1.A qualitative program evaluation study on the perceived impact of health and nutrition programs among beneficiaries of a civil society organization in the Philippines.
Kim Leonard G. DELA LUNA ; Alvin Duke R. SY ; Raycha Lei Concess M. RAMA-SABANDAL, ; Carlos Bernard K. JACINTO ; Rowel C. MALIMBAN ; Bernardyn Eliza G. SALES ; Ryann A. MAROLLANO ; Alberto C. MARIN
Acta Medica Philippina 2026;60(8):23-36
BACKGROUND
Undernutrition remains a public health concern in the Philippines despite multitude of government efforts using different nutrition specific and sensitive interventions. Hence, the role civil society organizations play is important in augmenting the health and nutrition programs in the country. Community feedback is important as they are the receiving end of these programs.
OBJECTIVEThe study aimed to know the perceived impact and community insights on the implemented health and nutrition programs in the four selected sites in the Philippines.
METHODSQualitative program evaluation was used, and 50 discussants were recruited through purposive sampling. Semi-structured interview guide for focus group discussion was utilized to determine the perceived impact of the programs among the discussants, and thematic analysis was used to generate codes and themes.
RESULTSThe implemented health and nutrition programs were found to be a source of hope for the family and community and beyond basic necessities. However, there remain barriers in successful acquisition of new information such as a lack of resources and environmental influences. There are also learned opportunities such as continued support from the Civil Society Organization (CSO), and impact capacity building that are not sponsor-driven.
CONCLUSIONOverall, the participants see the health and nutrition programs as helpful for their children as these programs foster proper child rearing. The programs also empower the parents and the community through capacity building. However, there is a need to revisit implementing rules and guidelines to further maximize the benefits and resources of the programs.
Program Evaluation ; Public Health ; Play And Playthings ; Residence Characteristics ; Evaluation Studies As Topic ; Malnutrition ; Nutritional Status
2.A qualitative program evaluation study on the perceived impact of health and nutrition programs among beneficiaries of a civil society organization in the Philippines.
Kim Leonard G. DELA LUNA ; Alvin Duke R. SY ; Raycha Lei Concess M. RAMA-SABANDAL, ; Carlos Bernard K. JACINTO ; Rowel C. MALIMBAN ; Bernardyn Eliza G. SALES ; Ryann A. MAROLLANO ; Alberto C. MARIN
Acta Medica Philippina 2026;60(8):23-36
BACKGROUND
Undernutrition remains a public health concern in the Philippines despite multitude of government efforts using different nutrition specific and sensitive interventions. Hence, the role civil society organizations play is important in augmenting the health and nutrition programs in the country. Community feedback is important as they are the receiving end of these programs.
OBJECTIVEThe study aimed to know the perceived impact and community insights on the implemented health and nutrition programs in the four selected sites in the Philippines.
METHODSQualitative program evaluation was used, and 50 discussants were recruited through purposive sampling. Semi-structured interview guide for focus group discussion was utilized to determine the perceived impact of the programs among the discussants, and thematic analysis was used to generate codes and themes.
RESULTSThe implemented health and nutrition programs were found to be a source of hope for the family and community and beyond basic necessities. However, there remain barriers in successful acquisition of new information such as a lack of resources and environmental influences. There are also learned opportunities such as continued support from the Civil Society Organization (CSO), and impact capacity building that are not sponsor-driven.
CONCLUSIONOverall, the participants see the health and nutrition programs as helpful for their children as these programs foster proper child rearing. The programs also empower the parents and the community through capacity building. However, there is a need to revisit implementing rules and guidelines to further maximize the benefits and resources of the programs.
Program Evaluation ; Public Health ; Play And Playthings ; Residence Characteristics ; Evaluation Studies As Topic ; Malnutrition ; Nutritional Status
3.Nutritional status of children 0-59 months old and household enrollment in the Pantawid Pamilyang Pilipino Program (4Ps) in a rural municipality in Leyte: A cross-sectional study.
Angelita C. Jaya ; Hannah Grace D. Pugong ; Daryne Aya H. Bolla ; Edelmer B. Azcueta ; Charlie C. Falguera
Acta Medica Philippina 2026;60(5):7-16
BACKGROUND
Child malnutrition is a prevailing global public health concern especially in low- and middle-income countries. Conditional cash transfer (CCT) programs were implemented to help address this problem.
