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Prevalence of Malnutrition and Its Risk Factors among Under-Five Children: A

Case Study in the Second Congressional District of Camarines Norte,
Philippines

Article in Journal of Public Health Sciences · April 2025

DOI: 10.56741/jphs.v4i01.813

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 Journal of Public Health Sciences (JPHS)
Vol. 4, No. 01, pp. 73-103
[Link]/[Link]/JPHS
DOI: 10.56741/jphs.v4i01.813

Prevalence of Malnutrition and Its Risk Factors

among Under-Five Children
A Case Study in the Second Congressional District of Camarines Norte, Philippines
1Leni M. Malabanan*, 1Eden C. Miguel
Corresponding Author: * lenimalabanan@[Link]
1Camarines Sur Polytechnic Colleges, Philippines

ARTICLE INFO ABSTRACT

Article history Malnutrition among children under five remains a critical

Received 15 January 2025 public health concern, impacting growth, development, and
Revised 18 March 2025 overall well-being. This retrospective cohort study was
Accepted 24 March 2025 conducted to thoroughly examine the prevalence of
malnutrition and its associated risk factors among children
under five in the Second Congressional District of Camarines
Norte. Data collection involved reviewing documents,
specifically the records of 340 under-five children obtained
from the Field Health Service Information System (FHSIS).
These records were assessed using a guide checklist, with the
data analyzed through percentage technique, prevalence
rates, odds ratios, and multivariate regression analysis.
Results revealed a predominance of male children, most aged
24-35 months, with parents largely employed, high school
graduates, and earning household incomes of Php 5,000–
10,000 per month. Mild to moderate household food
insecurity was also noted, necessitating attention to prevent
long-term health impacts. Low household income strongly
predicted underweight status, while stunting was
significantly associated with low maternal education and
maternal unemployment. However, none of these factors
were significant predictors of wasting. Furthermore, no
significant correlation was found between malnutrition
indicators (underweight, stunting, wasting) and healthcare
service utilization, including routine check-ups, growth
monitoring, and nutrition counseling. The study underscores
the importance of targeted nutritional interventions
addressing stunting and iron deficiency, coupled with
strategies to improve maternal education and employment.
A proposed plan has been developed to enhance the

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nutritional status of under-five children and reduce

malnutrition prevalence through comprehensive,
community-focused approaches.

Keywords This is an open-access article under the CC–BY-SA license.

Malnutrition
Prevalence
Risk Factors
Under-five Children

Introduction
Malnutrition continues to be a global public health challenge, particularly among
children under the age of five. It is a condition resulting from insufficient or excessive intake of
essential nutrients, with consequences that range from impaired physical and cognitive
development to increased susceptibility to infections and higher mortality rates. Addressing
malnutrition is critical to achieving sustainable development goals, particularly those related
to health, education, and poverty alleviation.
Malnutrition has received significant attention in the health sector and from
governments around the world for decades. The considerations resulted from the impact.
Malnutrition has a variety of repercussions, but researchers have identified the most serious
ones: poor fetal growth, low birth weight (LBW), short and long-term mother and newborn
morbidity, and mortality. Malnutrition is a health problem caused by a diet providing
insufficient or excessive calories, carbs, vitamins, proteins, or minerals. It is a state of under-
or overnutrition, characterized by a lack or excess of vital nutrients. Good nutrition is essential
for children's survival, development, learning, play, and participation.
Sustainable Development Goal (SDG) 2: Zero Hunger, aims to end hunger, achieve food
security, and improve nutrition. This SDG emphasizes the need to address malnutrition,
particularly among vulnerable populations such as young children, to ensure they achieve their
full physical and cognitive potential. Malnutrition during the critical early years of life can lead
to stunted growth, weakened immunity, and impaired development, perpetuating cycles of
poverty and poor health [1].
According to the World Health Organization's 2024 vision, everyone would be healthy
and happy, and there would be no malnutrition of any kind. The 2016–2025 nutrition strategy
states that the WHO works with partners and Member States to guarantee that everyone has
access to nutrient-dense meals and efficient nutrition treatments that come from resilient and
sustainable food systems. In addition to developing evidence-based guidance based on sound
scientific and ethical frameworks, the WHO uses its convening power to help set, align, and
advocate for global nutrition priorities and policies. It also encourages the adoption of guidance

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and the implementation of successful nutrition actions and keeps an eye on and assesses the
nutritional outcomes of programs and policies.
The UNICEF Nutrition Strategy 2020–2030: Nutrition for Every Child outlines
UNICEF’s strategic intent to support national governments and partners in upholding
children’s right to nutrition and ending malnutrition in all its forms. Despite significant
challenges, there is optimism as the proportion of children under five suffering from stunting
has declined by one-third since 2000. To sustain this progress, UNICEF's strategy emphasizes
a life-cycle approach, evidence-based programs, systems strengthening, and private sector
engagement, aiming to secure a more equitable future for all children by 2030 [2]. Furthermore,
in many low- and middle-income nations, especially in Asia and Africa, malnutrition is still a
serious public health issue. Because of the strong need for food during their growing years,
children under five are particularly susceptible to macro- and micronutrient deficits. Acute
malnutrition can impede cognitive and physical development and result in illness, mortality,
and disability. Ending hunger, food insecurity, and malnutrition in these regions requires
continued, focused efforts [3].
Undernutrition deprives Filipino youngsters of their chance at a bright future. Children
growing up in poverty require equal investments in nutrition, health, education, and wellness
to fulfill their full potential as healthy, skilled individuals capable of improving their quality of
life. For nearly 30 years, there has been little change in the frequency of undernutrition in the
Philippines. One in every three children (29%) under the age of five was stunted, which means
they were undersized for their age.
Furthermore, 19% were underweight for their age, and 6% of children under the age
of five were categorized as "wasted," which is underweight for their height. The Philippines is
ranked fifth in the East Asia and Pacific area for stunting prevalence, and one of the top ten
countries in the world for stunted children. According to the WHO classification of
undernutrition rates, the stunting frequency among children in the Philippines is of "very high"
public health concern [4].
The imperative to invest in nutrition is enshrined in the 1989 Philippine Constitution,
which mandates the State to defend children's right to assistance, including proper care and
nutrition. Landmark legislation, such as Presidential Decree 491 of 1974 (Nutrition Act of the
Philippines), created the National Nutrition Council (NNC) to oversee the national nutrition
program. This program integrates and coordinates policies and programs across government
and private sectors, addressing the country's nutrition challenges.
The statistics derived from the National Nutrition Council's (NNC) annual OPT Plus
program, which assesses the nutritional status of children across the Philippines shows that

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the 2023 Operation Timbang Plus (OPT Plus) results for Camarines Norte indicate significant
malnutrition challenges among children under five years old. The province ranks fifth in the
Bicol Region for stunting prevalence, with 10.27% of children affected, totaling 5,906 cases.
Additionally, 1.22% (701 children) are classified as wasted, and 2.37% (1,306 children) are
considered overweight or obese [5].
The Second Congressional District of Camarines Norte is composed of municipalities
characterized by rural landscapes, a high prevalence of poverty, and limited access to
healthcare and nutrition services. Children under five in this district face significant challenges,
including food insecurity and suboptimal healthcare, which increase their vulnerability to
malnutrition. According to local health records, the prevalence of stunting and wasting among
children in this region exceeds the national average. The role of the nurse-in-charge of the
nutrition program is vital in addressing this public health challenge [6]. By providing
nutritional assessments, health education, and referrals to appropriate services, the nurse
contributes to improving the health outcomes of at-risk children. However, gaps in
understanding the prevalence and risk factors of malnutrition in the Second Congressional
District hinder the development of targeted and effective interventions.
A. Objectives of the Study
The study on the prevalence of malnutrition and its risk factors among under-five children
in the Second Congressional District of Camarines Norte aimed to attain the following
objectives:
• Determine the sociodemographic profile of under-five children in the Second
Congressional District of Camarines Norte, in terms of: Age, Sex, Educational
Attainment of Parents, Employment Status of Parents, Household Monthly Income
• Analyze the prevalence of malnutrition among under-five children in the Second
Congressional District of Camarines Norte in terms of: Weight-for-Age, Height-for-Age,
Weight-for-Height
• Assess the under-five children’s nutritional intake, household food security levels, and
healthcare service utilization in the Second Congressional District of Camarines Norte.
• Analyze the determinants of malnutrition among under-five children in the Second
Congressional District of Camarines Norte along with the following socioeconomic
factors: Low Household Income, Low Maternal Education, Unemployed Mother, Low
Paternal Education, Unemployed Father
• Propose a plan to enhance the nutritional status of under-five children and reduce the
prevalence of malnutrition in the Second Congressional District of Camarines Norte.

