and above 8,583 20.5 4,498 24.6 4,085 16.5

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The tenure status of house and lot is a measure of financial independence and stability of a

given household. Results showed that nine (9) out of 10 (88.8%) rural households had ownership of

their house, while the same is true for 75.5% of urban households. Rented dwellings were more common

in urban (12.5%) than in rural areas (1.8%) (p-value < 0.0000) (Table 39).

The same trend was observed for the tenure status of the lot, with 61.1% of rural households

and 57.8% of urban households having ownerships of their lots. Nearly one-third (31.6%) of rural

households lived on their lot for free with consent.

Table 39. Percent distribution of households by tenure status of house and lot, by type of residence: Philippines, 2015


n % n % n %

Tenure status of house

Own 35,137 82.2 13,588 75.5 21,549 88.8

Rent 2,356 7.1 1,927 12.5 429 1.8

Free-with consent 4,094 9.8 1,835 10.6 2,259 9.0

Free-without consent 294 0.9 196 1.3 98 0.4

Tenure status of lot

Own 25,271 59.5 10,322 57.8 14,949 61.1

Rent 3,545 9.7 2,407 14.9 1,138 4.7

Free-with consent 11,840 27.5 4,161 23.2 7,679 31.6

Free-without consent 1,225 3.3 656 4.1 569 2.6

In addition, the choice of cooking fuel affects not only the safety of a household’s cooking

facilities but can also be a source of exposure to toxins and dangerous particulate matter. A majority of

rural households regularly used wood for cooking (73.1%), while urban households use LPG more

frequently (52.8%). Only a very small percentage of households used fuel from natural gas or biomass

sources such as agricultural crops or animal dung (1.1%) (Table 40).

Table 40. Percent distribution of households by type of fuel used for cooking, by type of residence: Philippines, 2015

Fuel used for cooking All Urban Rural

n % n % n %

Wood 23,444 50.2 5,331 26.3 18,113 73.1

Liquefied petroleum Gas (LPG) 11,621 33.3 8,371 52.8 3,250 14.6

Charcoal 5,174 13.0 2,632 14.9 2,542 11.1

Electricity 470 1.4 365 2.3 105 0.5

Kerosene 325 1.1 299 2.1 26 0.1

Natural gas 266 0.9 212 1.5 54 0.3

Agricultural Crop 84 0.2 25 0.1 59 0.2

Animal Dung 6 0.0 4 0.0 2 0.0

The choice and availability of materials used to construct houses may be used as an economic

marker, as well as an indicator of preparedness to withstand natural disasters and calamities.

In rural areas, 82.9% of households used galvanized iron or aluminum sheeting, 14.7% made

use of cogon, nipa, and anahaw, while the remaining 3% used wood roofing or a combination of metal

68




and concrete/ tiles and improvised materials. On the other hand, majority of urban households utilized

galvanized metal sheeting (90.7%).

Moreover, 38.1% of households in rural areas used concrete, brick, or stone for their walls. In

this group, one-fourth of households (25.9%) used bamboo, sawali, cogon, or nipa for walls, while two

out of 10 (21.2%) utilized wood for the same purpose. In urban areas, majority of households (60.3%)

had concrete walls. Wood was utilized by 16.9% of households and 14.6% used a combination of

concrete and wood for the walls.

Nearly half of households in rural (49.3%) and more than half of households in urban areas

(55.3%) had plain cement flooring. About thrice as many urban households (21.5%) used ceramic tiles

compared with rural households (8.1%). It was also observed that the proportion of rural households

with earth or sand floors (11.9%) was higher compared with their urban counterparts (5.3%) (p-value <

0.0000).

Nine (9) out of 10 (95.4%) households in urban areas and eight (8) out of 10 households in rural

areas (83.5%) reported having electricity (Table 41).

Table 41. Percent distribution of households by presence of electricity and dwelling materials, by type of residence: Philippines, 2015


n % n % n %

Electricity (n = 41,660)

No 4,842 10.7 901 4.6 3,941 16.5

Yes 36,818 89.3 16,547 95.4 20,271 83.5

Roof Materials (n = 41,972)

Galvanized iron/aluminum 36,079 86.7 15,932 90.7 20,147 82.9

Cogon/nipa/anahaw 4,316 9.0 728 3.2 3,588 14.7

Tile concrete/clay tile 412 1.2 319 2.1 93 0.4

Half galvanized iron and half concrete 547 1.4 296 1.8 251 1.0

Wood 443 1.1 210 1.3 233 0.9

Makeshift/salvaged/improvised materials

151 0.4 98 0.6 53 0.2

Asbestos 24 0.1 20 0.1 4 0.0

Wall materials (n = 41,972)

Concrete/brick/stone 19,490 49.0 10,360 60.3 9,130 38.1

Wood 8,556 19.1 3,062 16.9 5,494 21.2

Half concrete/brick/stone and half wood 5,649 13.7 2,516 14.6 3,133 12.9

Bamboo/sawali/cogon/nipa 7,378 16.2 1,290 6.2 6,088 25.9

Galvanized iron/aluminum 522 1.0 168 0.8 354 1.1

Makeshift/salvaged/improvised materials

320 0.8 182 1.1 138 0.6

Asbestos 26 0.1 13 0.1 13 0.1

No walls 25 0.1 9 0.1 16 0.1

Glass 6 0.0 3 0.0 3 0.0

Floor materials (n = 41,972)

Plain cement 21,703 52.2 9,744 55.3 11,959 49.3

Ceramic tiles 5,408 14.7 3,576 21.5 1,832 8.1

Wood planks 5,009 10.6 1,780 9.5 3,229 11.6

Earth, Sand 3,876 8.6 994 5.3 2,882 11.9

Coco Lumber/Bamboo 5,043 11.2 866 4.2 4,177 17.8

Vinyl or asphalt strips 440 1.3 316 2.1 124 0.6

Marble 355 1.1 257 1.7 98 0.5

Parquet or polished wood 138 0.3 70 0.4 68 0.2

69




4.3 Household Health and Sanitation

One target of the Sustainable Development Goals (SDGs) is that all individuals shall have

access to safe and affordable drinking water by 2030. In the Philippines, safe drinking water is currently

available from improved water sources designed to eliminate or minimize contamination from

pathogens and wastes. Improved water sources include piped in water into individual dwellings, public

wells and stand pipes, protected dug wells and springs, rainwater, and bottled or mineral water. Non-

improved sources include unprotected springs and wells, water supplied from carts and tankers, or

surface water from rivers and dams.

Sanitation through proper disposal of household and industrial wastes is important in reducing

the transmission of waterborne diseases and parasites, as well as in eliminating pollution from

contaminants and hazardous chemicals. An important step at the household level is the provision of

improved, water-sealed toilets in lieu of non-improved facilities such as pit latrines. This helps eliminate

contamination of food and water sources with coliform bacteria that are among the leading etiologies

for gastrointestinal diseases.

Water sources for drinking, cooking, and handwashing is important in determining water safety,

as well as in controlling the incidence of waterborne diseases. Majority of households (94.5%)

nationwide used improved water sources for drinking, with nearly one third (31.7%) using bottled or

mineral water. This was true for nearly half (46.7%) of urban households and 17.0% of rural households.

In rural areas, approximately 20.0% of households drank water piped into dwellings. Other significant

sources of drinking water included tube wells (15.2%) or protected dug wells (12.0%) and springs

(11.9%). Unprotected springs (4.1%) were a common source of non-improved source of drinking water

in rural areas.

Majority of urban and rural households used water piped into their dwellings for cooking, at

68.0% and 29.7%, respectively. Other significant sources included tube wells, dug wells, and protected

springs, especially in rural areas. Bottled or mineral water was used for cooking by 2.2% of households

nationwide. Unprotected dug wells (3.8%) and unprotected springs (3.9%) were the most commonly

used non-improved sources of water for cooking in rural areas.

Majority of urban (70.2%) and rural households (30%) utilized water sources piped into

dwelling as water for handwashing. Tube wells, dug wells, and protected springs were also used by

more than 10% of rural households. Unprotected dug wells and unprotected springs also comprised the

largest percentage of unimproved water sources for handwashing both in rural and urban areas.