OBJECTIVETo determine the relationship between the nutritional status among 0-59 months old children and household enrollment in a Philippine CCT program, Pantawid Pamilyang Pilipino Program (4Ps).
METHODSA cross-sectional study was employed to 392 children and mothers/primary caregivers in a rural municipality in Leyte. Stratified random sampling technique was used in selecting the participants. Anthropometric characteristics were measured for these 392 children and were classified as 4Ps and non-4Ps members. Chi-square test was used to determine the relationship between the variables of interest.
RESULTS4Ps household beneficiaries had mothers/primary caregivers who were older and had fewer years of education. The 4Ps beneficiary households had more household members and had lower average monthly income compared to the non-beneficiaries. No significant differences were found between the 4Ps beneficiary and non-beneficiary households in terms of the household hunger scale, the mean age of the children, and the sex distribution of the children included in the study. Specific profile components were found to be correlated to the children’s nutritional status. The age of the children was significantly associated to their length/height-for-age (L/HFA) wherein stunting was noted to occur among children older than 12 months of age. Maternal education was significantly associated to the weight-for-age (WFA) of the children. Children who were underweight had mothers/primary caregivers with fewer years of education. No significant correlation was found between the child’s sex, age of the mother/primary caregiver, household size, average monthly household income, and household hunger scale and the children’s nutritional status Lastly, there was no significant correlation between 4Ps household enrollment and the WFA and L/HFA status of the children. 4Ps household enrollment was, however, significantly correlated to the weight-for-length/height (WFL/H) or wasting status of the children.
CONCLUSIONThe 4Ps program has the potential to enhance the nutritional outcomes of children hence the need to maximize its gains. In addition, the relationship of different sociodemographic variables with the children’s nutritional status reflects the complexity and multidimensionality of childhood malnutrition, implying the need for a holistic and multistakeholder approach in addressing the problem.
Human ; Infant Newborn: First 28 Days After Birth ; Infant: 1-23 Months ; Child Preschool: 2-5 Yrs Old ; Child Nutrition Disorders ; Nutritional Status ; Philippines
4.Factors associated with stunting among infants and young children in the Fourth District of Camarines Sur, Philippines
Jeena Sandra R. Manrique-de hitta ; Kim Leonard G. Dela luna ; Anna Paulina S. Rodriguez ; Mildred O. Guirindola
Acta Medica Philippina 2025;59(9):62-71
OBJECTIVE
This study aimed to investigate the determinants linked to stunting among infants and young children aged 0-23 months in the Fourth District of Camarines Sur.
METHODSAn analytical cross-sectional study was conducted among 628 primary caregivers with infants and young children aged 0-23 months in four municipalities of the Fourth District of Camarines Sur, Philippines, using a two stage stratified random sampling design. Data on sociodemographic and economic factors were collected through face-to-face interviews. Infant and young child feeding (IYCF) indicators were assessed using a list-based approach, while weight and length were evaluated using the World Health Organization Anthro Plus software. Descriptive statistics and multiple logistic regression were done using R statistical software version 4.3.1.
RESULTSThe study revealed that the prevalence of stunting was of significant public health concern, reaching 42.8%. Holding other variables constant, age of the child (OR=0.77; 95% CI: 0.63-0.94), having college undergraduate mothers (OR=0.26; 95% CI: 0.05-1.28), and belonging to a poor income household (OR=0.40; 95% CI: 0.14-0.88) were associated with stunting among infants aged 0.01-6.00 months. Moreover, after controlling for the confounding effects of other variables, age (OR=1.09; 95% CI: 1.05-1.14) and sex of the child (OR=1.55; 95% CI: 1.05-2.28) were associated with stunting among older children aged 6.00-23.99 months.
CONCLUSIONThis study emphasizes the challenge of stunting in the Fourth District of Camarines Sur. None of the IYCF indicators were associated with stunting; however, maternal education, the child’s age, sex, and socioeconomic status were identified as significant factors influencing stunting. Addressing these determinants through targeted interventions focusing on improving maternal education and enhancing socio-economic conditions were crucial to reducing stunting in the study areas.
Human ; Growth Disorders ; Risk Factors ; Nutritional Status ; Infant Nutrition Disorders
5.Micronutrient intake and diet quality of overweight/obese Filipino adults in the National Capital Region, Philippines
Jade Q. Florento ; Kim Leonard G. Dela luna ; Charina A. Javier ; Eldridge B. Ferrer
Acta Medica Philippina 2025;59(10):85-94
OBJECTIVES
This study aims to describe the micronutrient intake and diet quality of overweight and obese Filipino adults in the National Capital Region (NCR). Specifically, it seeks to assess micronutrient inadequacy among these individuals and analyze differences in food intake based on their sociodemographic profiles and lifestyle habits.