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B. Scope and Limitations of the Study

This study assessed the prevalence and risk factors of malnutrition among children under
five years old in the Second Congressional District of Camarines Norte. It aimed to provide
localized insights into the nutritional status of this vulnerable demographic within a defined
geographic area. The research encompasses an examination of dietary patterns, socioeconomic
status, and access to healthcare services as potential determinants of malnutrition. The study
also aimed to pinpoint key factors and gaps in existing interventions to offer evidence-based
recommendations for enhancing nutrition programs and policies specific to the province. Data
for the research was sourced from the records of the Municipal Health Offices within the
Second Congressional District of Camarines Norte, encompassing information on 340 children
under five years old based on records from January to June of the respective municipalities.
This study is geographically and demographically limited to children under five years old
residing in the Second Congressional District of Camarines Norte, which may restrict the
generalizability of findings to other areas or populations. Data collection relies on local health
records, which may introduce recall bias or data inconsistencies. The study does not account
for long-term trends or seasonal variations in nutritional status and risk factors. These
limitations may affect the comprehensiveness of the findings but do not diminish their value
in guiding local efforts to address malnutrition.
Material and Methods
A. Research Design
A retrospective cohort study design was employed to comprehensively investigate
malnutrition prevalence and its risk factors among children under five in the Second
Congressional District of Camarines Norte. A retrospective cohort study is a research design
that examines the relationship between historical exposures and outcomes by analyzing pre-
existing data. In this approach, the researcher identifies a cohort of individuals based on past
exposure to certain risk factors and then assesses the subsequent occurrence of specific
outcomes within these groups.
This study design is particularly useful for investigating the prevalence and risk factors of
conditions like malnutrition. The researcher can identify associations between past exposures
such as socioeconomic status, dietary habits, or environmental conditions and the current
nutritional status of under-five children in the Second Congressional District of Camarines
Norte. This method allows for the efficient assessment of multiple risk factors simultaneously,
providing valuable insights that can inform public health interventions aimed at addressing
malnutrition in the province.

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B. Respondents of the Study

The study population for the research on the prevalence of malnutrition and its risk factors
among under-five children in the Second Congressional District of Camarines Norte consists of
340 under-five children. This population represents a vulnerable group whose growth and
development are crucial indicators of public health. The selection of this demographic ensures
that the study focuses on a critical age group where malnutrition has the most significant long-
term impact on physical, cognitive, and emotional development.
The study focused on selecting children aged 0 to 59 months, as this age group represents
a critical period for growth and development, during which malnutrition has profound short-
and long-term impacts. Only children residing within the district were included to ensure that
the data accurately reflect the local context. Additionally, records with complete and consistent
information in the Field Health Service Information System (FHSIS) were selected, ensuring
that essential variables such as anthropometric measurements, growth monitoring data, and
health histories were available for analysis.
Children with incomplete or inconsistent records were excluded, as missing data could
compromise the accuracy of the results. Non-residents in the districts were also excluded to
ensure that the findings were representative of the local population. Furthermore, cases
involving children with severe congenital anomalies or conditions significantly affecting
growth and development were not included, as these could introduce confounding factors
unrelated to socioeconomic determinants of malnutrition.
C. Research Instrument
The study of the prevalence of malnutrition and its risk factors among under-five children
in the Second Congressional District of Camarines Norte utilized document review through a
guide checklist to gather the necessary data needed in the study.
In the study, the primary instrument used was a document review. This involved analyzing
records of under-five children from the Field Health Service Information System (FHSIS). The
FHSIS serves as a standardized database for health-related data collected by local health units,
offering a reliable source of information on the nutritional status of children, including
anthropometric measurements, growth monitoring records, and associated health conditions.
D. Data Gathering Procedure
The data-gathering process consists of the preparation and retrieval of the guide checklist.
Each phase is essential to the study's success and meticulously executed to achieve research
objectives and generate reliable and actionable results.
E. Data Analysis
A rigorous data analysis approach was employed to ensure a comprehensive examination
of each aspect of the study, utilizing appropriate statistical and analytical techniques, namely;

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percentage technique, prevalence rate, odds ratios, and multivariate regression analysis. This
enhances the findings' validity, robustness, and reliability, providing a solid basis for
developing effective interventions to address child malnutrition in the Second Congressional
District of Camarines Norte.
Percentage Technique was used to calculate the percentage results of the
sociodemographic profile of under-five children; and under-five children’s, household food
security levels and healthcare service utilization in the Second Congressional District of
Camarines Norte.
Multivariate Regression Analysis is a statistical technique that models the relationship
between multiple independent variables and multiple dependent variables simultaneously.
Multivariate regression analysis examined how variables like household income, parental
education levels, and access to healthcare services affect a child's nutritional status. These
factors determined which variables have the most significant impact and how they interact,
providing a nuanced understanding of the pathways leading to malnutrition. This
comprehensive analysis is essential for addressing the complex nature of malnutrition and
implementing effective public health strategies.
Results and Discussion
A. Sociodemographic Profile of Under-Five Children
This section presents the sociodemographic profile of under-five children in the second
congressional district of Camarines Norte in terms of age, sex, educational attainment of
parents (mother and father), employment status of parents (mother and father), and
household monthly income.
Table 1 presents the distribution of the respondents in terms of age. The distribution of
respondents in terms of age reveals critical insights into the nutritional status of under-five
children in the Second Congressional District of Camarines Norte. Children aged 24-35 months
comprise the largest group (29.41%), followed by those aged 36-47 months (25.59%) and 12-
23 months (19.41%). The youngest age group, 0-11 months, accounts for 14.71%, while the
oldest group, 48-59 months, represents the smallest proportion at 10.88%. These figures
indicate that children between 12 and 47 months constitute the majority of the population
studied, highlighting this age range as a critical focus for nutrition-related interventions.
The high representation of children in the 12-47 months range highlights a need for
targeted nutrition programs focusing on complementary feeding, micronutrient
supplementation, and early health interventions. Interventions for the youngest group should
emphasize breastfeeding promotion and the timely introduction of nutrient-dense

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complementary foods. Addressing nutritional deficits in the older groups could help mitigate
the long-term impacts of malnutrition, such as reduced cognitive and physical development.

Table 1. Distribution in Terms of Age

Indicator Frequency Percentage Rank
0-11 months 50 14.71 4
12-23 months 66 19.41 3
24-35 months 100 29.41 1
36-47 months 87 25.59 2
48-59 months 37 10.88 5
Total 340 100.00

The results of the study are closely correlated with the findings of Davenport et al. [7]
wherein the distribution of children by age group reveals a peak in the 24–35-month range
which is a crucial period for growth and development when nutritional deficiencies can have
the most profound and lasting consequences. This finding underscores the importance of
prioritizing interventions that target this vulnerable age group to prevent the onset and
progression of malnutrition. The relatively even distribution of children across the other age
groups emphasizes the need for continued monitoring and nutritional support beyond the first
two years of life, as early childhood remains a critical window for dietary interventions [8].
Table 2 illustrates the distribution of under-five children by sex in the Second
Congressional District of Camarines Norte. The population is nearly evenly split, with males
comprising 50.88% and females 49.12% of the total respondents. This indicates a slight
predominance of male respondents, ranking first, while female respondents are a close second.

Table 2. Distribution in Terms of Sex

Indicator Frequency Percentage Rank
Male 173 50.88 1
Female 167 49.12 2
Total 340 100.00

The near parity between the sexes provides a balanced dataset for evaluating the
nutritional status of under-five children and the prevalence of malnutrition. The equal
distribution of sexes suggests that nutritional assessments and malnutrition prevalence can be
analyzed without significant gender bias in the dataset. However, biological and cultural
factors may still influence the nutritional status of male and female children differently. Slightly
higher prevalence rates of malnutrition may occur as boys often have higher metabolic
demands due to growth spurts. If nutritional resources are inadequate, this could lead to
increased susceptibility to undernutrition in boys.
Cultural factors and potential disparities in care, such as prioritizing male children for food
or healthcare in some households, could contribute to nutritional challenges. Conversely, if

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nutritional support is equally distributed, the close proportion of males and females should
reflect similar malnutrition risks across genders. The findings emphasize the need for gender-
sensitive interventions in addressing malnutrition. For instance, programs should ensure
equitable access to nutritious food, healthcare, and supplementary feeding for both sexes.
Nutritional education for parents and caregivers should highlight the importance of balanced
feeding practices regardless of the child’s sex.
Community health programs should focus on improving overall food security, maternal
education, and access to health services to reduce malnutrition risks for all under-five children
in the district. By addressing both biological and sociocultural factors, policymakers and
healthcare providers can ensure equitable and effective interventions. The gender distribution
within the sample indicates a slight overrepresentation of males. However, this difference is
not statistically significant, suggesting that malnutrition is a pervasive issue affecting both
sexes. This finding aligns with previous research that has found no significant gender
differences in the prevalence of malnutrition in similar settings [9]. Thus, while gender-specific
factors may influence nutritional status in specific contexts, the current data suggests that
gender is not a primary independent risk factor for malnutrition in this population.
The educational attainment of the parents of children under five years old takes into
account the education levels of both the mother and the father. The data presented in Table 3
highlights the educational attainment of mothers in the Second Congressional District of
Camarines Norte and its potential implications for the prevalence of malnutrition among
children under five years old. The largest group of mothers are high school graduates, making
up 42.35% of the sample. This indicates that a significant portion of the population has attained
secondary education, which provides a foundational understanding of health and nutrition.
However, the prevalence of malnutrition in this group may suggest gaps in translating this
knowledge into effective child-rearing practices due to socio-economic challenges or lack of
access to resources. Mothers with elementary education represent 26.47%, while 7.94% of
mothers have no formal education. These groups are more likely to face barriers in
understanding and applying proper nutrition and healthcare practices, which can increase the
risk of malnutrition among their children. Limited education can lead to insufficient awareness
about balanced diets, breastfeeding practices, and the importance of healthcare visits,
exacerbating child health vulnerabilities. Addressing these gaps through targeted education
programs that are accessible and culturally sensitive is crucial.
On the other hand, only 23.24% of mothers are college graduates, reflecting a relatively
small proportion with higher educational attainment. Studies have shown that higher
education levels among mothers are associated with better child health outcomes, as educated

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mothers are more likely to make informed decisions about their children's nutrition,
healthcare, and overall well-being.