70




Table 42. Percent distribution of households by sources of water for drinking, cooking, and handwashing, by type of residence: Philippines, 2015

Household Health and Sanitation All Urban Rural

n % n % n %

Source of drinking water (n = 41,392)

Improved source 38,914 94.5 16,922 98.3 21,992 90.8

Piped into dwelling 9,999 26.3 5,397 33.0 4,602 19.8

Tube well or borehole 4,846 10.4 1,134 5.4 3,712 15.2

Protected Dug Well 3,493 7.8 646 3.3 2,847 12.0

Protected spring 3,666 7.0 441 1.9 3,225 11.9

Public tap/stand pipe 3,109 6.9 846 4.5 2,263 9.2

Piped to yard/plot 1,762 3.9 600 3.3 1,162 4.6

Rainwater 214 0.5 34 0.2 180 0.8

Bottled/Mineral water 11,825 31.7 7,824 46.7 4,001 17.3

Non-improved source 2,478 5.5 361 1.7 2,117 9.2

Unprotected spring 1,142 2.4 116 0.5 1,026 4.1

Unprotected Dug Well 802 1.9 86 0.4 716 3.3

Tanker truck 273 0.7 107 0.5 166 0.8

Surface water 191 0.4 41 0.2 150 0.6

Cart with small tank 70 0.2 11 0.0 59 0.4

Source of cooking water (n = 41,781)

Improved source 39,115 94.2 17,064 98.0 22,051 90.4



Protected Dug Well 4,439 9.8 990 5.1 3,449 14.4

Public tap/stand pipe 3,531 7.9 1,098 5.9 2,433 9.9



Rainwater 250 0.6 46 0.2 204 0.9

Bottled/Mineral water 790 2.2 594 3.6 196 0.9


Unprotected Dug Well 990 2.2 123 0.6 867 3.8

Unprotected spring 1,098 2.2 110 0.5 988 3.9

Tanker truck 287 0.7 135 0.6 152 0.7

Surface water 225 0.5 50 0.2 175 0.7


Source of water for handwashing (n = 41,761)

Improved source 38,967 93.9 17,048 97.9 21,919 90.0



Protected Dug Well 4,615 10.2 1,081 5.5 3,534 14.8


Public tap/stand pipe 3,490 7.9 1,107 6.0 2,383 9.7


Rainwater 262 0.6 54 0.3 208 0.9

Bottled/Mineral water 71 0.2 45 0.3 26 0.1


Unprotected Dug Well 1,240 2.8 194 0.9 1,046 4.6

Unprotected spring 1,024 2.1 108 0.5 916 3.7

Tanker truck 199 0.5 95 0.4 104 0.5

Surface water 276 0.6 51 0.2 225 0.9


The type of water treatment prior to drinking is an additional determinant of household water

safety and protection from contaminants. At the national level, four (4) out of 10 households (41.8%)

did not practice any water treatment method. In both rural (18.0%) and urban areas (13.2%), boiling

water was the most common practice for water treatment. Filtration is the next most commonly used

method, with the use of improvised filters practiced by 6.7% of households in rural areas and 3.3% of

households in urban areas.

71




Table 43. Percent distribution of households by treatment modalities prior to drinking, by type of residence: Philippines, 2015

Treatment Modalities All Urban Rural

n % n % n %

No Treatment 18,306 41.8 5,477 30.3 12,829 52.7

Bottled/Mineral Water 11,825 32.2 7,824 47.6 4,001 17.6

Boil 6,422 15.6 2,222 13.2 4,200 18.0

Improvised filter 2,152 5.0 569 3.3 1,583 6.7

Use water filter 1,155 3.1 603 3.9 552 2.3

Let it settle 504 1.3 188 1.2 316 1.4

Add bleach/ chlorine 378 0.8 83 0.4 295 1.2

Solar disinfection 43 0.1 24 0.1 19 0.1

Waste disposal practices are important in preventing contamination of soil and water with solid

waste, biological waste, or other toxins. It is also a reflection of compliance with legislation on waste

segregation and environmental protection. Only 7.7% of households nationwide reported not having

toilets. One (1) out of 10 households in rural areas reported having no toilet facilities (11.7%), and the

same is true for about four (4) in 100 (3.5%) urban households. Majority of urban (93.9%) and rural

households owned water-sealed toilets (80.8%) (Table 44).

Moreover, majority of households (78.1%) reported having exclusive ownership of toilet

facilities. Up to 14.6% of urban and 11.8% of rural households shared their toilet facilities with other

households.

Waste segregation was practiced by only six (6) out of 10 households in urban (61.3%) and

rural areas (59.3%). With regard to garbage disposal, approximately 77% of urban households had their

garbage regularly collected, compared to 19.8% for rural households (p-value < 0.0000). In rural areas,

burning garbage was practiced by more than half (52.0%) of households, and about one-third (32.6%)

made use of composting. Dumping garbage was practiced by 25.0% of households in rural areas and

10.8% of households in urban areas.

Table 44. Percent distribution of households by sanitation facilities and waste disposal practices, by

type of residence: Philippines, 2015

Household Health and Sanitation All Urban Rural

n % n % n %

Type of toilet facility (n = 41,392)

No toilet 3,275 7.7 664 3.5 2,611 11.7

Water-sealed 35,794 87.2 16,190 93.9 19,604 80.8

Not water-sealed 2,323 5.1 429 2.6 1,894 7.5

Ownership of toilet facility (n = 38,117)

Exclusive 32,229 78.1 13,920 80.7 18,309 75.5

Shared with other households 5,413 13.1 2,503 14.6 2,910 11.8

Public use 475 1.1 196 1.2 279 1.1

Waste segregation (n = 41,543)

No 16,286 39.7 6,628 38.7 9,658 40.7

Yes 25,257 60.3 10,815 61.3 14,442 59.3

Method of garbage disposal (n = 41,972)*

Collect 17,425 47.9 12,893 76.9 4,532 19.8

Burn 16,244 34.8 3,414 16.7 12,830 52.3

Composting 10,136 20.3 1,698 7.6 8,438 32.6

Dumping 7,985 18.0 2,035 10.8 5,950 25.0

*multiple response question

72




4.4 Household Possession

Ownership of vehicles and household appliances and technology are descriptors of the

economic capacity of households, as well as their spending patterns.

In both urban and rural communities, more than one-third of households owned a motorcycle

or tricycle.

When it comes to gadgets, three-fourths (74%) of households nationwide owned a basic

cellphone capable of calling or texting. Similarly, three-fourths of households (74.8%) owned a

television set.

Ownership of landline telephones was 13.6% in urban areas and 1.8% in rural areas. Likewise,

ownership of electric generators manifested the lowest proportions in both urban (1.8%) and rural areas

(1.3%) (Table 45).

Table 45. Proportion of households by ownership of vehicles and appliances, by type of residence:

Philippines, 2015

Household Possession* All Urban Rural

n % n % n %

Ownership of vehicles

Bicycle/trisikad 38,190 21.9 15,949 27.8 22,241 16.3

Motorcycle/tricycle 38,768 34.2 16,114 34.7 22,654 33.7

Car/Jeep/Van 37,734 8.6 15,708 12.6 22,026 4.9

Tractor 37,409 1.4 15,437 0.9 21,972 1.9

Caritela 37,403 1.8 15,424 0.6 21,979 2.9

Motor Boat/Banca 37,376 3.7 15,407 1.8 21,969 5.6

Ownership of gadgets and appliances

Computer/Laptop/Tablet/PlayStation 38,457 26.7 16,243 38.6 22,214 15.0

Telephone (landline) 37,884 7.6 15,842 13.6 22,042 1.8

Basic Cellphone (Call & text) 40,386 74.0 16,914 76.9 23,472 71.3

Smartphone 39,028 44.2 16,510 57.3 22,518 31.3

Television 40,474 74.8 17,124 85.4 23,350 64.4

Radio/Cassette Recorder 39,120 44.0 16,397 48.6 22,723 39.5

VCD/DVD Player/Mini component/ karaoke 38,947 40.6 16,389 49.9 22,558 31.5

Camera/Video Camera 37,981 12.3 15,902 18.5 22,079 6.3

Refrigerator/Freezer 38,960 39.4 16,503 51.5 22,457 27.4

Stove/Range/Microwave Oven 38,601 36.8 16,366 53.0 22,235 20.7

Food processor/blender 38,101 15.9 16,007 23.8 22,094 8.3

Electric generator 37,668 1.5 15,679 1.8 21,989 1.3

Air Conditioner 37,943 10.5 15,904 16.9 22,039 4.2

Washing Machine/dryer 38,721 33.5 16,402 48.0 22,319 19.2

Electric Fan 40,154 70.6 17,059 86.5 23,095 54.8

Sewing Machine 37,797 7.3 15,774 9.9 22,023 4.8

Piano/organ 37,714 2.4 15,718 3.7 21,996 1.2

Wall clock 39,443 51.7 16,655 64.2 22,788 39.4

Sala Set/sofa 39,253 46.4 16,591 56.5 22,662 36.4

*multiple response question

73




4.5 Wealth Quintile

Wealth is considered a determinant of a household’s economic capacities, social mobility, and

ability to avail of basic health services. Nearly 60% of households belonged to the poor and poorest

wealth quintiles in rural areas while the same is true for 21.1% in urban areas. Nearly 60% of urban

households belonged to the rich and richest wealth quintiles (Table 46).