METHODSThis analytical cross-sectional study utilized data from the Expanded National Nutrition Survey (ENNS) conducted in 2018, 2019, and 2021 by the Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI). A total of 3,154 overweight and obese subjects were included. ANOVA and Kruskal-Wallis tests were employed to analyze the food groups consumed by these adults.
RESULTSMajority of overweight and obese adults were found to be inadequate in vitamin A (81.7%), vitamin C (88.4%), thiamin (62.5%), riboflavin (70.7%), iron (69.8%), and calcium (88.7%). Significant differences were observed in the mean intake of various food groups across different age groups, sexes, civil statuses, wealth quintiles, educational attainments, employment statuses, and smoking and drinking statuses.
CONCLUSIONFilipino adults who are overweight and obese, and residing in urban settings face significant challenges related to micronutrient inadequacy. When their food intake was assessed based on sociodemographic and lifestyle characteristics, it was found that their diets were more calorie-dense than nutrient-dense. To address this issue, it is recommended to encourage a wider variety of nutrient-dense foods among overweight and obese adults.
Food Intake ; Eating ; Micronutrients ; Overweight ; Obesity ; Nutritional Status
6.Differences in the nutritional status among beneficiaries of a civil society organization according to sociodemographic and economic covariates.
Kim Leonard Dela LUNA ; Alvin Duke SY ; Raycha Lei Concess RAMA-SABANDAL ; Carlos Bernard JACINTO ; Rowel MALIMBAN ; Bernardyn Eliza SALES ; Ryann MAROLLANO ; Alberto MARIN ; Christle Grace CUBELO
Philippine Journal of Health Research and Development 2025;29(3):70-78
BACKGROUND
High-risk areas in the Philippines still experience a high prevalence of undernutrition. The efforts of the governments are not enough to reach those who are in need; hence, the presence of Civil Society Organizations (CSOs) is crucial. One CSO has implemented health and nutrition technical programs to increase the number of well-fed children in four selected areas in the Philippines.
OBJECTIVESThis study aims to shed light on the differences in the nutritional status of the children when they are characterized according to their sociodemographic and economic covariates.
METHODOLOGYAn analytical cross-sectional design was used to survey 692 households, including 764 children aged 0–5 years old. Descriptive analysis and the Chi-Square test of difference were used to answer the objectives.
RESULTSThe study results show that no significant differences were observed when the nutritional status of the children was characterized according to the sociodemographic of the caregiver, food consumption score (FCS) and food security status, water, hygiene and sanitation (WASH) practices, and economic indicators, except weight-for-height and marital status of caregivers, and weight-for-age and livelihood and economic support received by their caregivers (P = 0.02).
CONCLUSIONThe majority of children, regardless of their nutritional status, share the same experience and resources in terms of sociodemographics of caregivers, FCS and food security status, WASH practices, and economic indicators. CSO can boost the impact of their health and nutrition interventions by harmonizing their efforts with government programs, leading to better-targeted and more efficient outcomes.
Human ; Government ; Nutritional Status ; Malnutrition ; Philippines
7.Coping strategies to achieve food security among households with children in an urban poor community in Quezon City during COVID-19
Eryn M. Kiunisala ; Beatrice Ysabel G. Dy ; Ralph Alexander T. Flores ; Ramon Raphael M. Montierro ; Renaeus Arlchristian Rualdo D. Torres ; Kim Leonard G. Dela luna ; Ernani R. Bullecer
Acta Medica Philippina 2025;59(1):48-56
BACKGROUND
In the Philippines, the prevalence of food insecurity increased during the COVID-19 pandemic, affecting the nutritional status of communities nationwide. Urban areas in particular are vulnerable to the harmful effects of food insecurity, and the effects are extended and magnified when it comes to children.
OBJECTIVESThis study aims to evaluate the coping strategies of households with children aged 0-10 years old in an urban poor community in Quezon City. In particular, the study will determine Coping Strategies Index (CSI) scores and the frequency of specific coping strategies used.