Table 3. Distribution in Terms of Educational Attainment of the Mother

Indicator Frequency Percentage Rank
No Formal Education 27 7.94 4
Elementary Graduate 90 26.47 2
High School Graduate 144 42.35 1
College Graduate 79 23.24 3
Total 340 100.00

The lower proportion of college-educated mothers highlights the need for policies that
promote higher education for women, particularly in rural areas, as a long-term strategy to
improve maternal and child health outcomes.
The findings highlight the importance of health education programs tailored to the varying
educational levels of mothers. For mothers with no formal education, visual aids, hands-on
workshops, and peer support groups can help bridge knowledge gaps. For those with
elementary or high school education, community-based interventions focusing on practical
and actionable guidance can enhance their ability to prevent malnutrition. Empowering
mothers through education not only addresses malnutrition but also fosters a cycle of
improved health and well-being for future generations. Maternal factors also play a pivotal role
in shaping a child's nutritional status. The analysis reveals that children of mothers with less
than a high school education is more prone to underweight and stunting, emphasizing the
importance of empowering women through education to break the cycle of malnutrition, as
suggested by the work of Basu and Banerjee [10].
The data in Table 4 provides insights into the educational attainment of fathers of under-
five children in the Second Congressional District of Camarines Norte. The largest group,
comprising 37.06% of the sample, are high school graduates, while 33.23% are college
graduates. This indicates that a significant portion of fathers have achieved at least secondary
education, with a notable proportion attaining higher education. However, a considerable
number of fathers, 21.18%, have only completed elementary education, and 8.53% have no
formal education, suggesting disparities in educational access among the population.
The educational attainment of fathers has important implications for child nutrition and
health. Fathers with lower levels of education, such as elementary graduates or those with no
formal schooling, may lack adequate knowledge about proper nutrition, healthcare practices,
and access to essential health services, increasing the risk of malnutrition among their children.
Targeted interventions should address these gaps by providing accessible, community-based
education programs that simplify health and nutrition concepts using culturally relevant
methods.

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Table 4. Distribution in Terms of Educational Attainment of the Father

Indicator Frequency Percentage Rank
No Formal Education 29 8.53 4
Elementary Graduate 72 21.18 3
High School Graduate 126 37.06 1
College Graduate 113 33.23 2
Total 340 100.00

On the other hand, fathers with higher educational attainment are more likely to have
access to resources and information that support good parenting practices, including proper
child nutrition and healthcare. Their involvement in household decision-making can play a
crucial role in preventing malnutrition and ensuring the overall well-being of their children.
Health programs should capitalize on this by actively engaging educated fathers and
emphasizing their role in fostering a healthy environment for their families. For fathers with
limited educational backgrounds, peer education, visual aids, and practical demonstrations can
bridge knowledge gaps and encourage active participation in child-rearing responsibilities.
These efforts should also integrate both parents into health and nutrition programs to promote
joint decision-making, leveraging the strengths of more educated fathers to complement
maternal efforts.
The occupation of the parents of children under five years old takes into account the source
of income of both the mother and the father. Table 5 shows the employment status of mothers
of under-five children in the Second Congressional District of Camarines Norte. The majority,
65.89%, are employed, indicating that most mothers are engaged in formal or informal
employment outside the home. This is followed by 21.76% who are unemployed and 12.35%
who are self-employed. The data highlights the diverse economic roles mothers play within
their households and communities. Mothers who are employed may contribute significantly to
their family’s income, which could improve access to basic needs, including nutritious food and
healthcare services.
However, employment can also present challenges, such as limited time for direct child
care and meal preparation, potentially impacting the nutritional status of their children. On the
other hand, unemployed mothers may have more time to focus on child-rearing but could face
economic constraints, limiting their ability to provide adequate nutrition and healthcare. Self-
employed mothers, while maintaining flexibility in their schedules, may also experience
financial insecurity depending on the nature of their work. The high proportion of employed
mothers suggests the need for workplace policies that support child nutrition, such as paid
maternity leave, breastfeeding-friendly environments, and flexible work schedules. These
measures can help employed mothers balance their roles as caregivers and earners, reducing
the risk of malnutrition among their children.

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Table 5. Distribution in Terms of Employment Status of the Mother

Indicator Frequency Percentage Rank
Unemployed 74 21.76 2
Employed 224 65.89 1
Self-employed 42 12.35 3
Total 340 100.00

The mothers who are unemployed may face financial difficulties that limit their ability to
provide adequate nutrition for their children. Programs targeting this group should focus on
providing financial assistance, access to livelihood opportunities, and nutrition education to
address economic and knowledge-based barriers to child health. Self-employed mothers can
benefit from initiatives that promote entrepreneurship and financial literacy, enabling them to
generate more stable incomes.
Additionally, providing health education that aligns with their flexible schedules can
enhance their ability to support their children’s nutritional needs. To address malnutrition
effectively, interventions must consider the employment status of mothers. Community-based
programs should offer flexible schedules and resources to accommodate employed and self-
employed mothers, ensuring they have access to health and nutrition services. For
unemployed mothers, targeted financial and educational support can help mitigate the effects
of economic constraints. Maternal unemployment further exacerbates the risk of a child’s
nutritional status, with children of unemployed mothers experiencing heightened
vulnerability to all three forms of malnutrition: underweight, stunting, and wasting. This
finding underscores the need for comprehensive policies and programs that support maternal
employment and foster economic empowerment for women, aligning with the
recommendations of Bazzazian et al. [11].
Table 6 outlines the employment status of fathers of under-five children in the Second
Congressional District of Camarines Norte. The majority, 71.18%, are employed, indicating that
most fathers have stable or regular income-generating roles. A smaller percentage, 17.35%,
are unemployed, while 11.47% are self-employed.

Table 6. Distribution in Terms of Employment Status of the Father

Indicator Frequency Percentage Rank
Unemployed 59 17.35 2
Employed 242 71.18 1
Self-employed 39 11.47 3
Total 340 100.00

This distribution highlights the fathers’ significant contributions to their households’

economic stability, although a notable proportion faces employment challenges or relies on
informal or entrepreneurial income. The high percentage of employed fathers suggests a
substantial level of financial support for their families, which can positively impact their

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children’s nutrition and overall well-being. Stable employment increases access to resources
like nutritious food, healthcare, and education, which are crucial for preventing malnutrition
among under-five children.
The unemployed fathers may face economic hardships that limit their ability to provide
essential resources for their families. This could contribute to an increased risk of malnutrition
among their children. Interventions targeting unemployed fathers should focus on job creation,
skills training, and community support programs to improve their economic contributions.
Fathers who are self-employed may experience fluctuating income levels, making it
challenging to consistently meet their family’s nutritional and healthcare needs. Programs that
offer financial literacy, business development support, and access to microfinancing can help
stabilize their income and enhance their capacity to support their children.
The employment status of fathers directly influences their ability to participate in
programs addressing malnutrition. Flexible, family-centered health and nutrition
interventions can ensure fathers, regardless of their employment status, are actively involved
in child-rearing and nutritional decision-making. While fathers often play the role of primary
earners, their engagement in childcare and health decisions is equally critical. Programs should
emphasize the importance of shared parental responsibility to ensure the effective utilization
of resources for their children’s well-being.
The data presented in Table 7 reveals the distribution of household monthly income among
families in the Second Congressional District of Camarines Norte. A significant portion of
households, 37.65%, earn between ₱5,000 and ₱10,000 per month, followed by 25.29%
earning ₱10,001 to ₱15,000. Households with incomes below ₱5,000 account for 18.24%,
while those earning ₱15,001 to ₱20,000 make up 12.94%. Notably, only 5.88% of families have
a monthly income exceeding ₱20,000.