Table 46. Percent distribution of households by wealth quintile, by type of residence and region: Philippines, 2015

Variables

Wealth Quintile

Poorest Poor Middle Rich Richest

n % n % n % n % n %

Philippines 9,605 20.0 9,201 20.0 8,303 20.0 7,563 20.0 7,228 20.0

Type of residence

Rural 8,097 32.5 6,505 25.8 4,635 19.3 3,026 13.1 2,079 9.3

Urban 1,508 7.1 2,696 14.0 3,668 20.7 4,537 27.1 5,149 31.1

Regions

NCR 56 1.5 275 8.3 703 20.4 1,119 32.4 1,297 37.4

CAR 385 20.4 390 21.4 315 18.3 349 21.9 279 17.9

Ilocos Region 222 9.1 538 22.6 623 26.0 524 22.2 473 20.0

Cagayan Valley 308 13.1 574 24.6 555 23.9 493 21.6 381 16.8

Central Luzon 164 4.6 421 12.1 736 21.0 1,081 31.2 1,055 31.1

CALABARZON 296 6.3 603 13.4 947 21.5 1,183 27.7 1,308 31.1

MIMAROPA 387 29.4 304 22.8 267 20.2 194 14.9 165 12.7

Bicol Region 745 27.5 711 26.9 591 22.8 318 12.1 274 10.6

Western Visayas 931 29.2 850 26.6 619 19.5 438 13.9 329 10.7

Central Visayas 704 24.9 641 23.5 595 22.6 382 15.2 348 13.9

Eastern Visayas 741 29.6 762 30.7 495 20.1 231 9.5 237 10.0

Zamboanga Peninsula 705 39.7 425 24.2 268 15.5 203 11.9 146 8.7

Northern Mindanao 699 31.0 627 28.9 390 18.1 235 11.1 231 10.9

Davao Region 656 27.5 551 24.0 415 18.7 300 14.3 308 15.6

SOCCSKSARGEN 816 35.8 565 26.2 343 15.9 245 12.2 196 9.9

ARMM 1,135 70.4 387 19.2 125 6.0 56 3.0 31 1.5

Caraga 655 33.6 577 29.9 316 16.6 212 11.0 170 8.9

The region with the most households that fell under the poorest quintile was ARMM at 70.4%.

Other areas with high proportions of poorest households included Zamboanga Peninsula (39.7%),

SOCCSKARGEN (35.8%), Caraga (33.6%), and Northern Mindanao (31.0%). It was also noted that

more urbanized regions posted a higher percentage of households falling under the rich and richest

quintiles. Regions with more than 30% of households falling under the richest wealth quintile included

NCR (37.4%) and CALABARZON and Central Luzon (31.1%). The region with more than one-fourth

of households classified under the middle quintile was Ilocos Region (26.0%).

74




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76




6. APPENDICES

A. Sample Household Coverage

NCR

CAR

Iloco

s

Regio

n

Caga

yan

Valle

y

Cent

ral

Luzo

n

CALA

BA-

RZON

MIM

A-

ROPA

Bicol

Wes

tern

Visay

as

Cent

ral

Visay

as

Easte

rn

Visay

as

Zamb

oang

a

Penin

sula

North

ern

Mind

anao

Dava

oSO

CCSK

-

SARG

ENAR

MM

Carag

aTo

tal

Samp

le Ho

useh

olds

Comp

leted

(C)

65.9

78.1

83.2

87.7

82.6

83.0

81.7

87.8

89.3

76.2

83.0

77.2

91.6

75.5

79.9

63.8

84.6

80.1

Refu

sed

to Pa

rticip

ate (R

) 10

.73.7

2.41.1

2.83.5

1.71.6

1.12.8

1.50.9

0.53.6

1.91.0

1.43.0

No co

mpete

nt re

spon

dent

at ho

me (H

P)1.6

1.91.3

0.91.4

1.31.0

0.71.0

0.80.7

1.90.6

1.70.7

0.70.7

1.1

HH T

empo

rarily

out f

or an

exten

ded p

eriod

of tim

e (TO

)3.6

2.21.3

1.72.1

1.71.5

1.51.2

1.52.1

1.20.8

1.62.8

1.31.6

1.9

Dwell

ing U

nit D

estro

yed/

Demo

lished

(DUD

)3.4

0.71.0

1.11.6

1.92.4

2.42.4

3.62.6

5.71.6

2.82.8

1.03.7

2.4

Dwell

ing U

nit Va

cant

/Add

ress N

ot a

Dwell

ing U

nit (D

UV)

6.98.2

7.25.6

4.24.9

7.63.5

4.17.8

6.35.8

3.49.1

5.71.8

4.65.7

Dwell

ing N

ot Fo

und/

Cann

ot be

Loca

ted (D

NF)

4.74.6

2.91.8

4.83.0

3.22.2

0.86.8

3.55.7

1.24.8

4.88.6

2.73.9

Critic

al Ar

eas o

r Floo

ded A

reas (

CA)

0.00.1

0.30.0

0.00.0

0.50.0

0.00.0

0.01.1

0.00.2

0.721

.30.3

1.2

Othe

rs (O

)3.2

0.50.3

0.20.5

0.50.2

0.30.2

0.50.3

0.50.4

0.70.8

0.40.4

0.7

Total

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

Numb

er of

Samp

led Ho

useh

olds

5,355

2,244

2,898

2,655

4,238

5,273

1,638

3,063

3,560

3,511

2,996

2,268

2,384

2,965

2,754

2,732

2,281

52,81

5

Hous

ehold

Resp

onse

Rates

(HRR

)76

.286

.291

.094

.188

.189

.691

.293

.795

.786

.591

.487

.796

.786

.488

.166

.092

.887

.8

The H

RR is

calcu

lated

as:

C + R

+ HP +

TO +

DNF +

CA

C * 10

0__

____

____

____

____

____

____

Tabl

e A.1

Perc

ent d

istrib

utio

n of

hou

seho

lds b

y res

ults

of th

e hou

seho

ld in

terv

iews,

and

hous

ehol

d re

spon

se ra

tes,

acco

rdin

g to

regio

n (u

nweig

hted

): Ph

ilippi

nes,

2015

Cove

rage S

tatus

Regio

n

HRR

=

77




B. Estimates of Sampling Error13

Table B.1 List of selected variables for sampling errors: Philippines, 2015

Component/Variable Estimate Population No. of Replicate

Covered

ANTHROPOMETRY

0-60 months

Underweight Proportion All 0-60 months old children 4

Stunting Proportion All 0-60 months old children 4

Wasting Proportion All 0-60 months old children 4

Overweight-for-height Proportion All 0-60 months old children 4

61-120 months

Underweight Proportion All 61-120 months old children 4



Overweight/obese Proportion All 61-120 months old children 4

121-228 months



Overweight/obese Proportion All 121-228 months old children 4

20 years old & up

CED Proportion All 20 years old and above adults 4

Overweight Proportion All 20 years old and above adults 4

Obese Proportion All 20 years old and above adults 4

Overweight/Obese Proportion All 20 years old and above adults 4

Pregnant

Nutritionally at-risk Proportion All pregnant women 4

Lactating

CED Proportion All lactating mothers 4

overweight/obese Proportion All lactating mothers 4

Birth Weight

Low birth weight Proportion All 0-47 months old children 4

CLINICAL AND HEALTH

Current Alcohol Drinkers

10 - 19 y Proportion All 10 to 19 years old adolescents 1

20 y & above Proportion All 20 years old and above adults 1

Low Physical Activities Proportion All 20 years old and above adults 1

Current Smokers

10 - 19 y Proportion All 10 to 19 years old adolescents 1

20 y & above Proportion All 20 years old and above adults 1

Hypertension Proportion All 20 years old and above adults 4

DIETARY (Household)

Total Food Mean All sample households 1

Energy Mean All sample households 1

Protein Mean All sample households 1

Iron Mean All sample households 1

Calcium Mean All sample households 1

Vitamin A Mean All sample households 1

Vitamin C Mean All sample households 1

Thiamin Mean All sample households 1

Niacin Mean All sample households 1

13 (Philippine Statistics Authority (PSA), Philippines, and ICF International, 2014)

78




Component/Variable Estimate Population No. of Replicate

Covered

Riboflavin Mean All sample households 1

Fat Mean All sample households 1

Carbohydrates Mean All sample households 1

FOOD SECURITY

DDS Score Mean All sample households 4

Food Consumption Score - Poor Proportion All sample households 4

Food Consumption Score - Borderline Proportion All sample households 4

Food Consumption Score - Acceptable Proportion All sample households 4

GOVERNMENT PROGRAM PARTICIPATION

Household

4Ps Proportion All sample households 4

Individuals

Newborn Screening Proportion All 0-71 months old children 4

Vitamin A Supplementation Proportion All 0-71 months old children 4

Deworming Proportion All 0-71 months old children 4

Iron Supplements Proportion All 0-71 months old children 4

Deworming Participation Proportion All 0-71 months old children 4

Always Washing Hands Before Meal Proportion All 0-71 months old children 4

Always Washing Hands After Meal Proportion All 0-71 months old children 4

Always Washing Hands After Toilet Proportion All 0-71 months old children 4

Learned to brush teeth at home Proportion All 0-71 months old children 4

Visited a dentist Proportion All 0-71 months old children 4

Fully Immunized Child Proportion All 0-71 months old children 4

Deworming Participation Proportion All 6-12 years old children 4

Always Washing Hands Before Meal Proportion All 6-12 years old children 4

Always Washing Hands After Meal Proportion All 6-12 years old children 4

Always Washing Hands After Toilet Proportion All 6-12 years old children 4

Learned to brush teeth at home Proportion All 6-12 years old children 4

Visited a dentist Proportion All 6-12 years old children 4

Public school gardening Proportion All 6-12 years old children 4

MATERNAL HEALTH AND NUTRITION

Antenatal care Proportion All mothers with 0-36 months old children and currently pregnant women

