CHAPTER 1

The Problem

Background of the Study

Good nutrition is the cornerstone for survival, health and development for current

and succeeding generations. Well–nourished children perform better in school, grow

healthy adult and in turn give their children a better start in life.

Nutritional status or nutriture is the condition of the body resulting from the

utilization of essential nutrients. One may be classified as having good, fair or poor

nutriture depending upon the primary and secondary factors. Good or Optimum Nutriture

means that the body has adequate supply of nutrients that efficiently utilized such that

growth and good health are maintained at the highest possible level. Fair Nutriture means

the body has enough supply of essential nutrients needed for growth and development.

Poor Nutriture means that the body has inadequate supply of essential nutrients.

Malnutrition is the opposite of good nutrition. 1

Individual nutritional status depends on the interaction between food that is eaten,

the overall state of health and the physical environment. Malnutrition is a major

health problem especially in developing countries. Water supply, sanitation, and

hygiene are important for preventing malnutrition. 2

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According to P.A. Sanchez and M.S. Swaminathan, there are 854 million people in

the world (about 14% of the world population) who are chronically or acutely

malnourished. In addition, hidden hunger from micronutrient deficiencies affects

more than 2 billion people worldwide. Most are in Asia, with sub-Saharan Africa the

only region where hunger prevalence is over 30%, and the absolute numbers of

malnourished people are increasing.. More than 90% are chronically malnourished,

with a constant or recurrent lack of access to sufficient quality and quantity of food,

good health care, and adequate maternal caring practices. Acute hunger (the wasting

and starvation resulting from famines, war, and natural disaster) represents 10% of

the hungry yet receives most of the media coverage and attention. 3

The Survey Team of Food and National Research Institute-DOST, who conducted

the data collection from July to December 2003, covered 17 regions of the Philippines, at

most 5,520 households and 25,897 persons. There were 808 survey areas that were drawn

from the 75 provinces of the country and 17 cities/municipalities of Metro Manila. A

survey area comprised of one or more barangays. The nutritional situation of primary

school-age children (6-10 years old) has improved between 2001 and 2003. This was

revealed by the results of the 6th National Nutrition Survey conducted by the Food and

Nutrition Research Institute, Department of Science and Technology (FNRI-DOST) from

July to December, 2003. The anthropometric results for 0-10 years old, among 0-5 years

old 27.6 % or 3,180,000 is underweight, 30.4% or 3,500,000 is underheight, 5.5% or

630,000 is short, and 1.4 % or 160,000 is overweight. The result shows that among 6-10

years old, 26.7 % or 2,490,000 is underweight, 36.5% or 3,410,000 is underheight, and

1.3% or 120,000 is overweight. 4

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The researchers choose pupils of Paringao Elementary School to be the subject of

the research because when the researchers requested some information about the

Nutritional Status of barangays in Bauang, POPCOM (Population Commission) in the

municipality of Bauang presented that the total estimated population of children under 6

years old for the year 2004 is 737 and only 600 children have taken weight. Among the

600 children 18 children have weight that is below normal and 101 children have

moderate weight. In the statistics, Barangay Paringao has the highest cases of

malnourished children.

It is in this context, that this study was undertaken in order to generate

information on the nutritional status of Paringao Elementary Pupils as an output in the

improvement in planning, implementing and evaluating nutrition education program in

the school.

Theoretical Framework
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Maslow's hierarchy of needs was an alternative to the depressing determinism of

Freud and Skinner. He felt that people are basically trustworthy, self-protecting, and

self-governing. Humans tend toward growth and love. According to Maslow, there

are general types of needs (physiological, safety, love, self-esteem and self-

actualization) that must be satisfied before a person can act unselfishly. He called

these needs "deficiency needs." As long as we are motivated to satisfy these

cravings, we are moving towards growth, toward self-actualization. Physiological

Needs are the very basic needs such as air, water, food, sleep, sex, etc. When these

are not satisfied we may feel sickness, irritation, pain, discomfort, etc. These

feelings motivate us to alleviate them as soon as possible to establish homeostasis.