Table 7. Distribution in Terms of Household Monthly Income

Indicator Frequency Percentage Rank
Less than ₱5,000 62 18.24 3
₱5,000-₱10,000 128 37.65 1
₱10,001-₱15,000 86 25.29 2
₱15,001-₱20,000 44 12.94 4
₱20,000 and above 20 5.88 5
Total 340 100.00

These findings suggest that the majority of households fall within low-income brackets,
reflecting a socioeconomic environment that may contribute to food insecurity and
malnutrition, particularly among vulnerable groups like under-five children. The prevalence
of malnutrition, especially stunting, wasting, and underweight conditions, can be closely linked
to low household income. Limited financial resources often restrict access to nutritious food,
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adequate healthcare, and other essentials for children’s growth and development. Families
earning below ₱10,000 per month (55.89% combined) are likely to face challenges in meeting
their children’s nutritional needs. This economic strain can exacerbate the risk of chronic
malnutrition, leading to developmental delays, weakened immunity, and poor overall health
outcomes for under-five children.
These findings are significant for policymakers, healthcare providers, and local
government units. First, targeted intervention programs such as food supplementation,
livelihood training, and conditional cash transfer schemes (e.g., 4Ps) should prioritize
households in the lowest income brackets to reduce malnutrition rates. Second, nutrition
education campaigns should be conducted to help parents optimize limited resources and
promote affordable yet nutritious food choices. Lastly, improving access to maternal and child
healthcare services can mitigate the adverse effects of poverty on child health outcomes.
Addressing these socioeconomic factors is critical to breaking the cycle of malnutrition and
ensuring the health and well-being of under-five children in Camarines Norte.
The result is consistent with findings from other studies in low- and middle-income
countries, where stunting often emerges as a significant public health concern [9]. This high
prevalence indicates a substantial burden of chronic undernutrition, likely stemming from
prolonged inadequate dietary intake and recurrent infections. As highlighted by Davenport et
al. [7], socio-economic factors and environmental challenges can exacerbate the risk of
stunting, particularly in vulnerable populations.
The long-term consequences of stunting are far-reaching, impacting physical growth,
cognitive development, and future earning potential. This underscores the urgent need for
sustainable interventions addressing the root causes of food insecurity and promoting long-
term nutritional well-being. The literature supports the notion that being underweight is often
associated with a combination of factors, including inadequate dietary intake, recurrent
infections, and poor socioeconomic conditions [12]. Addressing underweight necessitates a
dual approach: tackling the underlying causes of chronic malnutrition while providing
immediate nutritional support to those with acute deficiencies.
B. Prevalence of Malnutrition Among Under-Five Children
This section discusses the prevalence of malnutrition among under-five children in the
Second Congressional District of Camarines Norte in terms of Weight-for-Age, Height-for-Age,
and Weight-for-Height. The prevalence was identified based on the gathered data from the
different Rural Health Units of the Second Congressional District of Camarines Norte.
Table 8 highlights the prevalence of three critical malnutrition indicators: stunting,
underweight, and wasting among children under five, along with their respective 95%
confidence intervals. These findings provide insight into the nutritional status of the

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population and serve as a basis for addressing the underlying determinants of malnutrition.
Stunting, measured by height-for-age, shows the highest prevalence of 32.68%. This suggests
a widespread issue of chronic malnutrition, which is often the result of prolonged dietary
deficiencies, repeated infections, and suboptimal maternal health during pregnancy.

Table 8. Prevalence of Malnutrition Among Under-Five Children

Indicators Prevalence 95% CI Rank
Underweight (Weight-for-Age) 23.74% (18.31% - 30.01%) 2
Stunting (Height-for-Age) 32.68% (26.45% - 39.45%) 1
Wasting (Weight-for-Height) 9.34% (5.75% - 14.19%) 3

Stunting reflects long-term exposure to poor socioeconomic and environmental conditions

and has significant implications for child development. Chronically malnourished children are
at risk of impaired cognitive development, reduced physical capacity, and a higher likelihood
of health complications later in life. The persistent high prevalence of stunting indicates the
need for sustained interventions that address both immediate and systemic factors affecting
child nutrition. Underweight, as indicated by weight-for-age, has a prevalence of 23.74%, lower
than stunting but still concerning. This indicator captures both acute and chronic malnutrition,
making it a valuable metric for assessing overall nutritional health. Underweight children are
more vulnerable to infections and illness due to weakened immune systems, creating a vicious
cycle that exacerbates nutritional deficits. The prevalence of underweight highlights the dual
need for both immediate interventions to combat acute malnutrition and longer-term
strategies to improve chronic nutritional inadequacies. Further, wasting, defined by weight-
for-height, has the lowest prevalence of 9.34%, reflecting fewer cases of acute malnutrition in
the region. While less prevalent, wasting represents a severe and immediate threat to child
survival, as it often results from sudden weight loss due to illness or inadequate dietary intake.
Children who are wasted face an increased risk of mortality if not promptly treated. This
highlights the importance of community-based nutrition programs and healthcare services
that can identify and address wasting early through therapeutic feeding and treatment of
underlying health issues.
The implications of these findings extend beyond individual health outcomes. The high
rates of stunting and underweight, combined with the acute risks of wasting, point to broader
socioeconomic disparities. As observed in related income distribution data, households in low-
income brackets may lack access to adequate nutrition and healthcare, perpetuating the cycle
of malnutrition. Addressing these issues requires an integrated approach that combines direct
nutritional interventions with strategies to improve food security, access to healthcare, and
education on optimal feeding practices. Ultimately, these data reinforce the need for multi-
sectoral policies and programs to combat malnutrition in this region. Investing in maternal and
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child health, promoting early detection and intervention, and addressing the root causes of
poverty and food insecurity will be critical in reducing the prevalence of stunting, underweight,
and wasting among under-five children. Such efforts will not only improve immediate health
outcomes but also contribute to the long-term development and well-being of the population.
C. Under-Five Children’s Nutritional Intake and Household Food Security Levels
1. Nutritional Intake
This portion presents the results of the assessment of the under-five children’s
nutritional intake and household food security levels in the Second Congressional District
of Camarines Norte. The analysis of the mean intake of macronutrients and micronutrients
among under-five children in the Second Congressional District of Camarines Norte as
reflected in Table 9 reveals a nuanced picture of their nutritional status. The data highlights
both strengths and areas for improvement in their dietary patterns. The mean intake of
macronutrients such as protein, fat, and carbohydrates meets or exceeds the
Recommended Dietary Allowance (RDA). Protein intake is recorded at 19.5 g/day, aligning
with the recommended range of 13-19 g/day, indicating adequate support for the growth
and repair of tissues in young children.
Similarly, fat intake at 26.8 g/day falls within the acceptable range of 20-30 g/day,
ensuring sufficient energy reserves and aiding the absorption of fat-soluble vitamins such
as A, D, E, and K. The mean carbohydrate intake, at 138.5 g/day, exceeds the minimum
requirement of 130 g/day, suggesting that energy needs are adequately met, supporting
the children’s daily activities and growth. These findings underscore the positive aspect of
the children’s diets in terms of macronutrient sufficiency, which is crucial for preventing
energy malnutrition and promoting healthy physical development.

Table 9. Mean Intake of Macronutrients and Micronutrients Among Under-Five Children

Nutrients Mean Intake RDA
Protein (g/day) 19.5 13-19
Fat (g/day) 25.8 20-30
Carbohydrates (g/day) 138.5 130
Iron (mg/day) 6.8 7-10
Vitamin A (mcg/day) 395 300-600
Zinc (mg/day) 4.5 3-5

However, the data reveals a slight deficiency in the intake of iron, a critical
micronutrient. The mean iron intake of 6.8 mg/day falls below the recommended range of
7-10 mg/day. This poses a risk for iron-deficiency anemia, a condition that can impair
cognitive development, immunity, and overall health in young children. Addressing this
gap is vital to prevent long-term developmental and health complications. On the other
hand, the intake of vitamin A and zinc is adequate, with mean levels of 395 mcg/day and

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4.5 mg/day, respectively, both falling within their respective RDAs. These nutrients are
essential for immunity, growth, and cellular function, indicating that children are receiving
sufficient support in these areas. The adequate intake of macronutrients reflects positive
feeding practices, suggesting that most children in the district have access to sufficient
energy and nutrient sources. However, the marginal iron deficiency signals the need for
targeted interventions. Programs focusing on iron supplementation or fortification of
commonly consumed foods can help bridge this gap. For example, distributing iron-
fortified rice or cereals and educating parents about iron-rich foods like red meat, legumes,
and dark green leafy vegetables could address this deficiency effectively.
Moreover, the maintenance of adequate vitamin A and zinc intake is encouraging and
should be sustained through nutrition education and access to diverse, locally available
food options. Continued community-based nutritional surveillance can help identify
emerging deficiencies and provide timely support. Policymakers and healthcare providers
should integrate micronutrient supplementation, particularly for iron, into existing
maternal and child health programs to comprehensively address malnutrition risks.
In summary, while the overall macronutrient intake among under-five children in the
district is sufficient, the identified gap in iron intake requires immediate attention. A
combination of education, food fortification, and supplementation can help mitigate this
risk and ensure optimal growth and development for children in the municipality. This
finding underscores the pivotal role of dietary variety in fostering optimal growth and
development, aligning with previous research that has established a strong link between
dietary diversity and improved nutritional outcomes in children [13]-[15]. A clear
association is expected between dietary diversity and nutritional status, consistent with
previous studies demonstrating a positive correlation between dietary diversity and
expected growth patterns in children [16]. Children with average weight and growth
patterns consistently exhibit higher dietary diversity scores, indicating a greater variety in
their food intake. Conversely, malnourished children categorized as underweight, stunted,
or wasted are expected to have notably lower scores, suggesting a potential lack of
essential nutrients in their diets and hindering their healthy development, as supported by
existing literature [12].
These findings highlight the significance of dietary diversity in promoting healthy
growth and development and align with a wealth of research highlighting the importance
of a varied diet in providing a broader spectrum of essential nutrients [17],[18]. The
expected results emphasize the critical need to address dietary diversity as a cornerstone

