What determines the decline of wasting in the Philippines?

In the past three decades, the prevalence of child wasting in the Philippines has generally fluctuated between 6% and 8%. As a result, the country fell short of the 2022 Philippine Plan of Action for Nutrition target of 5%. However, between 2013 and 2018, the decline in the wasting prevalence (-2.3 percentage points) in the Philippines was sharp and statistically significant. Still, the numbers remain substantial, with 800,000 children in the Philippines still affected by wasting who could be at risk for mortality. Thus, this progress must be sustained to meet future targets, including the Sustainable Development Goals (3.7%). Using the 2013 and 2018 rounds of the National Nutrition Survey (NNS), we identified the factors contributing to this decline during these periods using the Oaxaca-Blinder decomposition model. We found that total energy, wealth quintile, and maternal nutrition status have sufficient statistical evidence to determine weight-for-height Z-score (wasting) and the improvement in economic outcomes of household (wealth), maternal nutrition status, and energy intake could explain in part the improvement in the wasting status of children in the Philippines between 2013 and 2018. Sustaining public efforts for maternal and child characteristics including the underlying determinants such as socioeconomic characteristics are important in further reducing the wasting prevalence in the country. Further studies to examine other factors including child morbidity and diet diversity are recommended to assess if it could explain the rest of the gap in wasting prevalence during this period.