Once they are alleviated, we may think about other things. A person who is starving

or deprived of fluid for an extended time will center all of his/ her activities on

meeting that need. After physiological needs are meet the need to feel safe in one’s

environment emerge. This need for safety has both physical and psychological

aspects; the person needs to be safe and to feel safe, both in physical environment

and relationship. All basic needs generally must be met. Failure to meet needs in one

or more result to homeostatic imbalance, which eventually result to illness.5

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Rosenstock said that the health belief model is based upon the idea that it is the

world as it is perceived that will determine an individual's actions and not the actual

physical environment. (This theory is derived from phenomenology, a branch of

philosophy.) According to this model, individuals will act to avoid a health problem, but

they first need to believe they are personally susceptible to the problem. Second, they

need to perceive the severity of the situation before they will take a particular action.

Third, the probability that an individual will act to improve his or her health is

determined by the individual's perception of the benefits of and barriers to alternative

behaviors. A beneficial alternative is one that is likely to reduce the severity of a health

problem or one’s susceptibility to it. Finally, a "cue to action" such as an internal

stimulus (e.g., perception of bodily states) or an external stimulus (e.g., mass media

communications, personal knowledge of someone affected by the condition) must occur

to trigger the appropriate health behavior. 7

According to Joyce Travelbee on her Interpersonal Aspects of Nursing Model, the

goal of nursing is to assist individual or family in preventing or coping with illness,

regaining health, finding meaning in illness, or maintaining maximal degree of health. She

further viewed that interpersonal process is a human-to-human relationship formed during

illness and “experience of suffering”. She believed that a person is a unique, irreplaceable

individual who is in a continuous process of becoming, evolving and changing.8

Conceptual Framework

In line with the priority of the government to provide optimum health to children,
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The Food and Nutrition Research Institute-DOST, being lead agency in food and

nutrition research conducted the 6th National Nutrition Survey. According to EO

(Executive Order) 128 section 22, the FNRI is mandated to undertake research that

defines the citizenry’s nutritional status, with reference to particularly to the

malnutrition problem, its causes and effects and identify alternative solutions to

them. It is also mandated to develop and recommend policy options, strategies,

programs and projects, and disseminate research findings and recommendations.

FNRI is designed to conduct the national nutritional survey every five (5) years, at

the national and regional levels, and to disseminate the results one (1) year after the

reference year. Among 6-10 years old children, 26.7% are underweight, 36.5% are

short, and 1.3% is overweight. Among these age groups, under nutrition has

decreased while overweight increased between 1988 to 2003. There has been a

general improvement between 1988 and 2003 in the country’s over all nutrition,

affecting various population groups, as evidenced specifically by reductions in

underweight and stunting among 0-5 and 6-10 years old children. There is however

trend towards increasing overweight among children.9

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Proper nutrition is considered important for human development. Indeed, it is a key

to the promotion and maintenance of good health and economic productivity. The

new outlook in the development therefore, puts the spotlight on nutrition in the

strategy of development. Because of this, man today can maintain higher level of

health, vigor and efficiency throughout many more years than would have been

possible before. It has been said that through better nutrition not only have years

been added to man’s lives but life to his years. However with the rapid rise of our

standard of living, the incidence of malnutrition persisted and has increased and

affected in all walks of life. Malnutrition can be considered as social and economic

ill. Lifetime mental and physical damages follows as a result when it hits the young,

particularly infants and pre-schoolers retarded growth, small size and bone

deformities happen, the brain, needing nourishment for its growth and development
10
fails to grow to its fullest thus resulting in poor mental performance later in life.