4

Postnatal care Proportion All mothers with 0-36 months old children and currently pregnant women

4

Tetanus toxoid Proportion All mothers with 0-36 months old children and currently pregnant women

4

Ontime Antenatal care Proportion All mothers with 0-36 months old children and currently pregnant women

4

INFANT AND YOUNG CHILD FEEDING

Exclusive Breastfeeding, 0-5 months old

Proportion All 0 to 5 months old infants 4

Breastfeeding Initiation within 1 hour, 0-23 months old


Ever-Breastfeeding, 0-23 months old Proportion All 0 to 23 months old infants 4

Minimum Dietary Diversity, 6-23 months old


Minimum Meal Frequency, 6-23 months old


Minimum Acceptable Diet, 6-23 months old


79




Table B.2 Sampling errors: All Samples, Philippines 2015

Component/Variable Value

(R)

Standard Error (SE)

Number of

Cases (n)

Design Effect (DEFT)

Relative Error (SE/R)

Confidence Limits

R-2SE R+2SE

ANTHROPOMETRY

0-60 months

Underweight 0.216 0.004 17,186 1.142 0.017 0.209 0.223

Stunting 0.335 0.004 17,016 1.197 0.013 0.326 0.343

Wasting 0.071 0.002 17,023 1.082 0.030 0.067 0.075

Overweight-for-height 0.038 0.002 17,023 1.122 0.043 0.035 0.042

61-120 months

Underweight 0.312 0.004 20,171 1.206 0.013 0.304 0.319

Stunting 0.311 0.004 20,152 1.285 0.013 0.302 0.319

Wasting 0.084 0.002 20,150 1.078 0.025 0.080 0.088

Overweight/obese 0.086 0.002 20,150 1.225 0.028 0.081 0.091

121-228 months

Stunting 0.319 0.004 33,086 1.435 0.012 0.312 0.326

Wasting 0.125 0.002 33,082 1.248 0.018 0.120 0.130


20 years old & up

CED 0.103 0.001 82,821 1.199 0.012 0.100 0.105

Overweight 0.242 0.002 82,821 1.231 0.008 0.238 0.246

Obese 0.069 0.001 82,821 1.274 0.016 0.066 0.071

Overweight/Obese 0.299 0.002 82,821 1.371 0.007 0.295 0.303

Pregnant

Nutritionally at-risk 0.247 0.013 1,491 1.121 0.051 0.222 0.272

Lactating

CED 0.136 0.006 4,005 1.140 0.046 0.123 0.148


Birth Weight

Low birth weight (<2500 g) 0.144 0.004 8884 1.145 0.029 0.136 0.153

CLINICAL AND HEALTH

Current Alcohol Drinkers

10 - 19 y 0.055 0.003 9,255 1.211 0.055 0.049 0.061

20 y & above 0.233 0.004 21,954 1.373 0.017 0.226 0.241

Low Physical Activities 0.425 0.008 20,903 2.285 0.018 0.409 0.440

Current Smokers

10 - 19 y 0.149 0.005 9,226 1.318 0.034 0.139 0.160

20 y & above 0.449 0.006 21,871 1.756 0.013 0.437 0.460

Hypertension 0.239 0.002 88,976 1.534 0.009 0.235 0.243

DIETARY (Household)

Total Food (g) 3399.956 28.183 9,930 1.376 0.008 3343.590 3456.322

Energy (kcal) 7597.095 59.016 9,930 1.405 0.008 7479.062 7715.128

Iron (mg) 38.837 0.346 9,930 1.402 0.009 38.146 39.528

Calcium (g) 1.663 0.023 9,930 0.001 0.014 1.617 1.709

Protein (g) 231.051 1.804 9,930 1.329 0.008 227.443 234.658

Vitamin A (mcg RE) 1916.752 58.394 9,930 1.142 0.030 1799.965 2033.539

Ascorbic Acid (mg) 180.427 3.364 9,930 1.421 0.019 173.698 187.155

Thiamin (mg) 3.414 0.037 9,930 1.455 0.011 3.340 3.488

Riboflavin (mg) 2.939 0.032 9,930 1.296 0.011 2.875 3.004

Niacin (mg) 76.087 0.639 9,930 1.357 0.008 74.809 77.366

Carbohydrates (g) 1314.760 11.413 9,930 1.503 0.009 1291.934 1337.586

Fats (g) 155.792 2.221 9,930 1.522 0.014 151.350 160.235

80




FOOD SECURITY

DDS Score 9.352 0.023 40,893 2.412 0.002 9.306 9.399

Food Consumption Score - Poor 0.023 0.001 40,893 1.377 0.044 0.021 0.025

Food Consumption Score - Borderline 0.108 0.002 40,893 1.455 0.021 0.103 0.112

Food Consumption Score - Acceptable 0.869 0.003 40,893 1.656 0.003 0.864 0.875

GOVERNMENT PROGRAM PARTICIPATION Household

4Ps (among poorest households) 0.512 0.008 7,229 1.194 0.015 0.497 0.527

Individuals

Among 0-71 months

Newborn Screening 0.505 0.006 19,970 1.776 0.012 0.492 0.517

Vitamin A Supplementation 0.706 0.007 16,180 1.987 0.010 0.692 0.720

Deworming 0.581 0.006 14,584 1.507 0.011 0.569 0.594

Iron Supplements 0.172 0.004 15,142 1.395 0.025 0.163 0.180

Deworming Participation 0.894 0.003 28,131 1.786 0.004 0.888 0.901

Always Washing Hands Before Meal 0.678 0.005 28,000 1.716 0.007 0.669 0.688

Always Washing Hands After Meal 0.706 0.005 27,971 1.672 0.006 0.697 0.715

Always Washing Hands After Toilet 0.786 0.004 27,642 1.601 0.005 0.778 0.794

Learned to brush teeth at home 0.910 0.003 25,715 1.509 0.003 0.905 0.915

Visited a dentist 0.274 0.005 27,894 1.722 0.017 0.265 0.283

Fully Immunized Child 0.619 0.011 2,818 1.152 0.017 0.598 0.640

Among 6-12 years old

Deworming Participation 0.894 0.003 28,131 1.786 0.004 0.888 0.901

Always Washing Hands Before Meal 0.678 0.005 28,000 1.716 0.007 0.669 0.688

Always Washing Hands After Meal 0.706 0.005 27,971 1.672 0.006 0.697 0.715

Always Washing Hands After Toilet 0.786 0.004 27,642 1.601 0.005 0.778 0.794

Learned to brush teeth at home 0.910 0.003 25,715 1.509 0.003 0.905 0.915

Visited a dentist 0.274 0.005 27,894 1.722 0.017 0.265 0.283

Public school gardening 0.707 0.005 27,967 1.998 0.008 0.696 0.717

MATERNAL HEALTH AND NUTRITION

Antenatal Care

At least one (1) 0.953 0.003 8118 0.013 0.003 0.947 0.958

At least four (4) 0.758 0.006 6201 0.012 0.007 0.747 0.769

Postnatal Care

Within 4-24 hours after delivery 0.013 0.001 94 0.014 0.111 0.010 0.016

2 days after delivery 0.007 0.001 55 0.013 0.160 0.005 0.010

More than 2 days after delivery 0.022 0.002 170 0.012 0.090 0.019 0.027

Tetanus Toxoid 0.763 0.006 6251 0.013 0.008 0.751 0.776 Ontime Antenatal Care 0.695 0.006 5522 0.012 0.009 0.683 0.707

INFANT AND YOUNG CHILD FEEDING

Exclusive Breastfeeding, 0-5 months old 0.488 0.014 1,377 1.095 0.029 0.461 0.516

Breastfeeding Initiation within 1 hour, 0-23 months old

0.651 0.008 5,475 1.206 0.012 0.636 0.666

Ever-Breastfeeding, 0-23 months old 0.931 0.004 5,846 1.183 0.004 0.923 0.938

Minimum Dietary Diversity, 6-23 months old 0.292 0.008 4,765 1.185 0.027 0.276 0.307

Minimum Meal Frequency, 6-23 months old 0.917 0.004 4,732 1.080 0.005 0.908 0.925

Minimum Acceptable Diet, 6-23 months old 0.186 0.006 4,732 1.110 0.033 0.174 0.198

81




C. Profile of Sample Population by Response Status, Age, Sex, Type of Residence and

Wealth Quintile

C.1. Response and non-response rates by age group, physiologic group and sex: Philippines 2015

