STATEMENT OF THE PROBLEM

●Why do children still suffer from malnutrition if we’re working so hard to prevent it?

●How does poverty lead to malnutrition

●What are the factors that contribute to malnutrition

I. INTRODUCTION

Malnutrition is a common health issue that develops when a person does not
consume enough of the correct foods or experiences difficulties absorbing nutrients
from their diet. The most typical sign of malnutrition is weight loss. This indicates that
you are not obtaining all the nutrients, such as proteins, vitamins, and minerals, that you
require. Being undernourished might make you sick since your body needs food to
function effectively as fuel. Malnutrition can also result from illness since it frequently
causes bad eating habits. Malnutrition comes in many forms. Malnutrition is a
deficiency, excess, or imbalance in a person's nutrient intake. Children who experience
stunting and wasting are more likely to suffer from diet-related chronic diseases,
weakened immune systems, and are less responsive to vaccinations, making them more
susceptible to a range of long-term health problems.

Here in Bacacay Albay, barangay 1 got our attention to conduct research because once
you go to this place you will see children who are very thin and those who are naked and
dirty children. Malnutrition is prone in the said barangay especially to the families who
can't afford to sustain their basic needs. They are growing up without being able to take
in the nutrients they need to perform. Barangay one also has Poor access to food,
especially healthy food, which causes both undernutrition and overnutrition, increasing
the risk of low birth weight, childhood stunting, and overweight or obesity.
The most effective way to reduce the burden of malnutrition is through a
multidisciplinary approach aimed at improving nutrition at all critical life stages and
linking nutrition services and solutions to broader health systems and programs. and
improve water, sanitation, hygiene (WASH) and food systems. , social protection,
education, climate change, gender, and maternal mental health

A. RATIONALE

In this study we proposed to determine about Effects of Health Difficiency of Children in

Barangay 1 (Malnutrition). The purpose of this study is to examine how malnutrition
affect children in the said barangay. This study focus most in children of barangay 1
which is a very common issue in their barangay, Especially for those families who can't
afford and sustain their basic needs in daily lives. This is the reason why more increasing
cases because the Government didn't give attention to the issue of malnutrition in the
community. We conducted this topic to decrease affected children's weight lost. And to
have the children in Barangay 1 have a healthy lifestyle where they can live active in
everyday lives. This study needs to support behavioral change campaigns to adopt
behaviors crucial to improving nutritious outcomes for children. To manage their
unintentional weight loss, the government should be active about having nutrition
screening more

B. SYNTHESIS of THE ART

Children's resistance to infection as well as their high mortality rate ate directly related
to childhood malnutrition. This is a tragedy for the entire future existence, not just a
momentary hardship in childhood. Cognitive ability is lowered by malnutrition. This
Research Project aims to sustainably reduce acute malnutrition in Barangay 1 ,
Municipality of Bacacay. The shortage, excesses, or imbalance in the amount of energy
and/or nutrients ingested by a particular individual. One of the causes of undernutrition
is poverty.

The citation in other related literature taught that malnutrition can manifest as
stunning, being underweight, wasting in women or adolescent girls, poor hygiene, and
inadequate support for breastfeeding. Even mild malnutrition poses a threat to survival,
with over 80% of deaths related to childhood malnutrition ( Bagil, V. & Savanadatti, 2015
). Other related literature said that a children who experience under malnutrition who
early in rises life are at disadvantage they most likely will not recover from, which leads
to loss of millions of potentially bright future and the perpetuation of poverty.

However the study of this research have some opposite idea about the possible effects
of the children’s health. Barangay 1 is also one of the highest rate of poverty among all
barangays that we have here in the municipality of Bacacay, on the other hand it also
says that malnutrition or being malnourish can cause the rises of death that is related in
childhood malnutrition.

Distinguish between both related literature have there different broad sub-form of
under malnutrition; wasting, stunting, underweight, and deficiencies in vitamins and
minerals, separate with our research study also have known that focus on the
prevention, and comprehend to other related literature that have different perspective
about the specific topic.

The Uniqueness of our research topic is Malnutrition negatively impacts physical well-
being, restricts medical treatments, and raises health care expenses. It has been
recognized as a serious clinical problem in hospital settings both domestically and
internationally. This study shows hope for a future where more children could receive
timely treatment for acute malnutrition, thus preventing the severest caused here in
Barangay 1, Municipality of Bacacay.
C. RESEARCH GAP

The effect of Malnutrition here at Barangay 1, Municipality of Bacacay, offer solutions

that can help and to enhance their everyday life, having healthy lifestyle of the Children
affected of Malnutrition. One of the reason why many cases of Malnutrition in the said
barangay because of poverty. This start with inadequate support from parents. Health
deffiency also and without health care expenses. Lack of parental education about
nutrition also plays a very important role in child nutritional health. To give them
unending support food their health issues. Feeding programs may can help to them in
everyday lives. From that this start with the support of barangay leader of barangay 1
which is the many cases of Malnutrition to publish positive solution to them. Will have a
important role in changing practices and strengthening research to prevent malnutrition.
In addition, the barangay leaders change to have a feeding program every day. This is the
Gap Bridged by the present research undertaking.

