SPECIAL PROBLEM

FITTING A LOGISTIC REGRESSION MODEL IN PREDICTING THE LIKELIHOOD OF BEING MALNOURISHED AMONG CHILDREN AGED 0-5 YEARS IN THE PHILIPPINES

DAN OLIVER VILLALUZ ESQUIVEL

2nd Semester, SY 2010-2011

Institute of Statistics College of Arts and Sciences University of the Philippines Los Baos College, Los Baos , Laguna, 4031 The Special Problem attached hereto entitled FITTING A LOGISTIC REGRESSION MODEL IN PREDICTING THE LIKELIHOOD OF BEING MALNOURISHED AMONG CHILDREN AGED 0-5 YEARS IN THE PHILIPPINES, prepared and submitted by DAN OLIVER V. ESQUIVEL in partial fulfillment of the requirements for the degree of BACHELOR OF SCIENCE in STATISTICS is hereby accepted.

________________________________ CONSORCIA E. REAO, PH.D Adviser

__________________ Date Signed

Accepted as partial fulfillment of the requirements for the degree of BACHELOR OF SCIENCE in STATISTICS.

______________________________ ZITA VJ ALBACEA, PH.D Director, INSTAT

__________________ Date Signed

TABLE OF CONTENTS

ABSTRACT ... 1

I. INTRODUCTION

A. Background of the Study 1

B. Statement of the Problem ... 2

C. Objectives of the Study ... 3

D. Significance of the Study 3

II. REVIEW OF LITERATURE . 3

III. THEORETICAL FRAMEWORK

A. Test of Independence .. 5

B. Weights . 5

C. Odds . 6

D. Multinomial Logistic Regression Model ... 6

E. Estimation of the Regression Coefficients i . 7

F. Testing the Significance of the Logistic Regression Coefficients ... 7

G. Evaluation of the Adequacy of the Model 7

H. Conceptual Framework ..... 8

IV. METHODOLOGY

A. Data Resources 9

B. Data Analysis .. 9

V. RESULTS AND DISCUSSIONS .. 11

VI. SUMMARY AND CONCLUSION ........ 19

ACKNOWLEDEGEMENT ... 20

APPENDICES ..... 22

REFERENCES 29

LIST OF TABLES

Table 1

Title
List of redefined variables with their corresponding values, 2008 7th NNS

Page
10

Weighted percentage distribution of nutritional status of children by age

11

Weighted percentage distribution of nutritional status of children by age of the HH

12

Weighted percentage distribution of nutritional status of children by civil status of the HH

12

Weighted percentage distribution of nutritional status of children by highest educational attainment of the HH

13

Weighted percentage distribution of nutritional status of children by region

13

Weighted percentage distribution of the nutritional status of children by household size

13

Weighted percentage distribution of the nutritional status of children by presence of appliances of household

14

Weighted percentage distribution of the nutritional status of children by presence of electricity of household

14

10

Measure of association between nutritional status of children and the independent variables

14

12

Estimated parameters in the multinomial regression model of underweight with normal as the reference category

15

12

Estimated increase/decrease of odds of being underweight instead of being normal

16

13

Estimated parameters in the multinomial regression model of overweight with normal as the reference category

17

14

Estimated increase/decrease of odds of being overweight instead of being normal

17

15

Percentage of correct classification of the multinomial logistic regression model

18

LIST OF FIGURES

Figure
1

Title
Weighted percentage distribution of the nutritional status of children by sex

Page
11

Weighted percentage distribution of the nutritional status of children by sex of household head

12

FITTING A LOGISTIC REGRESSION MODEL IN PREDICTING THE LIKELIHOOD OF BEING MALNOURISHED AMONG CHILDREN AGED 0-5 YEARS IN THE PHILIPPINES1
1

An undergraduate special problem, under the supervision of Consorcia E. Reao, Ph. D, submitted to the Institute of Statistics, College of Arts and Sciences, University of the Philippines, Los Baos, as a partial

by Dan Oliver V. Esquivel ABSTRACT

The National Nutrition Survey (NNS) is a nationwide survey conducted once every 5 years by the Food and Nutrition Research Institute with the aim of updating the official statistics on the Philippine food, nutrition, and health situation. Based on the results of the 7 th NNS, it was estimated that 20.8% and 1.6% of the children in the Philippines were underweight and overweight for their ages, respectively. From the secondary data set used in this study, twelve variables were selected to describe the demographic characteristics of a malnourished child and to determine the possible factors influencing the nutritional status of children aged 0-5 years in the Philippines. Estimation of the different parameters was done taking into account the multi-stage sampling design of the survey. Rao-Scott 2 test of independence showed that the nutritional status is associated with the age of child, age of household head, sex of household head, educational attainment of household head, island of residency, household size, presence of appliances, presence of electricity, and participation in the programs Dewormization and Growth Monitoring. Moreover, Cramers V showed that the nutritional status of children is moderately associated with the educational attainment of the household head, presence of appliances, and presence of electricity. Only the significant variables were included in fitting the multinomial logistic model. Results showed that a child who does not participate in the Growth Monitoring program, belonging to household that has no appliances and has no electricity and whose household head did not finished college is more likely to be underweight. In addition, as the number of household member increases, the likelihood of a child being underweight also increases, but as the age of the household head increases, the likelihood of a child being underweight decreases. On the other hand, a child who belongs to a household whose head did not finish college is less likely to be overweight. In addition, as the age of the household head increases, the likelihood of a child being overweight also increases, but as the number of household members increases, the likelihood of a child being overweight decreases. The multinomial logistic model classified 75.6% of the children according to their nutritional status correctly. Keywords: NNS, underweight, overweight, Rao-Scott 2 test of independence, Cramers V, Multinomial logistic model