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of interventions aimed at mitigating child malnutrition, echoing the recommendations of

numerous studies and public health organizations [9],[19].
To achieve this, a multifaceted approach is warranted, encompassing comprehensive
nutrition education programs [20], strengthening local food systems to enhance the
availability, affordability, and accessibility of diverse, nutrient-rich foods [21], and targeted
supplementation in cases of severe malnutrition [22]-[24]. These strategies are supported
by evidence-based interventions that have successfully improved dietary diversity and
nutritional outcomes in children. By prioritizing dietary diversity in public health
initiatives, it can make significant strides in combating child malnutrition, fostering
healthier growth trajectories, and ultimately improving the overall health and well-being
of children in the community.
Notably, protein intake slightly surpasses the recommended daily allowance (RDA),
which is crucial for growth and development, aligning with findings from De Menezes et al.
[13], who highlight the importance of adequate protein intake in schoolchildren. Fat and
carbohydrate intake fall within the recommended ranges, ensuring sufficient energy for
daily activities.
However, the intake of micronutrients presents a slightly different picture. While
vitamin A and zinc intake seem adequate for most children, iron intake falls slightly below
the RDA. This finding raises concerns about the potential risk of iron deficiency anemia, a
prevalent nutritional deficiency among children, particularly those experiencing
malnutrition, as highlighted by Manrique et al. [19] in their study on the impact of public
health expenditure on malnutrition prevalence in the Philippines. While these mean intake
values provide valuable insights, it is essential to acknowledge that individual variations
exist [18].
A more in-depth analysis of specific food sources and individual dietary patterns is
warranted to pinpoint potential deficiencies or excesses in particular nutrients. This
detailed analysis will enable the development of tailored nutritional interventions to
address the unique needs of each child, as suggested by Keller et al. [22] in their discussion
on multidisciplinary nutrition care. In conclusion, while the macronutrient intake among
children seems satisfactory, the slightly lower iron intake underscores the importance of
monitoring and potentially addressing iron deficiency through dietary modifications or
supplementation. The adequate vitamin A and zinc intake is encouraging but requires
further investigation to ensure that all children meet their requirements. A comprehensive
understanding of children's dietary patterns and nutrient intake is crucial for developing
effective strategies to promote optimal growth, development, and overall health.

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2. Household Food Security Levels

This section explores the critical issue of food security within the context of child
nutrition. The data presented in Table 10 on the household food security levels shows the
distribution of participants based on their access to food and nutritional security. By
examining the prevalence of food insecurity among households in the study population, it
aims to understand the extent to which families consistently struggle to access adequate
and nutritious food. The Mild Food Insecurity (35.00%) ranks first, with 35% of
respondents experiencing mild food insecurity. These individuals likely have access to food
but may experience occasional disruptions in their food supply or concerns about the
adequacy of their food intake. This suggests a significant portion of the population faces
some challenges in food access, but not to a severe degree.

Table 10. Distribution in terms of Household Food Security Levels

Indicator Frequency Percentage Rank
Food Secure 95 27.94 4
Mild Food Insecurity 119 35.00 1
Moderate Food Insecurity 82 24.12 2
Severe Food Insecurity 44 12.94 5
Total 340 100.00

Moderate Food Insecurity with 24.12% of the population in this category, represents a
substantial portion of individuals who likely experience more frequent disruptions in their
food intake, potentially leading to a compromised diet. This ranks second, emphasizing the
prevalence of moderate food insecurity among the sample. The least common category,
severe food insecurity affects 12.94% of respondents. These individuals face significant
barriers to acquiring sufficient food and likely experience hunger on a regular basis. This
group ranks fifth, underscoring the severity of their condition.
The findings indicate that a large proportion (59.12%) of the sample faces some form
of food insecurity, with 35% of the population experiencing mild insecurity and 24.12%
experiencing moderate insecurity. This highlights a concerning issue related to food access
and could point to socioeconomic challenges, poor distribution systems, or both. The
relatively high percentages of mild and moderate food insecurity suggest that intervention
programs, such as food assistance, nutrition education, and income-support initiatives, are
crucial. Programs targeting these groups could prevent the escalation to more severe forms
of food insecurity, improving overall health outcomes.
Given that 12.94% of individuals suffer from severe food insecurity, targeted support
such as emergency food aid, direct financial assistance, and social programs would be
necessary for this group. Identifying the underlying causes of severe food insecurity, such

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as unemployment, low income, or regional disparities, will be important for long-term

solutions. Such a high prevalence of food insecurity raises significant concerns regarding
the nutritional well-being of children within these households, as supported by the findings
of Ahmad et al. [6] and Munir [12], who identified a strong association between food
insecurity and child malnutrition in Pakistan.
The observed high prevalence of food insecurity aligns with the equally concerning
high prevalence of malnutrition, particularly stunting, among children in the study
population. This alignment strongly suggests a direct link between food insecurity and
malnutrition, highlighting the detrimental impact of limited access to nutritious food on
children's growth and development. Food insecurity deprives children of essential
nutrients and disrupts their eating patterns and overall dietary quality, as evidenced by
research conducted by Capanzana et al. [9] in the Philippines. The findings underscore the
critical importance of addressing food insecurity as a key intervention point in any
comprehensive effort to combat malnutrition and improve child health outcomes, echoing
the recommendations of Manrique et al. [19], who emphasized the need for increased
public health expenditure to address malnutrition in the Philippines.
By prioritizing interventions that enhance food security, such as strengthening social
safety nets, improving access to affordable and nutritious food, and promoting sustainable
agricultural practices, we can create a more conducive environment for children's healthy
growth and development. Addressing food insecurity is not merely a matter of providing
calories but ensuring that children have access to a diverse and balanced diet that meets
their nutritional needs, as emphasized in the studies by De Menezes et al. [13] and Martín-
Rodríguez et al. [14]. By tackling this root cause of malnutrition, the cycle of undernutrition
can be broken, paving the way for a healthier future for children.
3. Healthcare Service Utilization.
The data from Table 11 on the distribution in terms of healthcare service utilization
reveals that routine check-ups rank highest, with 50% of the respondents utilizing this
service, indicating that half of the households prioritize regular medical consultations for
their under-five children; growth monitoring is utilized by 37.94%, ranking second,
suggesting moderate engagement in monitoring child development milestones, which is
essential for detecting growth issues early; and nutrition counseling, though critical for
addressing malnutrition, ranks lowest at 27.06%, indicating that less than one-third of
households access this vital service for improving dietary practices and nutritional
knowledge. The higher utilization of routine check-ups suggests that families may have
basic awareness and access to healthcare services. However, the lower uptake of nutrition

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counseling highlights gaps in specialized support for addressing malnutrition. This may be
due to insufficient promotion of these services or logistical barriers like distance and cost.

Table 11. Distribution in terms of Healthcare Service Utilization

Nutrients Frequency Percentage Rank
Routine check-ups 170 50.00 1
Growth Monitoring 129 37.94 2
Nutrition counseling 92 27.06 3

Growth monitoring, though moderately utilized, indicates room for improvement in

tracking developmental progress. Enhancing awareness of its importance could help
identify at-risk children earlier and reduce malnutrition prevalence. The findings suggest
the need for targeted health education campaigns to improve the utilization of underused
services like nutrition counseling. Strengthening outreach programs and integrating
nutrition counseling into routine check-ups may increase accessibility and awareness.
Lastly, community-based approaches, such as mobile clinics and barangay-level nutrition
programs, could address barriers to service utilization, especially in underserved areas of
the Second Congressional District.
The result is consistent with the result of Haryanto [21] where the lack of a significant
association with malnutrition suggests potential inadequacies in addressing nutritional
concerns during these check-ups. Similarly, over half of the children reported participating
in growth monitoring programs; however, this did not translate into a significant difference
in malnutrition prevalence, indicating that more than growth monitoring alone may be
required [25]. The lack of a significant association with malnutrition suggests the need for
further evaluation and possible strengthening of existing counseling services [22].
Additionally, geographical barriers, including the distance to healthcare facilities and
lack of affordable transportation, emerged as significant challenges, particularly for
families residing in remote areas [21]. Long waiting times at public health facilities also
discouraged many families from seeking care, especially for preventive services like
growth monitoring and nutrition counseling [20]. Furthermore, families and healthcare
providers voiced concerns about public health facilities' limited availability of specialized
services, inadequate staffing levels, and insufficient resources, including medicines and
equipment [25]. Likewise, a lack of awareness regarding the importance of healthcare
services and distrust in healthcare providers emerged as additional barriers. This
underscores the importance of community-based health education programs to increase
awareness and promote trust in modern medicine while acknowledging and incorporating
traditional practices where appropriate [26]. These barriers contribute to the low
utilization of healthcare services and hinder the early detection and treatment of
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malnutrition in children, aligning with the findings of previous studies on barriers to

healthcare access [27].
D. Determinants of Malnutrition Among Under-Five Children
This section discusses the determinants of malnutrition, such as underweight, stunting,
and wasting among under-five children in the second congressional district of Camarines
Norte, along with the following socioeconomic factors, namely: low household income, low
maternal education, unemployed mother, low paternal education, and unemployed father.
1. Socioeconomic factors as a determinant of underweight
The analysis presented in Table 12 identifies several socio-economic factors as
determinants of underweight among under-five children, measured by adjusted odds
ratios (aOR) and 95% confidence intervals (CI). The analysis highlights key socio-economic
factors influencing underweight among under-five children. Low household income
significantly increases the risk of being underweight (aOR = 3.82, 95% CI: 1.98-7.36),
indicating that children from low-income families are nearly four times more likely to
experience poor nutritional status.