METHODSA descriptive cross-sectional study was conducted to assess the coping strategies of 405 households with children in the community during the pandemic. Mothers or caregivers were given a survey inquiring about the sociodemographic data and CSI.
RESULTSSociodemographic profiling showed that the households generally belonged to class D and E (PhP 15,000 and below) income households (73.8%). The majority of the household heads (52.6%) have their highest educational attainment at the high school level. The majority (77.5%) of the households were categorized as having low CSI classification (90%CI: 73.9, 80.8). This could indicate that relief operations conducted in the community may have helped ease their food insecurity. Coping strategies that were most frequently employed by the households were depending on less preferred or more affordable food (74.8%), rationing money for prepared food (69.1%), and purchasing food on credit (58.5%).
CONCLUSIONLow CSI classification was noted, which may be due to increased adaptation to persistent food insecurity and the utilization of coping strategies not indicated in the questionnaire. Common coping strategies used by households include reliance on less favored or less costly food items, rationing resources for prepared food, and food on credit. It is recommended that the results collected be used to target food availability and accessibility interventions in the community.
Human ; Food Insecurity ; Adaptation, Psychological ; Nutritional Status ; Food Security
8.A study of the factors influencing the occurrence of refeeding syndrome in patients with sepsis and their prognosis.
Min LIU ; Wan TIAN ; Sumei WANG ; Kongmiao LU ; Yan QU ; Chun GUAN
Chinese Critical Care Medicine 2025;37(4):386-390
OBJECTIVE:
To analyze the factors influencing the development of refeeding syndrome (RFS) in patients with sepsis and its impact on clinical prognosis.
METHODS:
A retrospective case-control study method was used to collect the clinical data of patients with sepsis admitted to the intensive care unit (ICU) of Qingdao Municipal Hospital from December 2018 to December 2023. The patients were divided into RFS and non-RFS groups according to whether RFS occurred, and the basic data, nutritional status and assessment scale, laboratory indicators, nutritional intake, medical history and prognosis were compared between the two groups. Binary multifactorial Logistic regression analysis was used to screen the influencing factors of the occurrence of RFS in patients with sepsis.
RESULTS:
A total of 544 patients with sepsis were finally enrolled, of whom 250 did not develop RFS and 294 developed RFS, with an incidence of 54.0%. Compared with the non-RFS group, the patients in the RFS group had lower body mass index (BMI), albumin, prealbumin, baseline electrolytes (serum phosphorus, serum potassium, and serum magnesium), creatinine-height index, and protein intake, and had higher nutritional risk screening 2002 (NRS2002) score, sequential organ failure assessment (SOFA) score, calorie intake, and the proportions of feedings during the 48 hours of ICU admission, history of diabetes and septic shock. Binary multifactorial Logistic regression analysis showed that BMI [odds ratio (OR) = 0.910, 95% confidence interval (95%CI) was 0.857-0.947, P < 0.001], SOFA score (OR = 1.166, 95%CI was 1.085-1.254, P < 0.001), albumin (OR = 0.946, 95%CI was 0.902-0.991, P = 0.019), baseline serum phosphorus (OR = 0.343, 95%CI was 0.171-0.689, P = 0.003), baseline serum potassium (OR = 0.531, 95%CI was 0.377-0.746, P < 0.001), creatinine-height index (OR = 0.891, 95%CI was 0.819-0.970, P = 0.008), caloric intake (OR = 1.108, 95%CI was 1.043-1.178, P = 0.001), protein intake (OR = 0.107, 95%CI was 0.044-0.260, P < 0.001), and feedings during the 48 hours of ICU admission (OR = 0.592, 95%CI was 0.359-0.977, P = 0.040) and septic shock (OR = 0.538, 95%CI was 0.300-0.963, P = 0.037) were independent influence factors on the occurrence of RFS in septic patients. Of the 544 patients, 267 died at 28 days, with a mortality of 49.1%. The 28-day mortality of patients in the RFS group was significantly higher than that in the non-RFS group [54.4% (160/294) vs. 42.8% (107/250); χ2 = 7.302, P = 0.007]. 544 patients had a length of ICU stay of 20 (17, 24) days. The patients in the RFS group had a significantly longer length of ICU stay than that in the non-RFS group [days: 20 (17, 25) vs. 19 (17, 23); Z = -2.312, P = 0.021].
