The Food Assistance Program in the Philippines: The Issues Involved (Part 1 of 2) PDF Print E-mail
FNRI DIGEST
Written by Rodolfo F. Florentino and Ma. Regina A. Pedro   

INTRODUCTION

The government has been implementing a Food Assistance Program for malnourished children as a short term palliative intervention. Supplementary feeding has been the most popular strategy resorted to in countries where malnutrition is a concern. The Philippine Food Assistance Program reportedly reaches an average of 1.3 million preschoolers, 1.2M schoolchildren and 0.3M pregnant and lactating women annually (PPAN).

While food assistance is being criticized as palliative and encouraging a dole-out mentality besides being costly, it may have health and nutritional, behavioral and social, not to mention, political impact (Underwood, 1983).
More mothers participating in community services or changes in child feeding knowledge, attitudes and practices among child care providers are examples of social and behavioral impact attributed to food assistance. The demonstration of government concern and action to a wide segment of the population and the ability to address the problem is an evident positive political impact.

Brief History of Food Assistance Programs in the Philippines

The Philippines has a long history of food assistance, and it continues to be a major intervention to address Protein Energy Malnutrition (PEM) especially among children. The National Nutrition Council (NNC) established
guidelines for food assistance programs in the country and set policies to prioritize malnourished children aged 0-14 years, including their mothers and the lactating women. Food commodities are being distributed to these groups
through the programs of the DOH, DSWD, DECS, the Church and the Local Governments.

Majority of the assistance consists of the US PL 480 foods. For nearly fifty years, we have been the recipient of "food aid" from the United States through the Food for Peace Program, also known as the US Public Law 480 Title II Food Program. The law was enacted in 1954 primarily as an agricultural surplus disposal measure for humanitarian and development purposes in countries in need of aid (Flores, 1984). Since 1957, the Catholic Relief Services (CRS), the Cooperative for American Relief Everywhere (CARE) and the United States Agency for International Development (USAID) were coordinating with the recipients for the formulation of projects and the
distribution of the PL 480 foods.

In the early years, the commodities distributed include corn-soy blend, corn-soy milk and non-fat dry milk. The "nutribun", prepared from soy-fortified wheat flour, was being distributed to target recipients in schools and feeding centers in the 1970's. Recently, it consisted mostly of bulgur wheat and green peas.

This year, there was a 50% reduction in the volume of PL 480 food commodities. In 1997, the program will be completely phased out in the Philippines. CRS has prepared for the phase-out by initiating in a number of
participating Archdioceses in the Food Transition Strategy (FTS) or provision of credit to households of its beneficiaries (CRS, 1995).

Since the 70's, the FNRI has developed many formulations following the guidelines set by the then Protein Advisory Group of FAO. The Department of Agriculture's Malnutrition Prevention Program in the late 70's to early
80's encouraged community level processing of supplementary mixes, patterned after the FNRI formulations called "Insumix". The Rural Improvement Clubs (RIC) distributed these to malnourished young children. The Nutrition Center of the Philippines also produced pre-cooked supplementary mixes known as "Nutripak", and made these available to government and NGOs carrying out food assistance programs.

The Issues on Food Assistance


The single important concern of implementors of food assistance programs these days is the phase-out of the US PL 480 Program in the country in 1997. Moreover, the number of priority recipients has not drastically decreased. The FNRI 1993 National Nutrition Survey estimates a total of 1.1 million moderately and severely underweight preschoolers alone (FNRI, 1995).

With the phase-out, the following questions need answers
Is food assistance program still necessary?
- If it is, what form should it take--supplementaryfeeding or food related income transfer or both?
- If supplementary feeding, should it be center-based or take-home feeding?
- Who should the targets be?
- What types of food commodities should supplementary feeding programs use?
- At what levels should the production of food commodities be? Can and will the private sector and industry play a role?
- Where will the sources of support for food assistance programs come form?
- Will cost-sharing among all sectors concerned feasible?
- What complementary programs and services need institutionalization ?

Besides supplementary feeling, is there a place for food subsidies and other food related income transfers?
If so, how do we go about with the implementation?

- Who should be the targets and how should targeting be done?
- What food commodities should it cover?
- What should be the system of procurement by the beneficiaries?
- What are the possible financial schemes?
- How should we monitor enforcement?

Answers to these questions will prepare us for the impending PL 480 phase-out.
Is It Still Necessary?

Let us answer the question by looking at the situation of children and mothers in the Philippines and the significance of investments in nutrition.

From the most recent available data, and using Philippine standards, protein-energy malnutrition affects 8.4% of Filipino children below the age of six years (FNRI,1995). In absolute numbers, this amounts to 1.1 million
Filipino children below six years old. In addition, 7% of 7-10 year old schoolers are also moderately or severely undernourished. This translates to 456,000 7-10 year old schoolers. Finally, assuming a prevalence of underweight pregnant women of 15%, there would be about 670,000 pregnant women needing food assistance.


The worst-off regions according to the 4th NNS regarding the prevalence of PEM are Eastern Visayas, ARMM, Western Visayas and Bicol. Quantitatively, the worst-off regions include Southern Tagalog, Western Visayas, Central Luzon, and NCR.

Now we ask: are the causes of malnutrition amenable to food assistance? Malnutrition in the country is primarily the result of insufficient dietary energy and protein, often in combination with some forms of infection, together with lack of micronutrients, especially iron, vitamin A and iodine. Behavioral factors as well as poverty and the lack of buying power for food are underlying factors. Where household calorie availability is more than adequate, nutrition education may be sufficient; whereas, if resources are an absolute constraint, some forms of resource transfer as in food assistance, may be required (Rogers, 1995). Without neglecting the need for nutrition education, the major causes of malnutrition in the country are amenable to food assistance.

Why invest in nutrition? According to the World Bank, resources put into nutrition are investments with significant returns, today and in the future, and which meet the objectives of alleviating poverty and spurring economic growth (Del Rosso, 1992). A computer simulation (PROFILES Model) of the impact of improving child malnutrition in the country indicated significant potential benefits. It estimated that a 50% reduction in PEM would avert more than 37,000 infant and child deaths each year and save 150 million to 120 million days of illness every year (Heaver & Hunt, 1995).

If food assistance is still necessary, then what form should it take?

The choice of form of food assistance to carry out depends on the objectives of the program. If the objective is primarily to rehabilitate malnourished children and mothers, supplementary feeding is the form of choice. If the objective is preventive, i.e. to avert growth faltering among the at-risk children belonging to households with severe resource constraints, increased consumption of food and nonfood goods made possible by the implicit  income transfer from food assistance such as food stamps, food subsidies or food-for-work, can significantly improve welfare (Rogers, 1995). Such income transfer strategy can be carried out in combination with supplementary  feeding to children of these households.


Regarding supplementary feeding programs, the country has applied both the center-based and take-home schemes for distributing food rations. The time for conducting the feeding thus becomes an important consideration. The nutrition workers have also expressed difficulty in getting the mothers to bring their children regularly to feeding centers during periods of feeding, usually lasting from 6-24 months (Ramos, 1996).

In the case of take-home feeding, an evaluation by Abt Associates found this to be ineffective in reducing the numbers of the moderately and severely malnourished children. Sharing with other members of the household has been a common observation. Feeding Project that conducts on-site feeding (CRS, 1984). Besides requiring a higher volume of commodities, a well-designed formulation that discourages sharing is essential.

Some experts however, claim that there is yet insufficient data on the occurrence and effects of sharing or displacement (Amla, 1996; Katona-Apte,1992).

 

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