The Casual and Outcome model shows that the nutritional status of Filipino child

is a result of different underlying causes at the household, community and country levels

which interact and ultimately affect him as an individual. It has been recognized that

malnutrition is closely related linked to country’s level of economic development. There

is a sufficient evidence to show that considerable human development and economic

waste is caused by inadequate nutrition. It is like a cycle that worsens without immediate

and proper interventions, thus eventually leading to greater health and nutrition problem

as well as overall national instability and underdevelopment.11

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PD 603 otherwise known as the child and youth welfare code states; Article 1-

General Principle. “The child is one of the most important assets of the nation. Every

effort should be enacted to promote his welfare and enhance his happy opportunity

for the useful and happy life.” Every child should be provided all their needs to have

a safe and healthy life. They are the hope of our nation so their welfare must be

promoted. In order that they must do their future roles and responsibilities, they must

be healthy and or physically fit. Article 2-Promotion of Health. “It should be the

responsibility of the health welfare and education entities to assist the parents in

looking after the health of the child.” Promoting health of children is not only a sole

responsibility of parents but it is also the responsibility of the government and also

the school supervising the condition of the children and provide health services to

ensure that they have a healthy life. Article 3-The Rights of the Child. “Every child

has the right to balanced diet, adequate clothing, sufficient shelter, proper medical

attention, and the basic physical requirements of a healthy and vigorous life.” Parents

should pay attention to the needs of their children. They should provide adequate

food to meet the needs of their children; adequate clothing, and sufficient shelter to

promote safety. Children must also have regular check ups to watch for their health

condition. They can do this without paying much for they can have the check up in

their Barangay Health Center so they can maintain the health condition of their

children.12
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Figure 1, presents the research paradigm of the study. The independent variable in

the study is the profile of the respondents age, gender, and the family’s’ average daily

income, and number of households. The dependent variable in the researchers’ study is

the nutritional status of the children. The arrow represents the relationship between the

independent variable and the dependent variable.

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INDEPENDENT VARIABLE DEPENDENT VARIABLE

Children’s Profile

a.1. Age Nutritional

a.2. Gender Status of the

a.3. Average monthly Children.

family
Income

a.4. Number of
Children

Figure 1.

Research Paradigm
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Statement of the Problem

This study aimed to determined the nutritional status of elementary pupils in

Paringao Elementary School, Paringao, Bauang, La Union from July to August

2005.

The student researchers were guided by the following sub-problems:

1. What is the profile of the children in terms of the following?

a.1. age

a.2. gender

a.3. average monthly family income

a.4 number of children

2. What is the nutritional status of the children?

3. Is there a significant relationship between the profile of the children and their

nutritional status?

Hypotheses

The hypotheses are cited below in order to answer the identified problem in the

study.

The profile of children with regards to age ranges from six to twelve (6-12) years old, as

to their gender, most are female, average monthly income is below Php 13,000 in a

month, and the average number of children is four.

The nutritional status of children in terms of height and weight corresponding to their

age; most are below normal, as to their height and weight corresponding with their

gender; most of them are below normal.

There is no significant relationship between children’s profile and their nutritional status.
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Scope and Delimitation

The present study is delimited to the nutritional status of elementary pupils in

Paringao Elementary School, Paringao, Bauang, La Union from July to August 2005.

The total of 273 pupils from grade one to grade six for the school year 2005-2006

participated in the study.

This study covered such aspects as: age, gender, average monthly family income,

number of children, and height and weight for age.

Importance of the Study

This study is important to the following:

Government, as a basis to review the results of the study and will provide them a

basis for planning and implementing better nutritional programs.

Department of Education, as an index for them to provide information in the

planning and formulation of strategies in the improvement of quality education hence

quality grade

School Administrators, which could be a useful eye-opener to assess and

evaluate the nutritional status of the elementary pupils.

Teachers, as a motivator and challenge to make proper integration of nutrition

subjects in the elementary curriculum more effectively. It makes likewise help in

formulating appropriate measures to help solve the problem in nutrition.

School Nutritionist, this study will help them to introduce, orient and guide the

pupils in selecting foods that have nutritional value

Nurses, this will help them inform and educate the parents concerning preventive
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measures to reduce health threats of malnutrition. The findings of the study therefore will

be useful in planning and implementing realistic health program on nutrition.

