INTRODUCTION

Malnutrition or malnourishment can be defined as a lack of

proper nutrition. United Nations Childrens Fund or UNICEF (2004)
categorizes the causes of malnutrition as basic, referring to
poor economic and political structures; immediate, referring to
poor dietary intake, psycho-social stress and trauma and diseases
such as diarrheal and acute respiratory conditions, which further
complicate malnutrition; and underlying causes, referring to
household food insecurity, lack of knowledge and education,
caring practices and health services, as well as an unhealthy
environment.
There are two basic types of malnutrition. The first and
most crucial is called Protein Energy Malnutrition (PEM). This,
as the name suggests is the lack of glucose and proteins in
foods. This is a more dangerous type and it is typical in almost
all areas of hunger in the world. It is more lethal because every
body part and senses need chemical energy to work. This energy
comes from the calories we take in, in the form of carbohydrates
and starch. The second type is called Micronutrient (vitamin and
mineral) deficiency. Unlike PEM, the body can survive longer with
this deficiency. This type is also called Hidden Hunger (World
Food Programme, 2010).

Malnutrition remains a pervasive problem in developing

countries, where poverty is a strong underlying determinant,
contributing to household food insecurity, poor child care,
maternal undernutrition, unhealthy environments, and poor health
care. All ages are at risk, but underweight is most prevalent
among children under five years of age, especially in the weaning
and post-weaning period of 6--24 months. WHO has estimated that
approximately 27% (168 million) of children under five years of
age are underweight (WHO 2002). Underweight children are at
increased risk of mortality from infectious illnesses such as
diarrhea and pneumonia (Rice et al 2000). The effects of
undernutrition on the immune system are wide-ranging, and
infectious illnesses also tend to be more frequent and severe in
underweight children.
The prevalence of malnutrition globally had been estimated
with a prevalence of 13.9, and the number of underweight in
millions as 93.4, which was comparatively lower than that of
2014, which was at 95.5 million. Developed countries had a
prevalence of 1.4 at 1.0 million, while developing countries had
a staggering 92.5 million at a prevalence of 15.4. Asia and
Africa had the most prevalence of malnutrition than that of other
countries, with Africa having 15.9 (29.4 million) and Asia having
16.9 prevalence (61.3 million). Contrary to the publics
imagination, it was not sub-Saharan Africa that was the home of

malnutrition, but Asia, particularly South Asia (World Health

Organization, 2015).
South Asia has the largest number of malnourished children
in the world. Asia leads other world regions with not only the
highest percentage of children under 5 who are underweight or
wasted (21.9% and 11.2% respectively, as of 2011), but given the
population density across the region, it is also home to the
greatest total number of children under 5 who are stunted,
wasted, or underweight (103.5 million, 39.2 million, and 76.6
million respectively, as of 2011). Of the five sub-regions in
Asia, Southeast Asia has the second highest prevalence and total
number of children who are stunted (29.4%, 15.6 million), wasted
(9.4%, 5.0 million) and underweight (18.3%, 9.7 million) (Black
et al. 2013).
Burma, Indonesia, the Philippines, and Vietnam, all of which
belong to the Southeast region of Asia belong to the 20 countries
with the highest burden of malnutrition which constitute 80% of
the worlds undernourished children (Bryce et al. 2008). Of the
countries with trend data, low birth weight and child
malnutrition has decreased in Cambodia, Indonesia, and Vietnam
since 2000, while in Laos and the Philippines the incidence of
low birth weight and child malnutrition has increased. Of all
seven countries, the Philippines has the highest level of low

birth weight and child malnutrition (21%) and Vietnam the lowest
(5%).
In the Philippines, only 63.2 per cent of children 6-23
months old reach the minimum variety of foods for a good diet.
Twenty-eight per cent of children under 5 were moderately or
severely malnourished in 2003-2008. It is also estimated that
malnutrition is an underlying condition in more than a third of
deaths of children younger than five years. Severely wasted
children have a high likelihood of dying if they dont receive
appropriate treatment. The long term effects of malnutrition are
impaired learning and development and reduced income earning
potential as adults (UNICEF, 2010).
Malnutrition is an unbearable burden not only on the health
systems, but the entire socio-cultural and economic status of the
society. It is therefore critical that we address this problem as
soon as possible, to prevent future ramifications.
Anemia (from Greek an- without; hemia blood) is a
condition in which the number of red blood cells or their oxygencarrying capacity is insufficient to meet physiologic needs,
which vary by age, sex, altitude, smoking, and pregnancy status
(World Health Organization, 2015).
Iron deficiency is thought to be the most common cause of
anemia globally, although other conditions, such as folate,

vitamin B12 and vitamin A deficiencies, chronic inflammation,

parasitic infections, and inherited disorders can all cause
anemia. In its severe form, it is associated with fatigue,
weakness, dizziness and drowsiness. Pregnant women and children
are particularly vulnerable.
There are more than 400 types of anemia, which are divided
into three groups: anemia caused by blood loss, anemia caused by
decreased or faulty red blood cell production, and anemia caused
by destruction of red blood cells. Globally, anemia affects 1.62
billion people (95% CI: 1.501.74 billion), which corresponds to
24.8% of the population (95% CI: 22.926.7%). The highest
prevalence is in preschool-age children (47.4%, 95% CI: 45.7
49.1), and the lowest prevalence is in men (12.7%, 95% CI: 8.6
16.9%). However, the population group with the greatest number of
individuals affected is non-pregnant women (468.4 million, 95%
CI: 446.2490.6) (World Health Organization, 2008).
Philippines had been ranked as the 90th country in the world
with the highest prevalence of anemia in children, with a value
of 34.90. Prevalence of anemia among children (% of children
under 5) in Philippines was 34.90 as of 2011. Its highest value
over the past 21 years was 48.20 in 1990, while its lowest value
was 34.70 in 2007.

Anemia could be caused by malnutrition, as a result of

nutritional deficiency which occurs when the body doesnt absorb
the necessary amount of a nutrient. Deficiencies can lead to a
variety of health problems, such as problems of digestion, skin
problems, stunted or defective bone growth, and even dementia.
The most widespread nutritional deficiency worldwide is iron
deficiency, which can result in anemia. Iron is found in foods
such as red meat, dark, leafy greens, and egg yolks. It helps
your body make red blood cells. When youre iron-deficient, your
body produces a reduced amount of red blood cells. The red blood
cells it produces are smaller and paler than healthy blood cells
(Blake, 2012).
According to the World Health Organization, over 30 percent
of the worlds population suffers from this condition. It is
prevalent in both developing and industrialized countries. In
fact, iron deficiency anemia affects so many people that it is
now widely recognized as a public health epidemic.