Variable/Disaggregation Response Non-Response Difference

n % n % p-value

All 161577 89.1 19807 10.9

0-60 months (0-5.0 years old) 17,202 92.3 1439 7.7

Male 8,880 51.6 759 52.7 0.5523

Female 8,322 48.4 680 47.3 0.5731

61-120 months (5.08-10.0 years old) 20,173 92.2 1707 7.8

Male 10,337 51.2 881 51.6 0.8333

Female 9,836 48.8 826 48.4 0.8384

10.08-19.9years old 35,206 82.4 7,511 17.6

Male 18,346 52.1 3,875 51.6 0.5565

Female 16,860 47.9 3,636 48.4 0.5696

20.0-59.9 years old 66,880 90.9 6667 9.1

20.0-29.9 years old 16,556 81.9 3,649 18.1

Male 9,293 56.1 2,041 55.9 0.8706

Female 7,263 43.9 1,608 44.1 0.8851

30.0-39.9 years old 15,631 93.0 1,170 7.0

Male 7,943 50.8 641 54.8 0.0530

Female 7,688 49.2 529 45.2 0.0772

40.0-49.9 years old 18,300 95.2 918 4.8

Male 8,830 48.3 492 53.6 0.0210

Female 9,470 51.7 426 46.4 0.0309

50.0-59.9 years old 16,393 94.6 930 5.4

Male 7,563 46.1 440 47.3 0.6304

Female 8,830 53.9 490 52.7 0.6112

60.0 years old and above 16,613 88.0 2261 12.0

60.0-69.9 years old 10,375 91.9 919 8.1

Male 4,672 45.0 433 47.1 0.4043

Female 5,703 55.0 486 52.9 0.3753

70.0 years old and above 6,238 82.3 1,342 17.7

Male 2,399 38.5 503 37.5 0.6821

Female 3,839 61.5 839 62.5 0.5981

Pregnant 1,493 94.2 92 5.8

Lactating 4,010 96.9 130 3.1

82




C.2 Response and non-response rates by age group, physiologic group and type of residence: Philippines 2015


n % n % p-value

All 161577 89.1 19807 10.9

0-60 months (0-5.0 years old) 17,202 92.3 1439 7.7

Rural 10329 60.0 882 61.3 0.4677

Urban 6873 40.0 557 38.7 0.5631

61-120 months (5.08-10.0 years old) 20,173 92.2 1707 7.8

Rural 12573 62.3 1058 62.0 0.8236

Urban 7600 37.7 649 38.0 0.8615

10.08-19.9 years old 35,206 82.4 7,511 17.6

Rural 20,904 59.4 4,761 63.4 0.0000

Urban 14,302 40.6 2,750 36.6 0.0001

20.0-59.9 years old 66,880 90.9 6667 9.1

20.0-29.9 years old 16,556 81.9 3,649 18.1

Rural 8,555 51.7 2,055 56.3 0.0002

Urban 8,001 48.3 1,594 43.7 0.0007

30.0-39.9 years old 15,631 93.0 1,170 7.0

Rural 8,864 56.7 576 49.2 0.0005

Urban 6,767 43.3 594 50.8 0.0004

40.0-49.9 years old 18,300 95.2 918 4.8

Rural 10,764 58.8 444 48.4 0.0000

Urban 7,536 41.2 474 51.6 0.0000

50.0-59.9 years old 16,393 94.6 930 5.4

Rural 9,463 57.7 454 48.8 0.0002

Urban 6,930 42.3 476 51.2 0.0001


60.0-69.9 years old 10,375 91.9 919 8.1

Rural 5,867 56.5 436 47.4 0.0002

Urban 4,508 43.5 483 52.6 0.0001


Rural 3,764 60.3 822 61.3 0.6280

Urban 2,474 39.7 520 38.7 0.6990

Pregnant 1,493 94.2 92 5.8

Rural 909 60.9 57 62.0 0.8721

Urban 584 39.1 35 38.0 0.8995

Lactating 4,010 96.9 130 3.1

Rural 2585 64.5 90 69.2 0.3525

Urban 1425 35.5 40 30.8 0.5341

83




C.3. Response and non-response rates by age group, physiologic group and wealth quintile: Philippines 2015


n % n % p-value

All 161577 89.1 19807 10.9

0-60 months (0-5.0 years old) 17,202 92.3 1439 7.7

Poorest 4,831 28.3 485 34.4 0.0046

Poor 4,030 23.6 289 20.5 0.2292

Middle 3,332 19.5 184 13.1 0.0302

Rich 2,708 15.9 210 14.9 0.7128

Richest 2,167 12.7 241 17.1 0.0546

61-120 months (5.08-10.0 years old) 20,173 92.2 1707 7.8

Poorest 5,937 29.7 675 40.3 0.0000

Poor 4,928 24.6 320 19.1 0.0251

Middle 3,697 18.5 236 14.1 0.0895

Rich 2,985 14.9 191 11.4 0.1823

Richest 2,467 12.3 255 15.2 0.1871

10.08-19.9 years old 35,206 82.4 7,511 17.6

Poorest 8,064 23.1 2,365 31.9 0.0000

Poor 8,334 23.9 1,448 19.6 0.0003

Middle 7,283 20.9 1,250 16.9 0.0012

Rich 6,069 17.4 1065 14.4 0.0161

Richest 5,170 14.8 1,277 17.2 0.0300

20.0-59.9 years old 66,880 90.9 6667 9.1

20.0-29.9 years old 16,556 81.9 3,649 18.1

Poorest 2,706 16.5 696 19.4 0.0652

Poor 3,239 19.7 742 20.7 0.5437

Middle 3,517 21.4 658 18.4 0.0773

Rich 3,500 21.3 685 19.1 0.1967

Richest 3,447 21.0 799 22.3 0.4142

30.0-39.9 years old 15,631 93.0 1,170 7.0

Poorest 3,351 21.6 223 19.9 0.5352

Poor 3,389 21.9 219 19.5 0.4111

Middle 3,072 19.8 213 19.0 0.7626

Rich 2,907 18.8 205 18.3 0.8592

Richest 2,781 17.9 263 23.4 0.0285

40.0-49.9 years old 18,300 95.2 918 4.8

Poorest 3,798 20.9 187 21.2 0.9161

Poor 3,959 21.8 158 17.9 0.2483

Middle 3,836 21.1 143 16.2 0.1588

Rich 3,385 18.6 175 19.9 0.6835

Richest 3,190 17.6 218 24.7 0.0076

50.0-59.9 years old 16,393 94.6 930 5.4

Poorest 3,012 18.5 169 19.1 0.8375

Poor 3,476 21.4 153 17.3 0.2322

Middle 3,358 20.6 140 15.9 0.1694

Rich 3,130 19.2 175 19.8 0.8487

Richest 3,297 20.3 246 27.9 0.0046

84




Cont. C.3. Response and non-response rates by age group, physiologic group and wealth quintile: Philippines 2015


n % n % p-value


60.0-69.9 years old 10,375 91.9 919 8.1

Poorest 1,900 18.4 134 15.1 0.3403

Poor 2,084 20.2 167 18.9 0.6765

Middle 2,119 20.6 169 19.1 0.6509

Rich 2,028 19.7 175 19.8 0.9741

Richest 2,178 21.1 240 27.1 0.0327


Poorest 1,329 21.5 224 17.1 0.1327

Poor 1,298 21.0 298 22.7 0.5114

Middle 1,213 19.6 275 20.9 0.6127

Rich 1,134 18.3 238 18.1 0.944

Richest 1,216 19.6 278 21.2 0.565

Pregnant 1,493 94.2 92 5.8

Poorest 385 25.9 21 23.6 0.8148

Poor 373 25.1 23 25.8 0.9351

Middle 312 21.0 13 14.6 0.5785

Rich 243 16.3 19 21.3 0.5731

Richest 174 11.7 13 14.6 0.7550

Lactating 4,010 96.9 130 3.1

Poorest 1,285 32.2 42 33.6 0.8526

Poor 1,040 26.1 35 28.0 0.8005

Middle 752 18.9 12 9.6 0.4143

Rich 547 13.7 18 14.4 0.9346

Richest 362 9.1 18 14.4 0.4490

85




D. Ethical Clearance

86




E. PSA Approval

87




88




89




90




91




F. Informed Consent Forms

92




93




94




95




96




G. Interview Guides - Household Membership and Information

97




98




99




100




101




102




103




104




H. Regional DOST Officials

DOST-NCR Dr. TERESITA C. FORTUNA Regional Director Department of Science and Technology National Capital Region (NCR) DOST-NCR Building, DOST Compound, Gen. Santos Ave., Bicutan, Taguig City DOST Trunk Line : (02) 837 2071 to 82 Local 2017 Telephone number/s: (02) 837 3162/ 519 8702 Fax number: (02) 837 3162 Email address: [email protected]; [email protected];[email protected] Website address: http://ncr.dost.gov.ph DOST-CAR Dr. JULIUS CAESAR V. SICAT Regional Director Department of Science and Technology Regional Office Cordillera Administrative Region (CAR) Km. 6, La Trinidad, Benguet 2601 Telephone number/s: (074) 422-0981; 422-2214; 422-0979 (Technical) Fax number: (074) 422-2214 Email address: [email protected]; [email protected] Website address: http://car.dost.gov.ph DOST- I Dr. ARMANDO Q. GANAL Acting Regional Director Department of Science and Technology Regional Office No. I DMMMSU-MLU Campus, Catbangen, San Fernando City, La Union Telephone number/s: (072) 700 2372/888 3399 Fax number: (072) 700 2372/888 3399 Email address: [email protected]; [email protected];[email protected] Website address: http://region1.dost.gov.ph DOST-II Dr. URDUJAH A. TEJADA Regional Director Department of Science and Technology Regional Office No. II Regional Government Center, Carig Sur, Tuguegarao City, Cagayan Telephone number/s: (078) 846 7241 / 304-8654 Fax number: (078) 304-8654 Email address: [email protected] Website address: http://region2.dost.gov.ph DOST-III Dr. VICTOR B. MARIANO Regional Director Department of Science and Technology Regional Office III Diosdado Macapagal Government Center, Maimpis, City of San Fernando, Pampanga 2000 Telephone number/s: (045) 455-0800 / 861-3730 / 861-3731 Fax number: (045) 455-0800 Email address: [email protected];[email protected]; Website address: http://region3.dost.gov.ph