D. OBJECTIVES OF THE STUDY

This study will know some of the malnourished children in Barangay 1, Bacacay Albay and this
study aims to:

●To prevent undernutrition, micronutrient deficiencies, and overweight in early childhood

●prevents obesity and reduces the risk of chronic disease

●to take action about this malnutrition in children

E. THEORETICAL FRAMEWORK

Applied nutrition is currently experiencing a bit of a confidence crisis. Given the numerous
spectacular examples of acute starvation as well as the pervasive persistence of chronic hunger,
this may appear unusual, even annoying, to many individuals. In the past, a chapter like this
might have started with a review of the severity of various nutritional deficiency diseases and
their unique causes, and would have then gone on to describe appropriate interventions:
correction of nutrient deficiencies (vitamins, minerals, and especially proteins); education
programs to correct cultural "errors" in the use or intra-household distribution of different foods;
or correction of consumer behavior distortions

Therefore, we must draw the conclusion that despite all of our achievements in the
agricultural, industrial, and technological fields over the past 30 years, as well as a number of
"applied nutrition programs" and "supplementary feeding programs," we have not really made a
dent in the issue of childhood malnutrition. We have made some progress in lowering newborn
and child mortality, and as a result, we have saved a lot of kids who would have otherwise been
taken by the kind hand of death. As a result, there is an expanding population of survivors who
have narrowly averted death but who live in poor health and nutrition with long-term functional
competence and productivity impairments. The 'quality' of our human resources gradually
erodes and degrades as a result.
Cause of Malnutrition

Conceptual framework of Causation of Malnutrition

Manifestation

Malnutrition

Inadequate dietary Immediate

intake cause

Underlying causes

Basic causes

Malnutrition's immediate, underlying, and fundamental causes at the said

Barangay are explained by the conceptual framework. This offers a crucial
foundation and a holistic plan to address nutritional issues
The direct causes of malnutrition are inadequate food intake and illnesses. The
relationship between these two elements is established. Long-term poor
nutritional intake would indicate a lack of nutrients, which might cause
malnutrition, which may eventually result in disease or illness. Diseases, on the
other hand, place a significant nutritional demand on the body. This demand can
be the result of the body's attempt to combat the illness and make up for the
losses brought on by the stress. Additionally, a loss of appetite brought on by a
number of illnesses might result in inadequate nutrient intake. In addition, illness
frequently results in wasting, diarrhea, and acute respiratory illnesses, which are
the main causes of health issues related to nutrition.

HOW DO WE VALIDATE MALNUTRITION?

A nutrition evaluation must be completed in order to determine whether a person

is at risk; in fact, this assessment should be included in a normal physical
examination conducted by a medical expert who has received specialized
training in the diagnosis of risk people. Simply said, nutritional assessment is the
evaluation of one's nutritional status. To establish whether an individual or group
of individuals is well-nourished or malnourished (undernourished or over-
nourished), anthropometric, biochemical (laboratory), clinical, and dietary data
are interpreted.

The purpose of nutritional assessment is to learn more about the distribution and
prevalence of nutritional problems within a certain community or population. It
can be used to create successful public health nutrition (PHN) programs for
diseases connected to nutrition, as well as to monitor how well these
interventions are working.

The nutritional status of a person or community can be determined through

nutritional evaluation. Nutritional status refers to a person's physical and
physiological state as determined by their food. The condition of our body as a
result of the foods we eat and how our bodies use them is another way to define
nutritional status. It depicts the state of a person's health in connection to how
their body uses nutrients to meet their nutritional demands, as well as how that is
represented in their physical, physiological, and biochemical features, as well as
their functional capacity and health status.

Several techniques can be applied, and measurements or observations can be

compared to reference values, to determine the nutritional status of an individual
or group. The term ABCD stands for four different nutritional evaluation
techniques, including:

A - Anthropometric method

B - Biochemical (laboratory) method

C - Clinical method

D - Dietary method

1. ANTHROPOMETRIC METHOD:

This method uses physical attributes such body size and shape as external
dimensions. Anthropometric measurements are used to evaluate the growth and
variations in body composition brought on by changes in fat, muscular mass, etc.
The mid-upper arm circumference (MUAC), head circumference, chest
circumference, waist circumference, and skinfold are among the anthropometric
measurements.

Height and weight are also included.

After that, measurements are contrasted with references or standards. Results

that are out of the ordinary may show obesity, edema, wasting (catabolism),
failure to thrive in children or other conditions related to nutrient excesses or
shortages.

Stadiometers or height meters, bathroom scales or spring balances, measuring

tapes, calipers, and other tools are used for measurements.

Merits

* They are simple, easy to measure, and do not involve much time.
* Instruments are cheap and easily available

* If instructions are followed clearly, data is more likely to be accurate.

* This method is non-invasive (it does not require the use of sharp
instruments/equipment like needles, or syringes to pierce the body).

Limitations

* Possible errors due to weighing.

* It may not be socially or culturally acceptable.

* This method cannot be used to identify micronutrient deficiencies.

* It cannot be used to identify small changes in the proportion of body fat to lean
body mass.

