Philippines: Children’s health and survival must be a priority amid the COVID-19 pandemic

The JFA is alarmed and calls for urgent government action to halt the increase in the  number of children becoming undernourished due to hunger and food insecurity brought about by the loss of income and livelihoods among parents and guardians resulting from COVID-19   quarantine restrictions. 

According to a UNICEF study released in 2019, 95 children die from malnutrition in the Philippines every day, and 28 out of 1,000 Filipino children do not reach the age of 5. Meanwhile, a third of Filipino children are stunted, which can be permanent and even fatal when it occurs beyond 2 years of age. The World Health Organization (WHO) also published a study that showed being underweight is a predisposing factor to 45% to 52% of deaths among under-5 children.  During emergencies and disasters, when hunger is more acute, children especially those from marginalized and vulnerable groups are twice more likely to die due to preventable diseases such as diarrhea and pneumonia with undernutrition as a predisposing condition. Children with disabilities are two to three times more likely to be malnourished. 

The WHO estimates that 16,000 Filipino young children die each year because of suboptimal breastfeeding and inappropriate complementary feeding practices.  Infants who are not exclusively breastfed are prone to undernutrition and are 14 times more likely to die compared to those who are breastfed. However, even breastfeeding practices are affected during emergencies when families and communities are displaced, and breast milk substitutes are sometimes distributed as part of food or relief packs. Children, along with pregnant and lactating women as well as adolescents, suffer the most from rising hunger in the country as their physical requirements for adequate food and proper nutrition must be met to ensure their survival and health during the pandemic.

Considering the present health crisis, the JFA calls for the continuation of health, nutrition, and other essential care and services for children, along with pregnant and lactating mothers, and adolescents who suffer the most from rising hunger in the country as their physical requirements for adequate food and proper nutrition must be met to ensure their survival and health during the pandemic.

It is in this light that, we, the Joining Forces Alliance, appeal to the government to support continued access of children, pregnant and lactating mothers, and adolescents to health, nutrition, and other essential care and services during the pandemic.

To minimize risks for children from the infection by:

• Intensifying information dissemination campaigns and drives to increase the knowledge of the public on COVID-19 infection prevention and control protocols using online and offline platforms and including child-friendly materials in various languages.
• Ensuring that work places are compliant to COVID-19 precautions for parents and caregivers who have returned to work to minimize the risk of bringing home the virus and infecting other family members.
• Emphasizing non-pharmacological interventions such as risk mitigation and containment to prevent and control the spread of COVID-19 while a vaccine and treatment drugs are still being developed.
• Ensure that COVID-19 infection prevention and control measures are strictly complied with.

To sustain and even intensify the delivery of health programmes and services, specifically by

• Maintaining the uninterrupted delivery of immunization schedules for children and of essential health and nutrition care services including sexual and reproductive health services such as family planning, in line with the Department of Health (DOH) issued Department Memorandum No. 2020-0150 on April 29, 2020.  The directive was issued to ensure that local government units, health service providers and partner NGOs to also give importance to other health issues aside from COVID-19  so that vulnerable and marginalized groups continue to access quality necessary health care.
• Intensifying the implementation of national health and nutrition policies and guidelines supporting optimal infant and young child feeding, such as the Nutrition Cluster Advisories issued by the National Nutrition Council (NNC) regarding the prescribed contents of food packs and the strict compliance to the Milk Code, which bans the unethical promotion of milk formula at all times. The DOH Department Memorandum No. 2020-0231 on the standardized regulations to be followed by LGUs, NGOs, private groups and individuals on milk formula donations including feeding bottles and teats during emergency situations where the health and nutrition of infants and young children should also be strictly implemented and monitored.
• Ensuring that enough budgets are allocated for Barangay Health Stations and Rural Health Units to be operational and equipped to provide quality, essential health and nutrition services to children, pregnant and lactating mothers, and adolescents including services for mental wellness, mental health and psychosocial support (MHPSS) services.
• Ensuring that facility and community-based health and nutrition workers are properly trained and able to provide non-discriminatory services, including sexual and reproductive health services to adolescents and young people.

• Ensure that enough handwashing facilities and hygiene essentials are available when schools re-open in compliance with DepEd Order No. 014-2020 entitled Guidelines on the Required Health Standards in Basic Education Offices and Schools.
• Provide capacity building for teachers and other school personnel about COVID-19, its prevention and control.
• Allot a regular period during class hours to provide students with relevant information about COVID-19.
• Implement the school feeding program for all children once face to face classes are authorized. 

• Expedite the release of cash assistance and livelihood support to rice farmers and fisherfolks to mitigate the impact of the quarantine on their earning capacity.
• Encourage backyard and urban gardening by providing seeds and other agricultural inputs to help address nutrition and food security issues among affected families.

• Design COVID-19 messages that  convey and emphasize the importance of  infection prevention and control including personal prevention and containment measures;
• Come up with simplified guidelines on how to implement national protocols and guidelines at the various tiers of the LGUs.
• Mandate all LGUs to cascade national protocols and guidelines down to the community level and ensure that preparedness and contingency plans are reviewed and updated.
• Enforce the strict implementation of the Philippine Milk Code (Executive Order No. 51), Kalusugan at Nutrisyon ng Mag-Nanay Act (Republic Act No. 11148), and the Children’s Emergency Relief and Protection Act (Republic Act No. 10821) that prohibit the promotion of breastmilk substitutes as donations during emergencies and recommend measures to help mothers experiencing breastfeeding difficulties and problems;
• Ensure that social protection measures of the different line agencies (Department of Social Welfare and Development, Department of Agriculture, Department of Trade and Industry, Department of Labor and Employment among others) such as livelihood support, cash assistance, emergency subsidy programs and other support for affected families mandated under the Bayanihan to Heal as One Act are distributed in a timely and coordinated manner.