105




DOST- CALABARZON Dr. ALEXANDER R. MADRIGAL Regional Director Department of Science and Technology Regional Office No. IV-A (CALABARZON) Regional Science and Technology Center, Jamboree Road, Barangay Timugan, Los Baños Laguna 4030 Telephone number/s: (049) 536 4997 Fax number: (049) 536 4997 Email address: [email protected]; [email protected] Website address: http://www.region4a.dost.gov.ph DOST IV– MIMAROPA Dr. MA. JOSEFINA P. ABILAY Regional Director Department of Science and Technology Regional Office No. IV-B (MIMAROPA) 2nd Floor Imelda Building, DOST Compound, General Santos Avenue, Bicutan, Taguig City DOST Trunk Line : (02) 837 2071 to 82 Local 2093 Telephone number/s: (02) 837 3755 Fax number: (02) 837 3755 Email address: [email protected]; [email protected]; [email protected] Website address: http://www.region4b.dost.gov.ph DOST-V Dir. TOMAS B. BRIÑAS Regional Director Department of Science and Technology Regional Office No. V Regional Center Site, Rawis, Legazpi City 4500 Telephone number/s: (052) 820-5385 Fax number: (052) 820-5039 Email address: [email protected];[email protected]; [email protected] Website address: http://region5.dost.gov.ph DOST-VI Engr. ROWEN R. GELONGA Regional Director Department of Science and Technology Regional Office No. Vl Magsaysay Village, Lapaz, lloilo City Telephone number/s: (033)320 0908/ 508 5739 Fax number: (033) 320 0908 Email address: [email protected]; [email protected]; [email protected] Website address: http://region6.dost.gov.ph DOST-VII Engr. EDILBERTO L. PARADELA Regional Director Department of Science and Technology Regional Office No. VII The S&T Complex, Sudlon, Lahug, Cebu City 6000 Telephone number/s: (032) 254 8269/418 9032 Fax number: (032) 418 9032/254 8269 Email address: [email protected]; [email protected] Website address: http://www.ro7.dost.gov.ph

106




DOST-VIII Engr. EDGARDO M. ESPERANCILLA Regional Director Department of Science and Technology Regional Office No. VIII Government Center, Candahug, Palo, Leyte Telephone number/s: (053) 323 6356/323 7066 Fax number: (053) 323 7110/323 7111/323 6036 Email address: [email protected] Website address: http://region8.dost.gov.ph DOST-IX Dir. BRENDA L. NAZARETH-MANZANO Regional Director Department of Science and Technology Regional Office No. IX Pettit Barracks Zamboanga City 7000 Telephone number/s: (062) 992-1114 / 991-1024 Fax number: (062) 992-1114 Email address: [email protected]; [email protected] Website address: http://region9.dost.gov.ph DOST-X Dir. ALFONSO P. ALAMBAN Regional Director Department of Science and Technology Regional Office No. X J.R. Borja Memorial Hospital Compound Carmen, Cagayan de Oro City Telephone number/s: (088) 858-39-31 / 858-39-33 Fax number: (088) 858-39-31 Email address: [email protected]; [email protected] Website address: http://region10.dost.gov.ph DOST-XI Dr. ANTHONY C. SALES Regional Director Department of Science and Technology Regional Office No. XI corner Friendship and Dumanlas Roads, Bajada, Davao City Trunkline: (082) 227-1313 Telephone number/s: (082) 221-5295 / 227-5672 / 221-5971 (Technical) Fax number: (082) 221 5295 Email address: [email protected]; [email protected] Website address: http://region11.dost.gov.ph DOST-XII Dr. ZENAIDA P. HADJI RAOF-LAIDAN Regional Director Department of Science and Technology Regional Office No. XII ORG Compound, Cotabato City 9600 Telephone number/s: (064) 421 2712/421 6908 Fax number: (064) 421 2711/ 421 1586 Email address: [email protected] Website address: http://region12.dost.gov.ph

107 Food and Nutrition Research Institute



DOST-ARMM Sec. MYRA M. ALIH Regional Secretary LTP Complex, Cotabato City Telephone number/s: (064) 421-8183; 552-0263 Email address: [email protected] DOST- CARAGA Dir. DOMINGA D. MALLONGA Regional Director Department of Science and Technology Regional Office No. XIII (Caraga) Caraga State University Campus, Ampayon, Butuan City Telephone number/s: (085) 3425684/3429053 Fax number: (085) 3425684 Email address: [email protected] Website address: http://caraga.dost.gov.ph

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I. NNC Regional Officials NNC-NCR MILAGROS ELISA V. FEDERIZO Nutrition Program Coordinator Room 113 & 114, Building No. 2 Center for Health Development Metro Manila Welfareville Compound, Mandaluyong City Telefax: (+63 2) 533-2713 Email: [email protected] NNC-CAR RITA D. PAPEY Nutrition Program Coordinator DA Mutipurpose Bldg., Dairy Farm Compound Sto. Tomas Road, Baguio City Telefax: (+63 74) 447-0892 Email: [email protected] NNC-I MARIA EILEEN B. BLANCO Nutrition Program Coordinator DOH - Center for Health Development Parian, San Fernando City, La Union Telefax: (+63 72) 607-6594 Email: [email protected] NNC-II RHODORA G. MAESTRE Nutrition Program Coordinator 2nd Flr. Commission on Population Bldg. Bagay Road San Gabriel Village, Tuguegarao City Tel. No: (+63 78) 846-1353 Email: [email protected] NNC-III FLORINDA V. PANLILIO Nutrition Program Coordinator DOH-CHD3, Regional Government Center Barangay Maimpis, City of San Fernando, Pampanga Telefax: (+63 45) 961-2950 Email: [email protected] NNC-CALABARZON CARINA Z. SANTIAGO Nutrition Program Coordinator Generic Hall, Center for Health Development IV-A Quirino Memorial Medical Center Project 4, Quezon City Telefax: (+63 2) 440 - 3511 Email: [email protected]

http://www.nnc.gov.ph/component/contact/91-regional-nutrition-program-coordinators-rnpc/14-milagros-elisa-v-federizo

http://www.nnc.gov.ph/component/contact/91-regional-nutrition-program-coordinators-rnpc/10-rhodora-g-maestre

http://www.nnc.gov.ph/about-nnc/contact-us

http://www.nnc.gov.ph/component/contact/192-nnc-divisions-and-regional-offices-contacts/49-national-nutrition-council-region-viii

mailto:[email protected]




NNC-MIMAROPA CARINA Z. SANTIAGO Officer-In-Charge Generic Hall, Center for Health Development IV-A Quirino Memorial Medical Center Project 4, Quezon City Telefax: (+63 2) 421-2088 Email: [email protected] NNC-V ARLENE R. REARIO Nutrition Program Coordinator DOH - Center for Health Development Bagtang, Daraga, Albay Telefax: (63 52) 483-4358 Email: [email protected] NNC-VI NONA B. TAD-Y Nutrition Program Coordinator Iloilo Provincial Library Luna St. La Paz, Iloilo City Telefax: (63 33) 320-0260 Email: [email protected] NNC-VII PAROLITA A. MISSION Nutrition Program Coordinator DOH - Center for Health Development Osmena Boulevard, Cebu City Tel. No: (63 32) 254-3263 / 418-7182 [email protected] NNC-VIII CATALINO DOTOLLO JR. Nutrition Program Coordinator Popcom Compound, Government Center Candahug, Palo, Leyte Tel. No: (+63 53) 323-3646 / 524-9421 Email: [email protected] NNC-IX MA. DEL PILAR PAMELA R. TARROZA Nutrition Program Coordinator DOH - Center for Health Development Upper Cabatangan, Zamboanga City Telefax: (+63 62) 955-4657 Email: [email protected] NNC-X MARISSA DM NAVALES Nutrition Program Coordinator DOH - Center for Health Development Villarin St. Carmen, Cagayan De Oro City Telefax: (+63 88) 856-8700 Email: [email protected]

http://www.nnc.gov.ph/component/contact/192-nnc-divisions-and-regional-offices-contacts/49-national-nutrition-council-region-viii