Table 12. Socioeconomic Factors as a Determinant of Underweight

Wasting Interpretation
Predictor
(aOR, 95% CI)
Low Household Income 3.82 (1.98-7.36) Significant
Low Maternal Education 2.45 (1.25-4.80) Significant
Low Paternal Education 1.89 (0.96-3.72) Not Significant
Unemployed Mother 2.90 (1.48-5.68) Significant
Unemployed Father 1.65 (0.84-3.24) Not Significant
Note: aOR = adjusted odds ratio
Similarly, low maternal education shows a strong association with underweight (aOR
= 2.45, 95% CI: 1.25-4.80), suggesting that mothers’ educational attainment plays a critical
role in fostering better childcare practices and health outcomes. Maternal unemployment
also significantly elevates the risk (aOR = 2.90, 95% CI: 1.48-5.68), likely due to reduced
household financial resources and access to adequate nutrition. In contrast, while low
paternal education (aOR = 1.89, 95% CI: 0.96-3.72) and paternal unemployment (aOR =
1.65, 95% CI: 0.84-3.24) show increased odds of underweight, these factors are not
statistically significant. The findings underscore the critical impact of household socio-
economic conditions on child nutritional outcomes. Low household income is a significant
barrier to accessing nutritious food, healthcare, and essential resources for healthy child
development. Similarly, maternal education plays a pivotal role in shaping childcare
practices, as educated mothers may better understand nutrition, hygiene, and health-
seeking behaviors.

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The significant association between maternal unemployment and underweight

suggests that mothers' economic contribution could provide better food security and
caregiving resources. Conversely, the lack of statistical significance for paternal
unemployment and education implies that these factors may have a less direct impact on
immediate child nutritional status or could be influenced by other moderating variables,
such as maternal roles or household dynamics. The study of Zhang et al. [28] revealed that
the prevalence of underweight was highest among infants and young children aged 18–24
months. The study of Tedla et al. [29] revealed that the prevalence of malnutrition in under-
five children showed that 46.2%, 24.2%, and 11.3% were found to be stunted, underweight
and wasted respectively. Children aged 6-59 months were underweight.
2. Socioeconomic factors as a determinant of stunting
The analysis in Table 13 identifies socioeconomic factors as significant determinants of
stunting among under-five children, highlighting the critical role of household
circumstances on child growth and development. Low household income is strongly
associated with stunting (aOR = 4.15, 95% CI: 2.15-8.02), indicating that children from low-
income households are over four times more likely to experience stunted growth compared
to those from higher-income families. Similarly, low maternal education (aOR = 3.01, 95%
CI: 1.52-5.98) and low paternal education (aOR = 2.05, 95% CI: 1.04-4.04) significantly
increase the odds of stunting, suggesting that parental educational attainment is crucial for
understanding and implementing proper nutrition and health practices. Maternal
unemployment is also significantly linked to stunting (aOR = 3.33, 95% CI: 1.68-6.61), likely
due to reduced household resources and limited access to nutritional and healthcare
services.

Table 13. Socioeconomic Factors as a Determinant of Stunting

Wasting Interpretation
Predictor
(aOR, 95% CI)
Low Household Income 4.15 (2.15-8.02) Significant
Low Maternal Education 3.01 (1.52-5.98) Significant
Low Paternal Education 2.05 (1.04-4.04) Significant
Unemployed Mother 3.33 (1.68-6.61) Significant
Unemployed Father 1.72 (0.87-3.38) Not Significant
Note: aOR = adjusted odds ratio
On the other hand, paternal unemployment (aOR = 1.72, 95% CI: 0.87-3.38) shows a
potential risk but is not statistically significant. These findings emphasize the urgent need
for interventions that address socio-economic inequalities to combat stunting. Improving
household income through poverty alleviation programs and economic support can help
reduce stunting rates. Additionally, promoting parental education, particularly for mothers,

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is vital to empower families with knowledge and skills for better childcare and nutrition
practices. Efforts to create employment opportunities for mothers could further enhance
household resilience and resource availability for children. By addressing these socio-
economic determinants, public health initiatives can help mitigate stunting and improve
overall child health and development outcomes.
Likewise, the study of Zhang et al. [28] showed that the prevalence of stunting was
highest among infants and young children between 12 and 18 months. The study by Tedla
et al. [29] revealed that the prevalence of malnutrition in under-five children showed that
46.2%, 24.2%, and 11.3% were found to be stunted, underweight and wasted respectively.
There is a staggering slow in Stunting.
3. Socioeconomic factors as a determinant of wasting
The analysis in Table 14 highlights the influence of socioeconomic factors on wasting
among under-five children, with varying levels of significance. Low household income is
significantly associated with wasting (aOR = 2.56, 95% CI: 1.05-6.24), indicating that
children from low-income families are more than twice as likely to experience wasting
compared to those from higher-income households. This underscores the critical impact of
financial constraints on access to nutritious food and healthcare. Conversely, low maternal
education (aOR = 1.78, 95% CI: 0.69-4.61), low paternal education (aOR = 1.53, 95% CI:
0.59-3.96), maternal unemployment (aOR = 2.11, 95% CI: 0.82-5.43), and paternal
unemployment (aOR = 1.38, 95% CI: 0.53-3.60) show no significant association with
wasting, as their confidence intervals include 1. This suggests that these factors may not
independently contribute to wasting or that their influence could be moderated by other
variables not captured in the analysis.

Table 14. Socioeconomic Factors as a Determinant of Wasting

Wasting Interpretation
Predictor
(aOR, 95% CI)
Low Household Income 2.56 (1.05-6.24) Significant
Low Maternal Education 1.78 (0.69-4.61) Not Significant
Low Paternal Education 1.53 (0.59-3.96) Not Significant
Unemployed Mother 2.11 (0.82-5.43) Not Significant
Unemployed Father 1.38 (0.53-3.60) Not Significant
Note: aOR = adjusted odds ratio
The findings point to household income as a key determinant of wasting, emphasizing
the need for poverty alleviation programs that improve access to basic needs, particularly
nutrition and healthcare for young children. The lack of significant associations with
parental education and employment suggests that interventions should not only focus on
these individual factors but also address broader systemic issues that limit families’ ability
to support child nutrition. Integrating income support with community-based nutrition

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programs could provide a more effective strategy to reduce wasting and improve child
health outcomes in vulnerable populations. The varying prevalence rates of wasting,
stunting, and underweight suggest that different underlying factors may contribute to each
type of malnutrition.
This aligns with the findings of Celhay et al. [30], who highlighted socioeconomic
disparities in child nutrition. This observation calls for a nuanced understanding of the
specific causes and drivers of malnutrition within the community to develop tailored and
effective interventions. Overall, the anthropometric data reveals a substantial burden of
malnutrition among under-five children in the Second Congressional District of Camarines
Norte. A multi-pronged approach addressing immediate nutritional needs, underlying
causes of food insecurity, and improving access to healthcare is crucial to combat this
pressing public health issue and ensure these vulnerable children's healthy growth and
development.
Maternal factors also play a pivotal role in shaping a child's nutritional status. The
analysis reveals that children of mothers with less than a high school education are more
prone to underweight and stunting, emphasizing the importance of empowering women
through education to break the cycle of malnutrition, as suggested by the work of Basu and
Banerjee [10]. Moreover, maternal unemployment further exacerbates the risk, with
children of unemployed mothers experiencing heightened vulnerability to all three forms
of malnutrition: underweight, stunting, and wasting. This finding underscores the need for
comprehensive policies and programs that support maternal employment and foster
economic empowerment for women, aligning with the recommendations of Bazzazian et
al. [11].
While paternal education and employment status also contribute to malnutrition risk,
the analysis suggests that maternal factors exert a more pronounced influence on child
nutrition outcomes. This observation resonates with studies like that of Tang et al. [15],
which emphasized the impact of mothers' dietary patterns on children's nutritional status
in China. Therefore, a holistic approach to tackling malnutrition must prioritize
interventions addressing these maternal determinants, such as improving women's access
to education and employment opportunities. In conjunction with targeted nutritional
interventions, addressing these underlying socio-economic disparities is crucial to creating
a more equitable and healthier environment for all children to thrive.
The result is consistent with the result of Haryanto [21] where the lack of a significant
association with malnutrition suggests potential inadequacies in addressing nutritional
concerns during these check-ups. Similarly, over half of the children reported participating