* No special skill is needed.

* Some measurement may be impractical to make e.g height in people who are
unable to stand.

Interpretation of anthropometric measurement.

Single or more measures must be compared to a reference standard by age or

sex in order to interpret the anthropometric data. Nutrient interpretations may be
challenging until reference standards are obtained.

Index/indices or indicators are the names given to these composite

anthropometric measurements that are used to assess nutritional status. Body
mass index (BMI), body mass index for age (BMI for age), weight for age, height
for age, and weight for height are examples of commonly used markers.

Table I: Reference Standard for BMI

BMI(Kg/m°) cut-offs Nutritional status

More than 40.0 Very obese
30.0-40.0 Obese
25-29.9 Overweight
18.5-24.9 Normal
Less than 18.5 underweight

Height-for-age (H/A): measure stunting.

Stunting explains that the child is shorter than what is expected to be for his age.
Stunting is a measure of a long standing/chronic malnutrition. Stunting takes a
longer time for the child to recover. Stunted children have poor physical and
intellectual performance and lower work output leading to lower productivity at
individual level and poor socioeconomic development at the community level.
Interventions take a shorter time to recover.

Weight for height (W/H): measures wasting.

It is a measure of acute/ ongoing nutritional status of a child. It explains that the

child weighs less than expected for his age. Wasted children are vulnerable to
infection and stand a greater chance of dying.

Weight for age (W/A): This index measures underweight.

It combines wasting and stunting but can't be used to say exactly when
malnutrition started.

2. BIOCHEMICAL OR LABORATORY METHOD:

This method evaluates the levels/amounts of macro- and micronutrients (protein,

fat, iron, calcium, etc.) and immunological markers in a person's blood, urine, or
feces as opposed to anthropometric measurements. The nutrients, enzymes, and
metabolites in these samples reflect nutritional status and reveal particular
dietary failings. A skilled medical professional can utilize biochemical or
laboratory testing to diagnose malnutrition before symptoms show up and to
learn more about illnesses that may influence appetite or nutritional status.
Examples of tests performed with this technique include lipid profile tests,
calcium tests, creatinine ratio tests, glucose tests, and red blood cell counts.

Uses and limitation

* This method of assessment is reliable.

* It is an invasive method, expensive and require special instruments and so may

predispose one to infection and pain.

3. CLINICAL METHODS:

Clinical techniques of evaluating nutritional status include looking for deficiencies

at specific body sites or asking the patient if they are experiencing any symptoms
that might point to vitamin deficiencies.

Clinical indicators of nutritional inadequacy include pallor (on the palm of the
hand or the conjunctiva of the eye), Bitot's spots on the eyes, pitting oedema,
goitre, and severe apparent wasting, scurvy. The least reliable method is this
one, thus further research may be required.

4. Dietary method:

Here, nutritional status is evaluated by accounting for the person's dietary and
fluid intake. A crucial component of nutrition assessment is determining food and
liquid intake. It offers details on diet quality and amount, appetite variations, food
allergies and intolerances, and the causes of insufficient calorie intake during or
after illness.

The findings are compared to recommended intake, such as the recommended

dietary allowance (RDA), in order to give clients advice on how to improve their
diets in order to prevent malnutrition or treat diseases that are influenced by food
intake and nutritional status, such as cancer, diabetes, obesity, and
hyperlipidemia.

Dietary evaluation techniques include meal frequency questionnaires, food

diaries, and 24-hour dietary recall.
-24-hour dietary recall:

The individual is asked to recall the specific meals and liquids they consumed the
previous day. Measurements and portion sizes are calculated using real food,
household utensils, food models, pictures, or exact measurements; they are also
used as memory aids. A food composition data table is used to calculate nutrient
consumption. To take into consideration intake variations from day to day, the
process can be repeated numerous times.

Uses and limitations

* It is used to compare nutrient intake to health and the risk of chronic diseases
on a global scale.

* It is quick, simple, and uncomplicated with no stress on respondents.

* Literate people can utilize it to get full visibility.

* Single 24-hour dietary recall is can miss out foods consumed frequently.

* Subjects forget or are not always totally truthful. They are sometimes inclined to
say they have eaten certain foods because they know they should have done so.

* To get usual food intake, 24-hour recall must be done repeatedly.

* It relies on memory thus not satisfactory for elderly and young children.

* Under the condition that the sample is genuinely representative and the days of
the week are well represented, it is effective for determining the average intakes
of a large number of people.

2. Food frequency questionnaire (FFQ):

Detailed list of foodstuffs from which the respondent was questioned or

interviewed about their dietary habits during a specific time period. Record is
gathered by an interview or a self-administered survey. Subjects may be asked to
quantify the typical portion size of food products in a semi-quantitative
questionnaire. The food items on the list can be changed to reflect what is
available in the community's area.
Uses and limitations

* FFOs are used to obtain qualitative data on usual food intakes or classes of
foods over a long period of time.

* Ranking participants into low, medium, or high categories of consumption of

particular foods is helpful in epidemiological investigations. Although the method
is quick and requires few respondents, it is less accurate than other approaches.