http://www.nnc.gov.ph/component/contact/91-regional-nutrition-program-coordinators-rnpc/15-arlene-r-reario


http://www.nnc.gov.ph/component/contact/91-regional-nutrition-program-coordinators-rnpc/16-nona-b-tad-y


http://www.nnc.gov.ph/component/contact/91-regional-nutrition-program-coordinators-rnpc/17-parolita-a-mission


http://www.nnc.gov.ph/component/contact/91-regional-nutrition-program-coordinators-rnpc/19-ma-del-pilar-pamela-r-tarroza

http://www.nnc.gov.ph/about-nnc/contact-us

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NNC-XI MARIA TERESA L. UNGSON Nutrition Program Coordinator 2nd Floor, MHDO Building DOH Compound Bajada, Davao City Telefax: (63 82) 300-7269 Email: [email protected] NNC-XII ARCELI M. LATONIO Nutrition Program Coordinator 1st. Door, 2nd Floor Ong Building, Corner Aquino-Osmena St. Koronadal City Telefax: (+63 83) 228-1715 Email: [email protected] NNC-ARMM DR. KADIL M. SINOLINDING, JR., DPBO Regional Secretary of Health, DOH-ARMM & OIC NNC-ARMM Department of Health Gov. Gutierrez Avenue, ORG Compound, Cotabato City Telefax: (+63 64) 421-6842 / 421-7703 / 421-6510 Email: [email protected] NNC-CARAGA MINERVA P. MOLON, MD, MPH FFPA Director, CHD for CARAGA and OIC, NNC-CARAGA Department of Health Pizzaro St., Corner Narra Road, Butuan City Tel. No: (+63 85) 225-2970 Fax No: (63 85)815-5502 Email: [email protected]

http://www.nnc.gov.ph/component/contact/91-regional-nutrition-program-coordinators-rnpc/21-maria-teresa-l-ungson

http://www.nnc.gov.ph/component/contact/91-regional-nutrition-program-coordinators-rnpc/22-arceli-m-latonio




J. Organization and Team Composition

TEAM I

Team Coordinator: Marina B. Vargas

Assistant Coordinator: Rona C. Vito

Jacqueline E. Gurtiza

Team Leaders: Chriseldy S. America Gerald C. De Guzman

Arcelyn Arahan Jay S. Paniterce

Kathleine L. Balasan Andrea Claudine L. Porciuncula

Michael A. Barandino Anna Teresita S. Reginaldo

Aicel C. Barrida Anna Paulina B. Sabularse

Janina Krishna D. Cabello Alpha Amor O. Saguban

Katrina Mae R. Camba Anniezza Marie H. Santiago

Joanalyn E. Condes Mari Khrisna D. Socito

Rogelio C. Eijansantos Jenny Lyn V. Suarez

Riza B. Esmeralda Rhenalyn V. Templo

Anthropometric Researchers: Jeramie M. Alabado Joseph Emmanuel E. Laylo

Reinna Joy M. Alpas Samantha Grace L. Magadia

Retchil A. Amper John Gideon C. Maglaya

Marjhen G. Avila Maricel A. Manrique

Benny Baybay Ana Kris O. Matullano

Janine Ruth S. Barrozo Charlene B. Onas

Catherine B. Bornales Rosana C. Paccial

Loida M. Bumindang Ma. Isabel L. Palos

Rhea M. Busongan Arnolette T. Patnaan

Maryann D. Calabio Efrelee M. Paz

Claudette M. Carlos Lorelane C. Ramirez

Quennnie U. Catapang Ellen May Q. Requiz

Mary Emerose E. Clarin Ernanie M. Rillera Jr.