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in growth monitoring programs; however, this did not translate into a significant difference
in malnutrition prevalence, indicating that more than growth monitoring alone may be
required [25].
The lack of a significant association with malnutrition suggests the need for further
evaluation and possible strengthening of existing counseling services [22]. Additionally,
geographical barriers, including the distance to healthcare facilities and lack of affordable
transportation, emerged as significant challenges, particularly for families residing in
remote areas [21]. Long waiting times at public health facilities also discouraged many
families from seeking care, especially for preventive services like growth monitoring and
nutrition counseling [20]. Furthermore, families and healthcare providers voiced concerns
about public health facilities' limited availability of specialized services, inadequate staffing
levels, and insufficient resources, including medicines and equipment [25].
Likewise, a lack of awareness regarding the importance of healthcare services and
distrust in healthcare providers emerged as additional barriers. This underscores the
importance of community-based health education programs to increase awareness and
promote trust in modern medicine while acknowledging and incorporating traditional
practices where appropriate [26]. These barriers contribute to the low utilization of
healthcare services and hinder the early detection and treatment of malnutrition in
children, aligning with the findings of previous studies on barriers to healthcare access [27].
Furthermore, the study of Zhang et al. [28] revealed that the prevalence of wasting was
highest among infants and young children aged 18–24 months. The study by Tedla et al.
[29] revealed that the prevalence of malnutrition in under-five children showed that 46.2%,
24.2%, and 11.3% were found to be stunted, underweight, and wasted respectively.
Seventy-seven of children aged 6-59 months were wasted.
E. Proposed Plan to Enhance the Nutritional Status of Under-Five Children and Reduce
the Prevalence of Malnutrition
The nutritional status of children under five years old is a critical determinant of their
overall health, development, and well-being. Malnutrition during this formative stage not only
impairs physical growth but also affects cognitive development and increases susceptibility to
infections. In the Second Congressional District of Camarines Norte, malnutrition among
children remains a pressing public health issue, reflecting the broader socio-economic
challenges faced by the municipality.
Addressing this concern requires a holistic approach that integrates health, education, and
community support systems to ensure children receive adequate nutrition and thrive in their
early years. Efforts to combat malnutrition must prioritize accessible healthcare services,
sustainable food security programs, and nutrition education for families. Collaborative

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initiatives between government agencies, non-governmental organizations, and local

communities are essential to create lasting solutions to this multifaceted problem. By investing
in early childhood nutrition, the municipality can help break the cycle of poverty and improve
the long-term quality of life for its youngest residents.
Despite ongoing efforts to combat malnutrition, the prevalence of undernutrition among
under-five children in the Second Congressional District of Camarines Norte continues to be
alarming. Contributing factors include limited access to nutritious food, lack of awareness
among caregivers regarding proper feeding practices, and inadequate healthcare services. The
consequences of malnutrition are far-reaching, encompassing stunted growth reduced
learning capacity, and increased vulnerability to chronic diseases later in life. This proposed
plan is rooted in the urgency to address these challenges comprehensively by leveraging
community-based interventions, enhancing nutritional education, and improving the
accessibility of health services. By adopting evidence-based strategies, this initiative aims to
create sustainable improvements in the nutritional well-being of children and contribute to
the region's overall development.
The general objective of the proposed plan as reflected in Table 15 and Table 16 is to
enhance the nutritional status of under-five children and reduce the prevalence of malnutrition
in the Second Congressional District of Camarines Norte through the implementation of
community-based interventions, educational programs, and improved access to healthcare
services.

Table 15. Proposed Plan to Enhance the Nutritional Status of Under-Five Children and
Reduce the Prevalence of Malnutrition (Objectives and Strategy)
Objectives Activities/
Strategies
Areas of Concern: Prevalence of Stunting, Wasting, and Under-weight
• To reduce the prevalence of • Conduct workshops for caregivers on proper feeding practices,
stunting, wasting, and hygiene, and meal planning using locally available resources.
underweight among under- • Use interactive tools such as visual aids, storytelling, and cooking
five children demonstration
• To improve caregivers' • Implement a community feeding program in collaboration with local
knowledge and practices government units (LGUs), NGOs, and schools.
regarding nutrition, health, • Provide nutrient-rich meals to identified malnourished children.
and sanitation by conducting • Administer vitamins and mineral supplements, especially iron, zinc,
targeted educational and vitamin A, to children under five.
programs. • Conduct bi-annual deworming in coordination with barangay health
• To enhance access to centers.
affordable and nutritious • Promote backyard gardening to improve household food security.
food for families with under- • Train families on sustainable agricultural practices and provide
five children in the district. starter kits for gardening (e.g., seeds, tools).
• To strengthen existing health • Facilitate livelihood programs to increase household income.
and nutrition monitoring • Conduct regular growth monitoring through barangay health workers
and intervention systems for (BHWs).
early detection and • Use growth charts to track weight and height and identify cases of
management of malnutrition. malnutrition early.

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Objectives Activities/
Strategies
• Lobby for increased funding and policy support for nutritional
programs.
• Advocate for the inclusion of fortified foods in LGU nutrition
programs.
Areas of Concern: Socio-economic Factors
• To assess and address the • Conduct household surveys to gather data on income levels,
impact of socioeconomic educational attainment, employment status, and food access.
factors (e.g., income, • Analyze socioeconomic data to identify at-risk families and prioritize
education, and employment) interventions.
on the nutritional status of • Introduce livelihood training programs tailored to local
under-five children. opportunities, such as farming, fishing, handicrafts, or small-scale
• To empower families with enterprises.
limited resources by • Collaborate with government agencies and NGOs to provide
providing access to microfinancing or grants for family income generation.
sustainable livelihood • Offer parenting sessions focusing on nutrition, budgeting, and low-
programs and education to cost meal planning.
improve household income • Conduct workshops to improve literacy and provide skills training for
and food security. unemployed or underemployed parents.
• To create targeted • Establish community food banks to support families with limited food
interventions based on the access.
socioeconomic profiles of • Distribute fortified food and supplements to children in households
malnourished children for below the poverty threshold.
more effective nutrition • Provide regular deworming, immunization, and health check-ups to
programs. address co-morbidities that exacerbate malnutrition in low-income
families.
• Implement community-based feeding programs targeting children
from socioeconomically disadvantaged families.
• Form community councils involving parents, local leaders, and health
workers to promote awareness about the socioeconomic
determinants of malnutrition.

Table 16. Proposed Plan to Enhance the Nutritional Status of Under-Five Children and
Reduce the Prevalence of Malnutrition (Person Involved and Expected Outcomes)
Person Involved Expected Outcome
Areas of Concern: Prevalence of Stunting, Wasting, and Under-weight
• Parents and caregivers of under-five • Decreased rates of stunting, wasting, and underweight
children • Increased percentage of caregivers demonstrating proper
• Barangay Health Workers (BHWs) feeding practices and basic knowledge of child nutrition.
• Local Nutrition Scholars (LNS) • Growth in household food production through backyard
• Municipal Nutrition Offices gardening initiatives.
• Department of Health (DOH) • Increased early detection and treatment of malnutrition
• Department of Agriculture (DA) cases through regular growth monitoring.
• Department of Social Welfare and • Strengthened local government policies supporting child
Development (DSWD) nutrition and health programs.
• Non-Governmental Organizations • Overall improvement in the health and nutritional status
(NGOs) focused on child nutrition of under-five children in the district.
• Healthcare Providers
• Barangay Captains
• School Heads
Areas of Concern: Socio-economic Factors
• Families and caregivers of under-five • A significant decline in stunting, wasting, and underweight
children rates among under-five children, particularly in low-
• Parents with low income and/or low income households.
educational attainment • Increased household income from livelihood projects and
• Barangay Nutrition Committees microfinancing programs.
• Municipal Social Welfare and • A higher percentage of caregivers practice proper
Development Offices nutrition and budgeting strategies.
• Barangay Health Workers (BHWs) • Improved access to affordable, nutritious food for
• Nutritionists and dietitians socioeconomically disadvantaged families.
• Midwives and nurses

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Person Involved Expected Outcome

• Barangay Captains and Local Nutrition • Local policies established to address poverty and
Scholars malnutrition through sustainable socioeconomic
programs.
• Reduction in co-morbidities linked to malnutrition, such as
infections and anemia, especially in at-risk populations.

Conclusion
In light of the insights gleaned from the result on the prevalence of malnutrition and its
risk factors among under-five children in the Second Congressional District of Camarines
Norte, the following conclusions were derived. The majority of under-five children in the
Second Congressional District of Camarines Norte are male, with most falling within the 24-35
months age group. The parents, predominantly high school graduates, are largely employed,
with household incomes ranging from Php 5,000.00 to 10,000.00 per month. Stunting remains
a significant concern among under-five children in the district, highlighting a need for targeted
nutritional interventions. While the overall macronutrient consumption among children is
adequate, iron deficiency has been identified as a common gap in their dietary intake.
Additionally, a notable portion of households experience mild to moderate food insecurity,
indicating challenges in food access that, while not severe, still require attention to prevent
long-term effects on child health. Moreover, there is a higher utilization of routine check-ups
which suggests that families have basic awareness and access to healthcare services. Low
household income is a strong determinant of underweight status among children. Stunting, on
the other hand, is significantly associated with low maternal education and unemployed
mothers. However, low income, maternal education, and maternal unemployment are not
significant determinants of wasting. The proposed plan aims to enhance the nutritional status
of under-five children in the district and effectively reduce the prevalence of malnutrition
through comprehensive and targeted strategies.
Conflict of Interest
The authors declare that there is no conflict of interest.