Personnel of the Canteen, this study will urge them to prepare low cost and

nutritious foods for the pupils with healthy and proper preparation.

Parents, as a guiding tool for them to realize there role in food selection and

preparation for the growth and development of their children as partners in nation

building.

To the researchers of this study, this will serve as an enhancer to their knowledge

to the importance of health education. This will motivate and challenge them to

improve their roles as healthcare providers.

Definition of Terms

The terms used in this study are defined to help the reader fully understand.

Elementary School. A school giving a course of education in the first six or eight

grades.13

Pupils. A person under the care of a teacher.14

Height for Age. The linear measurement of child at a given age from head to toe

takes to the nearest 0.5cm and compared to the table for standard height for Filipino

children. 15

Nutritional Status. State of the body in relation to the consumption and

utilization of nutrients. 16

Profile. A outline or contour, a short biographical sketch

Number of households. This refers to the number of children in the family.

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Overweight. It refers to weighing more than is normal, necessary, or allowed,

especially having more body weight than is considered normal or healthy for one's age or

build. 17

Primary Factors. It refers to faulty diet like nutrient intake is lacking in quality

and quantity for a given individual. 18

Secondary Factors. It refers to multiple and include all condition within the

body that reduce the ultimate supply of nutrients to the cells after the food goes beyond

the mouth.19

Underheight or shortness. It refers to the reflection of long-standing poor

nutritional status. A child is considered underheight or short if her/his height is lower

than that of a normal child of the same age. 20

Underweight. This refers when her/his weight relative to her/his age is lower

than that of a normal child. 21

Weight for Age. The heaviness of the children at a given age measured by using

the weighing scale taken to the nearest 0.1 kg and compared to the table for standard

weight for Filipino children.22

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NOTES

1
Ma. Patrocinio E. de Guzman, Virginia S. Claudio, Moninia S. Oliveros,

Gemma P. Dimaano, Adelaida R. Reyes,”Basic Nutrition for Filipinos”, Manila,

Philippines, Merriam and Webster Bookstore, Inc., Manila Philippines, p. 6

2
http://www.who.int/water_sanitaion_health/diseases/malnutrition/en/,2000
3
http://www.undp.org/teams/english/facts.htm,1998
4
http://www.fnri.dost.gov.ph/nns/resultschildren.pdf,2005
5
http://web.utk.edu/~gwynne/maslow.HTM,1999
6
www.nutrition.org.UK/infonet/diet2005
7
http://www.ed.gov/pubs/PreventingSubstanceAbuse/Theories.html
8
Tomey, Ann Marriner, Alligood, Martha Raile.”Nursing Theorist and Their

Work Fifth Edition” Mosby Inc pp101,2002

9
http://www.fnri.dost.ph/nns/6tnns.pdf,2005
10
Americana Corporation, “Nutrition of Man”, Encyclopedia Americana ,xx,

1998, pp.564-565
11
Ibid, ,”Basic Nutrition for Filipinos”, pp. 330-332

. .12http://philsfamilylaw.blogspot.com/2005/04/pd-no-603-child-and-youth-

welfare-code.html

.13 William Webster and A.B. Walter,Webster Contemporary Dictionary New

Standard Encyclopedia Dictionary, Standard Eduactional Corporation, Chicago U.S.A.,

2000, Volume 1, p.229

14
Ibid, Walter,Webster Contemporary Dictionary New Standard Encyclopedia

Dictionary, Volume 2, p.590

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15
DECS, Memo No. 28,1997
16
www.webstersonlinedictionary.org/definition/english/Nu/Nutritional

%20Status.html, 2005
17
J.B. Forman,MACollins Double Book Dictionary and Encyclopedia, Wm.

Collins Sons and Co. Ltd., Great Britain, p.385

18
http://dictionary.reference.com/search?q=overweight
19
Ibid, Basic Nutrition for Filipinos p. 6
20
Ibid, Basic Nutrition for Filipinos”, p. 3
21
Ibid, www.fnri.dost.gov.ph,2005
22
DECS, Memo No. 28, 1997