CONCLUSIONS
The incidence of RFS in septic patients is high. Factors influencing the occurrence of RFS in septic patients include BMI, SOFA score, albumin, baseline serum phosphorus, baseline serum potassium, caloric intake, protein intake, feeding within 48 hours of ICU admission, and septic shock. RFS prolongs the length of ICU stay and increases the 28-day mortality in patients with sepsis.
Humans
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Retrospective Studies
;
Sepsis/complications*
;
Prognosis
;
Refeeding Syndrome/etiology*
;
Case-Control Studies
;
Intensive Care Units
;
Male
;
Nutritional Status
;
Female
;
Risk Factors
;
Middle Aged
;
Logistic Models
;
Body Mass Index
;
Aged
9.Relationship between the geriatric nutritional risk index and cognitive function: a cross-sectional study based on the NHANES database.
Long WANG ; Na WANG ; Weihua LI ; Huanbing LIU ; Lizhong NIE ; Menglian SHI ; Wei XU ; Shuai ZUO ; Xinqun XU
Chinese Critical Care Medicine 2025;37(5):465-471
OBJECTIVE:
To explore the relationship between the geriatric nutritional risk index (GNRI) and cognitive function.
METHODS:
A cross-sectional study method was conducted. People aged ≥ 60 years from the National Health and Nutrition Examination Survey (NHANES) databases from 1999 to 2002 and 2011 to 2014 were included as study subjects. The participants were divided into three groups based on their GNRI scores: a medium-high risk group (82 ≤ GNRI < 92), a low risk group (92 ≤ GNRI < 98), and a no-risk group (GNRI ≥ 98). Demographic characteristics (gender, age, race, education), chronic diseases [chronic bronchitis, emphysema, thyroid problems, coronary heart disease, angina pectoris, stroke, hypertension, diabetes mellitus, and depression score on the patient health questionnaire (PHQ-9)], lifestyle habits (history of smoking, hours of sleep), etc., were collected. Cognitive function was assessed using the consortium to establish a registry for Alzheimer's disease word learning subtest (CERAD-WL), animal fluency test (AFT), and digit symbol substitution test (DSST) for the 2011-2014 data, while only the DSST was used for the 1999-2002 data. Differences in the above information among the GNRI cohorts were compared. Factors affecting cognitive function in the population were analyzed using multifactorial Logistic regression.
RESULTS:
2 653 participants from 2011 to 2014 and 2 380 participants from 1999 to 2002 were enrolled, with a total of 5 033 participants in the study. There were statistically significant differences in age, stroke, diabetes mellitus, DSST score, AFT score, CERAD score test 1 recall (Cst1), and CERAD score test 2 recall (Cst2) among the GNRI groups. Multifactorial Logistic regression analysis of data from 2011 to 2014 showed that in model 3 (DSST score, age, gender, race, marriage, education, hours of sleep, history of smoking, emphysema, thyroid problems, chronic bronchitis, coronary heart disease, angina pectoris, hypertension, diabetes mellitus, depression score on the PHQ-9, and stroke) adjusted for all covariates, GNRI was a protective factor for DSST [odds ratio (OR) = 1.03, 95% confidence interval (95%CI) was 1.00 to 1.05, P = 0.03]; Logistic regression analyse for 1999 to 2002 and 2011 to 2014 showed a significant association even after adjustment for covariates (OR = 1.02, 95%CI was 1.00 to 1.03, P = 0.02). Subgroup Logistic regression analyses of the total population from 2011 to 2014 showed a significant association between GNRI and DSST scores (OR = 1.02, 95%CI was 1.01 to 1.03, P < 0.001), with significant associations in the age subgroups of 60 to 64 years old, across gender, non-Hispanic Whites and Blacks, by education, and by marital status associations were significant (all P < 0.05). Subgroup Logistic regression analyse of the total populations from 1999 to 2002 and 2011 to 2014 showed a significant association between the GNRI and DSST score (OR = 1.01, 95%CI was 1.01 to 1.02, P < 0.001), but did not show a significant year difference (interaction P = 0.503), and the newly found in the smoking population the association was also more significant (P < 0.01).
CONCLUSION
The GNRI correlates with the presence of cognitive functions related to processing speed, sustained attention, and executive function, and may be able to serve as an indicator for the assessment or prediction of related cognitive functions.
Humans
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Cross-Sectional Studies
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Aged
;
Middle Aged
;
Nutrition Surveys
;
Cognition
;
Female
;
Male
;
Nutritional Status
;
Risk Factors
;
Geriatric Assessment


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