References
[1] United Nations, "Transforming our world: The 2030 agenda for sustainable development," United
Nations, 2015. [Online]. Available: [Link]
[2] UNICEF, "UNICEF nutrition strategy 2020–2030: Nutrition for every child," United Nations
Children’s Fund, 2020. [Online]. Available: [Link]
2020-2030.
[3] WHO, "Malnutrition," WHO Response, 2024. [Online]. Available: [Link]
room/factsheets/detail/malnutrition?gad_source=1&gclid=cjwkcaia9vs6bha9eiwajpnxwzrn7o9o2
qvmkps9kl_bqvmndgv11kkxucohucekklcwxes9hh5ufrocyhiqavd_bwe#.
[4] World Bank, "Undernutrition in the Philippines Scale, Scope, and Opportunities for Nutrition Policy
and Programming," PH-Undernutrition-Report-Executive-Summary, 2021. [Online]. Available:
[Link]

Prevalence of Malnutrition and Its Risk Factors among Under-Five … (Malabanan & Miguel)

101
 JPHS Vol. 4, No. 01, April 2025, pp. 73-103

[5] National Nutrition Council (NNC), "Operation Timbang Plus Results 2023," Department of Health,
Republic of the Philippines, 2023. [Online]. Available: [Link]
statistics/operation-timbang.
[6] D. Ahmad, M. Afzal, and A. Imtiaz, "Effect of socioeconomic factors on malnutrition among children
in Pakistan," Future Business Journal, vol. 6, no. 1, 2020. [Online]. Available:
[Link]
[7] F. Davenport, K. Grace, C. Funk, and S. Shukla, "Child health outcomes in sub-Saharan Africa: A
comparison of changes in climate and socio-economic factors," Global Environmental Change, vol.
46, pp. 72–87, 2017. [Online]. Available: [Link]
[8] M. B. Gentner and M. Leppert, "Environmental influences on health and development: nutrition,
substance exposure, and adverse childhood experiences," Dev. Med. Child Neurol., vol. 61, no. 9, pp.
1008–1014, 2019. [Online]. Available: [Link]
[9] M. Capanzana, G. Demombynes, and P. Gubbins, "Why are so many children stunted in the
Philippines?," World Bank, Washington, DC, 2020. [Online]. Available:
[Link]
[10] S. Basu and B. Banerjee, "Impact of environmental factors on the mental health of children and
adolescents: A systematic review," Child. Youth Serv. Rev., vol. 119, p. 105515, 2020. [Online].
Available: [Link]
[11] S. Bazzazian, G. Ozgoli, H. Riazi, Z. Mahmoodi, M. Vafa, and M. Nasiri, "The relationship between social
determinants of health and postpartum weight retention based on the World Health Organization
model: path analysis," BMC Public Health, vol. 23, no. 1, 2023. [Online]. Available:
[Link]
[12] T. Munir, "Socio-Economic Risk Profiling of Child Nutrition Status: Evidence from the Most Populous
Province of Pakistan," Research Square, 2023. [Online]. Available: [Link]
2545610/v1.
[13] L. R. D. De Menezes, R. C. V. E. Souza, P. C. Cardoso, and R. C. V. E. Souza, "Factors Associated with
Dietary Patterns of Schoolchildren: A Systematic Review," Nutrients, vol. 15, no. 11, p. 2450, 2023.
[Online]. Available: [Link]
[14] A. Martín-Rodríguez et al., "Infancy Dietary Patterns, Development, and Health: An Extensive
Narrative Review," Children (Basel), vol. 9, no. 7, p. 1072, 2022. [Online]. Available:
[Link]
[15] D. Tang, T. Bu, Y. Liu, and X. Dong, "The impact of mothers’ dietary patterns on children’s nutritional
status in China," Am. J. Health Behav., vol. 44, no. 5, pp. 719–731, 2020. [Online]. Available:
[Link]
[16] E. Authur, "Effect of household socio-economic factors on child nutritional status In Ghana, Kenya
and Zambia," 2019. [Online]. Available: [Link]
[17] C. Gressies, P. Tribolet, and P. Schuetz, "Nutrition issues in the general medical ward patient: From
general screening to specific diagnosis and individualized treatment," J. Parenter. Enteral Nutr., vol.
47, S1, 2022. [Online]. Available: [Link]
[18] Y. S. Lee, "Analysis of Dietary Patterns, Intake, Output Performance, and Blood Lactate Concentration
According to Athlete Career: A Study on Elite Korean Wrestlers," Int. J. Appl. Sports Sci., vol. 33, no.
2, pp. 176–185, 2021.
[19] J. M. V. Manrique, G. Masangkay, and N. A. J. Agustin, "A silent crisis: The impact of public health
expenditure on malnutrition prevalence in children aged below five in the Philippines," J. Econ.
Financ. Account. Stud., vol. 4, no. 1, pp. 104–117, 2022. [Online]. Available:
[Link]
[20] M. T. Hidayat, P. Muljono, A. Saleh, and S. Maarif, "Communication strategy in implementing health
belief model (HBM) at Bali Province in dealing with COVID-19," Int. J. Health Sci., vol. 6, S4, pp. 5436–
5449, 2022. [Online]. Available: [Link]
[21] B. Haryanto, "Indonesia: country report on children’s environmental health," Rev. Environ. Health,
vol. 35, no. 1, pp. 41–48, 2020. [Online]. Available: [Link]
[22] H. Keller et al., "Multidisciplinary Nutrition Care: Benefitting Patients with Malnutrition Across
Healthcare Sectors," in Perspectives in Nursing Management and Care for Older Adults, (S.l.): (s.n.),
2021, pp. 177–188. [Online]. Available: [Link]
[23] A. F. Valladares et al., "How a Malnutrition Quality Improvement Initiative Furthers Malnutrition
Measurement and Care: Results from a Hospital Learning Collaborative," J. Parenter. Enteral Nutr.,
vol. 45, no. 2, pp. 366–371, 2020. [Online]. Available: [Link]

102 P-ISSN 2961-9106 ● E-ISSN 2961-8681

 JPHS Vol. 4, No. 01, April 2025, pp. 73-103

[24] J. Wills-Gallagher et al., "Implementation of malnutrition quality improvement reveals opportunities

for better nutrition care delivery for hospitalized patients," J. Parenter. Enteral Nutr., vol. 46, no. 1,
pp. 243–248, 2021. [Online]. Available: [Link]
[25] N. V. Lam et al., "High prevalence and burden of adult malnutrition at a tertiary hospital: an
opportunity to use nutrition-focused care to improve outcomes," Clin. Nutr. Open Sci., vol. 40, pp.
79–88, 2021. [Online]. Available: [Link]
[26] N. A. K. Amali et al., "Exploring learning environment through Bronfenbrenner’s Ecological Systems
Theory," Int. J. Acad. Res. Prog. Educ. Dev., vol. 12, no. 2, 2023. [Online]. Available:
[Link]
[27] N. Bayramova, "Affection of Pollution of Environment and Climatic Changes to the Child’s Health,"
Turk. Arch. Pediatr., pp. 356–357, 2023. [Online]. Available:
[Link]
[28] M. Zhang et al., "Prevalence of malnutrition and associated factors among children aged 6–24 months
under poverty alleviation policy in Shanxi province, China: A cross-sectional study," 2022. [Online].
Available: [Link]
[29] M. Tedla et al., "Prevalence and associated factors of malnutrition among under-five children living
in slum areas of Bahir Dar Town, Ethiopia," Pan Afr. Med. J., vol. 47, p. 176, 2022. [Online]. Available:
[Link]
[30] P. Celhay, S. Martínez, and C. Vidal, "Measuring socioeconomic gaps in nutrition and early child
development in Bolivia," Int. J. Equity Health, vol. 19, no. 1, 2020. [Online]. Available:
[Link]

Authors
Leni Moralde Malabanan is a Registered Nurse, a Master of Arts in Nursing and a
graduate of Doctor of Philosophy in Nursing Education in 2014 at St. Paul University Manila
and graduated Cumlaude. Presently, she is the Dean of the Graduate School of Camarines
Sur Polytechnic Colleges, Nabua, Camarines Sur. She handles both the Undergraduate and
Graduate Studies handling Maternal and Child Health Nursing and Community Health
Nursing as her field of expertise. Dr. Malabanan was the Dean of the College of Health
Sciences (June 2022- August 2024), Program Chair of the Master of Arts in Nursing(2020-
2024), and former GAD Director of CSPC(2015-2020). At present, she is an Associate
Professor 4 by academic Rank and also, a Research and Extension Advocate. (email:
lenimalabanan@[Link]).

Eden C. Miguel earned her Bachelor's Degree in Accountancy from the Philippine School
of Business Administration-Manila. Furthermore, in 2010, she enrolled in Mabini Colleges
of Daet, Camarines Norte for a Bachelor of Science in Nursing, in a ladderized curriculum.
After a year she received the National Certificate II (NC II) in Caregiving, continued her
studies, and got her Diploma in Midwifery after two years and passed the Professional
Regulation Commission (PRC) - Midwifery Licensure Examination. Continuing her
education in nursing at the same institution, she graduated and received her college degree
under Bachelor of Science in Nursing – Ladderized Curriculum in 2014 and her
undergraduate thesis on the Implementation of Basic Emergency Obstetric Care in San
Vicente, Camarines Norte. In the same year after graduation, she took and passed the Nursing
Licensure Examination. Presently, she is a Registered Nurse and Registered Midwife by
profession. (email: hermanas1278@[Link]).

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