Abigail Davillo Diana Dawn Z. Roque

Donna P. Dial George T. Saavedra III

Amber N. Dumanas Tyzine T. Sagayo

Crisanto N. Floriano III Cherry Mae L. Salinas

Aiza S. Getalla Neilfred T. Sumampat

Charlene A. Horcasitas Josephine M. Sibul

Krisna K. Kingking Lona May P. Quirino

Dietary Researchers: Hannah May Aragona Rhegy Lucena

Nuriza Camlian Rina Joy E. Mercado

Daryl Joy Devarbo Samantha Angeline Quindor

Melissa Laze C. Fabella Shelly Jane S. Ramos

Evangelyn Firmante Mariz Crizttle R. Rapanut

Mary Joy M. Menorca Jemery V. Tarin

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TEAM II

Team Coordinator: Ma. Lilibeth P. Dasco

Assistant Coordinator: Ma. Belina N. Nueva España

Taharudin B. Rachman

Team Leaders: Eden S. Abad Ana Maria B. Francisco

Alden G. Acedera Jennifer D. Gabriel

Agnes M. Aguilar Jannet O. Gutierez

Cyrene Joy S. Balonzo Mary Rose S. Mondala

Marife L. Baluyot Alysya Marie D. Pedraza

Laarni F. Bueno Abigail V. Quilatan

Mariz A. Cahayag Erwin Y. Salen

Rachelle G. Dela Cruz Christian Allan L. Sanvictores

Ronel Jay V. Ditching Elida Rose G. Supan

Edna R. Divina Virmie R. Valdez

Anthropometric Researchers: Ceelene Elyza D. Abler Darlyn F. Fermin

Kristine Isabel G. Año Jane M. Fernandez

Elshamarden M. Astarani Mark Alexis A. Francisco

Francis Rainer B. Atanacio Cheyenne Louise S. Godoy

Marilou G. Avila Janneah C. Kasid

Regine B. Badting Jackie Glorianne T. Libot

Jennybel B. Baldeo Noime M. Loable

Arrah June E. Baybay Maverick Mitchell M. Lopez

Hana Marie A. Belmontes Junnalyn L. Mamites

Althea Joy L. Benitez Rhonaleen F. Natividad

Debbie L. Bernadez Jelennie G. Olaño

Happie C. Capapas Trishia May A. Olario

Czarinna Mae V. Casimina George Michael A. Pimentel

Stephanie C. Catalogo Abegail O. Presto

Carlo R. Dadis Eliza V. Sikandal

Romulo F. Dimaala Jr. Cherradee O. Simondac

Jeeka M. Domingo Sherwin P. Sollano

Donna Grace R. Dominguez Rochele John B. Tagalogon

Michael V. Enerlan Krizza Kara B. Villamil

Mary Am S. Eraña Matthew M. Wang

Dietary Researchers: Sammilou P. Alejo Sitti Nadzra B. Alpha

Aziza Alimah M. Tan Crystle F. Coronel

Princess Jean M. Algones Liezel P. Bagsican

Josephine F. Lianko Jarmaida T. Alfad

Amira E. Jacob Cecil T. Ca-Ang

Nelly Rose L. Pablo Jihada Jaafar

May Ann N. Angeles Analyn W. Nanong

Muslima S. Masibpal Nur-Aisa T.Iraji

Hazelle M. Limare Raiza T. Ibrahim

Maria Belinda D. Miguel




TEAM III

Team Coordinator: Mildred O. Guirindola

Assistant Coordinator: Ma. Erlinda R. Tarrayo

Sheila Luz M. Punzalan

Team Leaders: Marites Ambayec Rebecca T. Masil

Nilo S. Canlas Robi Mae Mirador

Sarah Devanadera Rona S. Molina

Kimberly V. Dorig Maria Kathlynn M. Nolledo

Rose Ariane Gay C. Fajerga May Jane D. Patnaan

Matchelle I. Gannaban Ellaine O. Policarpio

Keren Faye M. Gaya Amparo D. Rivero

Hannah Leizl G. Kadile Caryl Denn Sayson

Rochelle Lloys B. Manansala Catherine J. Silvestre

Ruby C. Mangumpit Ma. Cristina L. Velez

Anthropometric Researchers: Yvette B. Abance Dalton O. Gonzaga

Tifanny Blanca Abellera Devina Jose

Mary Ann Agana Teresita K. Juantala

Zharina A. Agwilang Dianne Leticia A. Lambito

Almilyn Ahmad Mary Christine P. Ladia

Analiza D. Alejandro Sharme B. Malangay

Victoria T. Ampaguey Lourdine Joyce T. Masing

Olivia Baggas Catherine Nisperos

Fely Grace Calabias Miriam J. Paglinawan

Bernaline G. Calay Marsita Gracia Palermo

Sweet Rose B. Casipong Marina B. Palos

Maria Liza R. Compra Noelle P. Penueco

Rona Irina Delima Raymond I. Perez

Annievil Del Pilar Mary Ann Pertudo

Raneza D. Deoccampo Ann Gladys Retuya

Casandra Eparwa Mislyn G. Rimando

Jenelyn B. Espara Karen L. Rosalejos

Mary Ann Espina Evangelii Tolentino

Eroe Evangelista Janelle Anne C. Vinoya

Ronilie Ann E. Ferrer

Dietary Researchers: Khadija K. Abdulmandangan Abby Rose Flores

Sitti Hyfha-Neza A. Alsad Marites Naranja

Norness J. Arasid Ariane Rose Morales

Princess Baltoro Mary Emerene Pingol

Roxanne T. Delos Reyes Sahilyn T. Rivera

Karen L. Diaz Jan Abigail Sablon

Anginette R. Espiritusanto

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TEAM IV

Team Coordinator: Chona F. Patalen

Assistant Coordinator: Zenaida S. Isada

Ma.Karyn B. Vallejo

Team Leaders: Kathrina N. Almenie Melody H. Lamangen

Ara Sr. Bea Michelle P. Llabres

Analyn K. Caga Julie Anne D. Lusabia

Flor Jane M. Cagata Junnalyn L. Mamites

Rhea C. Crisostomo Emraida A. Mamalumpon

Harold King R. Combalicer Gracelyn B. Mathew

Paula Joy C. Escanilla Daisy Gail M. Paniterce

Reina B. Esmeralda Mark Christan C. Taguiam

Kirby Mae A. Fajanela Fely Marie Insel P. Veraque

Hannael M. Famorcan Narzarima A. Zuñiga

Sarah E. Guinto

Anthropometric Researchers: Marnellie S. Abanilla Rhea A. Lingbanan

Mary Grace E. Adolfo Glady May S. Loquillano

Krys S. Delos Santos Bernadette U. Mabalot

Mischelle Deloria Shirnyl Dorothy E. Magos

Kathleen Ruth Terese P. Dolores

Neil S. Magtasa

Danivic E. Domdom Archie Mar C. Martinez

Danica J V. Duran Jomar John T. Molina

Honey-Lyn J. Estelles Diana P. Monje

Christine P. France Katraine Rose P. Moro

Gwyn Mhar N. Fulgar Caryl S. Nocete

Aureen Precious F. Fulmaran

Jelennie G. Olaño

Rona Mae K. Gabuya Ma. Pamela Grace P. Padrones

Romnick J. Gallofin Chrissie Anne S.J. Reyes

Kristoffer A. Gavasan Sayda C. Ridao

Ann Francis R. Genove Aimee O. Rubia

Jailyn B. Gepana Aprille C. Sayucop

Darlene A. Gio Diana Z. Sicat

Margielyn B. Icao Ella Jane C. Sipalay

Ma. Fatima Shariena N. Imperio

James Andrei Justin P. Sy

Sarah Mae S. Inoferio Catherine Rose B. Tarculas

Khristine Camille G. Javier Czarina Anne A. Villareiz

Chuhima L. Julkipli

Dietary Researchers: Francis Vincent S. Badiang Sherlyn B. Junaid

Florito Y. Beduya II Aileen Laurentino

Giselle Rose A. Bernal Genile Roselle C. Pasumbal

Ana Gazel T. Carranza Vladimir E. Piñon

Chanice Mariane H. Dimasuay

Jenica Raina L. Rosales

Lea Jenica T. Fariolen Muslima K. Salasim

Yangmahar A. Jalilul Jeraldine M. Zapanta




TEAM V

Team Coordinator: Cristina G. Malabad

Assistant Coordinator: Juamina Belen T. Quioge

Agape Paula D. Apolinar

Team Leaders: Abbey Gail Bacay Rod Paulo Lorenzo

Lelian Bago Jobelle Mendoza

George Bura-ay Joana Lei Montorio

Kristine Antonette Caranay Polly Morales, Jr.

Alice Grace Casaba Diwata Nunag

Rica Paula Domingo Odessa Panliboton

Ces Marie Esmeralda Andressa Fae Ranchez

Trifena Gantas Mary Anne Ramirez

Gemmaly Galeon Ricky Reovoca

Juliet Julia Ma. Josylle Ruelo

Anthropometric Researchers: Agnes A. Abelinde Krista Nea G. Fernandez

Heva S. Amil Kaycee N. Floriano

Stephany Jane G. Angeles Daisy D. Francisco

Bienvenido E. Ander Maribeth G. Gabilo

Kris L. Ba-a Robert Dan P. Guerrero

Arvin J. Bayaca Kristel Mae C. Martin

Sayatul A. Berto Merjurie S. Miparanum

Martino A. Biluan Lemuel Navea

Nica Mariel Borja Vhal John P. Oblego

Christia Jesusa C. Buera Julie Mie S. Pacquiao

Alma C. Buldec Reyk Javik S. Pagdanganan

Marzerie C. Cabusao Sarah May R. Pascual

Gabriela Victoria P. Cayaban Mae Pearl P. Patricio

Prescila C. Calis James Erriksan Deminica DN. Ramos

Mary Kristal Helen A. Cajalne Celistine L. Rongavilla

Macey Kate Celestial Farisha D. Sakuddin

Zennie K. Caplis Clara Cecille V. Sison

Katherine Anne L. De Castro Mary Rose C. Soriano

Chariza Fe V. De Vera Cristin V. Talamante

Madilyn E. Escobal Lovelia Taguiam

Dennis B. Estepa Leo Mark P. Tampoco

Dietary Researchers: Nuricel K. Akmad Elvina Mae C. Gargaceran

Raiza J. Bakil Nursana A. Muharram

Rubilyn D. Balisalisa Liezel O. Olivar

Charity D. Balucas Axle Rose A. Patalinghug

Kesia D. Carmona Steffany Jim Q. Perez

Andren D. Detoya Jenna Delos B. Santos

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TEAM VI

Team Coordinator: Marlon O. Balitaon

Assistant Coordinator: Crisanta M. delos Reyes

Charina A. Javier

Team Leaders: Rose Ann C. Algura Ressielyn B. Javier

Melisa B. Allosada Joanne M. Martinez

Sheena Mae A. Bagayao Kenneth Nunez

Marjhorie C. Bustanera Carol Fe C. Repil

Ma. Chona M. Cabrera Niño Tammy Revis

Cristina N. Dasco Elaine M. Romero

Niwdelyn N. Eligoyo Arthur Anthony Ace V. Sabino

Gerwin N. Flores Maricar B. Sangalang

Edelisa V. Hilario Irene M. Umagap

Analiza Marie F. Jacob Catlhyn Joy P. Umlas

Anthropometric Researchers: Willyn April S. Allones Mary Marjoe S. Dimalanta

Isabel Andrea G. Baula Ma. Alysa S. Erana

Catherine V. Bantayaon Ma. Kay Ann U. Estrellones

Franco Ben M. Belarmino Jimmy Mar B. Gaffud

Jennifer V. Belleza Rocelynne T. Gonzalez

Virgil Clavier E. Bongat Sitti Rihana M. Hassan

Charlene C. Bragasin Nur-melyn H. Irin

Emily M. Cabanog Maharlika L. Lucaban

Crislyn Amor D. Cabilbigan Julie Ann V. Mapanao

Allan A. Cadalzo Daisy Glenn S. Masillones

Alejandro C. Camba Francis B. Molina

Xyndey Chrysanewor G. Campano

Gerard Christian R. Ortega

Marie Gonesa O. Canja Cathy Joy C. Pajarillo

Jumma Mae D. Castillones Jayson E. Polonia

Leah L. Conde Theresa Mimosa C. Prochina

Ma. Rizza R. Conde Marianne Regina A. Sison

Liezel T. Curva Mikhail S. Reyes

Hammisa Y. Dasid Cerees Joy S. Sanajon

Danilo M. Dawang, Jr. Emely G. Sanson

Leonel-Jake P. de Leon Abegail L. Vicenal

Dietary Researchers: Ma. Sydney F. Babao Remie Marian D. Mumbing

Mayvel M. Bustamante Genevie F. Rodriguez

Kim Nicole G. Fernandez Jolo Al-Ranul J. Sta. Maria

Eden Faith D. Flores Maricon A. Tagum

Diana C. Lodriguito Charlene May A. Valerio

Kevin A. Muallil Mary Ann Yongco




OTHER SURVEY STAFF

Validators

Kristel Alarice R.Aborido Chris Dianne S. America

Ahmed Jaber T. Asadil

Princess Bartolo

Theresa Jhoanna Marie Carreon

Macey Kate K.Celestial

Allan R. Colibao

Ma. Lourdes T. Cumagun

Clarisse Q. Durante

Aiza D. Macaraig

Christian Gabrielle S. Maniego

Victor Ehman D.Monzon

Lemuel D. Navea

Ashlyn Pangpangdeo

Christian Rich Rayos

John Marvin M. Reyes

Jenica Raina Rosales

Veronica Vianca C. Salazar

Mary Grace V. Tangi

Statisticians

Clark D. Baylon

John Michael E. Borigas

Rovie Jane B. Caliguiran

Jay Lord Q. Canag

Marvin C. Delos Santos

Jeanesse S. Lumibao

Jonel G. Patricio

Rosa Eliza D.M. Santos

Cheder D. Sumangue

IT Support Staff/Programmers

Gerard Paul D. Balde

J. Aaron Paul S. de Leon

Jesus P. Dimalanta, Jr.

Patrocinio F. Leonador

Aaron Gregor D. Lim

Alben A. Matanguihan

Brian B. Susa

Assistants to the Coordinator/Support Staff:

Remedios S. America

Maria Cecilia R. Colibao

Nelisa P. Cortez

Ma. Sheryl C. Velasco

philippine nutrition

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