Confronting Pervasive Under-Five Stunting: Insights from Nutritional Aid-Recipient Communities

Janine Patricia G. Robredo, MD, MBA, MMSc '24 

roberdoJanine is the executive director of an NGO in the Philippines that promotes ethical leadership, good health governance, and people empowerment through capacity-building and community development programs. She works with sectoral leaders and local governments across the country and has years of experience in grassroots political campaigns. She is a medical doctor who served as an emergency department physician and a health programs strategist of the Office of the Vice President of the Philippines during the COVID-19 pandemic. Janine has published multiple papers on health inequities in the Philippines. She is devoted to reducing discrepancies in healthcare access and delivery.
All study participants gave permission for their photos to be taken and shared. Caregivers gave consent for children to be photographed and for their photos to be shared. 
 

Anahi Strader interview 2023

Student Perspectives

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The photo on the left is of a house in Don Salvador Benedicto (DSB), a rural municipality in Negros Occidental. It is a house made of bamboo and yero (sheet metal), where five family members seek shelter. 

The house on the right is from Bago City. Although some parts of the house are cemented, most of the structure is still made of bamboo and yero. Because it's on the roadside, there is barely enough space for other functions (i.e., planting, cooking, etc.). However, this house is closer to a water pump and to the city center, where most resources are located. 

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I was able to visit the community markets in Don Salvador. 

This reflects how goods are transported to the barangay hall on Thursdays. Several trucks and mini-vans carry rice and other basic goods, such as dried fish and meat. There is variety, but the choices are still very limited. Regardless, the residents reported that they do not have the budget to afford anything other than what is available.

Pictured right is the community during their designated market day, only on Thursdays. Unlike perminant markets in Bago, DSB residents convene in the basketball court, where the stalls are set up weekly. Goods are brought from the neighboring town to DSB. This makes the process more accessible to residents who have no means of transportation, but the choices are also very limited.

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These photos were taken during a nutrition program hosted by Don Salvador Benedicto and NVC (non-profit partner). Mothers were asked to bring their children to the barangay basketball court to participate in the program, which included check-ups and nutrition counseling. This is conducted quarterly, and mothers are given incentives for their participation. Barangay Nutrition Scholars are given an allowance as well. 

The barangay nutrition scholars identify the most malnourished children in their catchment area and enroll them in a wet feeding program sponsored by the municipality. It runs for 60 days and is conducted in the barangay health centers.

While we recognize the contributions of this initiative, BNS reported that the children tend to revert to their malnourished state once the program ends.

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This photo was taken during our fieldwork for our caregiver in-depth interviews. The participant pictured is a 19-year-old mother of one who worked thrice weekly on a nearby sugarcane farm. She is a high school graduate dreaming of working in the city for additional income but is left to care for her son in a town on the outskirts of a far-flung municipality. She has a basic idea of what her son needs to be healthy but is unable to provide because of their lack of household income. She is able and willing to do more work but is afraid to ask her husband’s permission to leave their town, knowing that she will be requested to stay with their son.

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The Barangay Nutrition Scholars of Bago City
[There is a] culture of giving shared within [the] community. Most of them are impoverished but still find themselves getting by with each other’s assistance. Although it makes for a great story of resilience, I hope it sheds light on the lapses of the structures that are supposed to serve them: how they receive less than what they need, and how this forced them into relying on each other even when they have little means to do so.
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I had the privilege of meeting Barangay Nutrition Scholars of Bago City during an assembly. This was also in the middle of a typhoon, but most of them still came. They were eager to engage in informal conversation and share their job and community experiences. They barely earn a livable income from their full-time work and say that they consider this an act of service more than anything.

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These photos were taken during our fieldwork for our caregiver in-depth interviews. Because it was monsoon season, it was pouring rain, and it was a journey to get to this participant's house. They lived across the river and a hike away from the city center. This participant is the grandmother of one of NVC’s beneficiaries and took the role of primary caregiver and breadwinner at the age of 60. Despite working all day and night, she earns very little to support the rest of her children and grandchildren. Some days, they don’t have food to eat and only rely on the harvest of the banana tree they plant in their backyard. But when we finished our interview, she handed me a bag full of bananas to take home. Despite these struggles, she still insisted on sending me home with food. This could’ve lasted her household for a few more days, but she still wanted me to keep it. I felt guilty to take it, but she insisted that I do.

Read more about the Master of Medical Sciences in Global Health Delivery program here.