I. INTRODUCTION A. Background of the Study Children are recognized as one of the most important assets of the nation. Article 1 of the Presidential Decree No. 603 clearly states that every effort should be exerted to promote a childs welfare and enhance his opportunities for a useful and happy life. This presidential decree is well-supported by the Senate Bill 237 proposed by Senator Eduardo Angara. Also known as the Children Nutrition Act of the Philippines, the bill addresses malnourishment problem among Filipino children (Senate of the Philippines, 2010). Being healthy is one of the greatest gifts God can give to human kind. Being healthy, specifically among children, means performing better in school, growing into healthy adults, and in turn giving their children a most likely better start in life (Viernes, 2008). Conversely, malnutrition, be it underweight or overweight, has been recognized as one of the major public health problems among children in the Philippines. Although being overweight among Filipino children is considered by many as attractive, it still has its own risks. Children, specifically
fulfilment of the requirements for STAT 190 2nd semester 2010-2011.

preschoolers, are the ones easily affected by this problem and face the greatest risk of adverse consequences since they are relying on the nurturing adults to survive (Cerdea, et al., 2001). In addition, nutrition is so important especially to pre-school children that if not given proper and immediate intervention may lead to deficiencies such as weak immune system thereby increasing susceptibility to infections; poor growth and development; micronutrient deficiencies; mental retardation, poor cognitive development, and loss of IQ; poor school performance and attendance; irritability and physical inactivity, and; increased risk of morbidity when they become adults (FNRI, 2010). There are three indices used to assess the nutritional status of a child weight-for-age, height-for-age, and weight-for-height. As cited by Amar (2007), de Onis et al. (1993) described that the weight-for-age index represents a combination of the assessment of both linear growth and body proportion. Hence, among the three indices, the weight-for-age index is usually used to assess nutritional status of children since a child being underweight can be viewed as indication of lack in sufficient or balanced diet due to inadequacy to sustain linear growth and body proportion. In 2003, the Philippines used the National Center for Health Statistics (NCHS) International Reference Standards (NCHS-IRS) in assessing the nutritional status of children 0-5 years old. However, the NCHS-IRS does not adequately represent the early childhood growth at individual and population level assessment. Therefore, the National Nutrition Council Governing Board issued the Administrative Order No. 2010-0015 in which the Philippines will adopt the WHO-CGS, which was first launched by the World Health Organization (WHO) in cooperation with the United Nation Childrens Fund (UNICEF), in assessing the nutritional status of children 0-5 years old. Accordingly, the WHO-CGS is the single international standard that represents the best description of physiological growth for all children from birth to five years of age. Based on the 2008 7th National Nutrition Survey (NNS), it was estimated that 2.17 million children 0-5 years old were actually underweight for their ages. From 2003 to 2008, there was a significant increase in the proportion of children who were underweight for their ages (from 20.2% to 20.8%) which is alarming. Hence, an understanding of the contributory factors that influence the nutritional status of children in the country will be of great importance and deserves an explicit attention. B. Statement of the Problem Though efforts have been undertaken by the government and private sectors to minimize the prevalence of being malnourished among children 0-5 years old in the Philippines through intervention programs and services (Molano et al., 2007), these have not been adequately supported by empirical data on the determinants of malnutrition for program-focusing. Thus, it is of interest to find out the causes or determinants of malnutrition among children in the Philippines. This study may then contribute in creating cost-effective programs that address malnutrition which then may improve the nutritional status of children 0-5 years old in the Philippines. C. Objectives of the Study This study generally aims to fit a logistic regression model that could predict the likelihood of being malnourished of a given child aged 0-5 years in the Philippines based on the 7th NNS which was conducted by the FNRI-DOST in the year 2008. Specifically, the objectives of this study are the following:

1. to describe the demographic and nutritional status of children aged 0-5 years old in the Philippines using the weight-for-age index; 2. to determine the possible factors influencing the nutritional status of children aged 0-5 years in the Philippines, and; 3. to come up with a multinomial logistic model that would show the relationship between the independent variables and the likelihood of a child being malnourished (dependent variable) D. Significance of the Study Results of this study can help concerned institutions in giving the Filipino people their much needed information regarding nutritional status, especially to those parents who have children 0-5 years old. This study is done to identify the factors influencing nutritional status among children 0-5 years old. As such, these concerned institutions can formulate, or intensify programs and services that focus on these factors, and in turn may improve the nutritional status of children 0-5 years old in the Philippines.

II. REVIEW OF LITERATURE

It is believed that the molding of the character of a child starts at home; this also applies in the nutritional status of the child. Nutritional status of an individual is never consistent; it varies from place to place. A study in China conducted by Shuigao (2000) revealed that children are at a better nutritional state when they are living in the most developed areas than when they are living in the less developed areas. However, he added that there are community-based nutrition intervention programs which are effective strategies in improving the nutritional state of children especially in those poor areas.

A strong underlying determinant of undernutrition is poverty since it leads to household food insecurity, poor childcare, unhealthy environments, and poor health care. These factors also branches out to immediate determinants of undernutrition like low birth weight, inadequate intake of nutrients and proteins, and having frequent infectious diseases (Fishman et al., n.d.).

More or less the same set of determinants was given by Fu et al. (1996), as cited by Shiugao (2000). According to him, besides food availability, examples of determinants of nutritional status among children are intra-household distribution of food, child care (breastfeeding, supplementary food, etc.), disease prevention, and accessibility of health services. Moreover, Shiugao (2000) indirectly said that environmental sanitation is also an important factor since bad sanitation and lack of safe water supply were two of the major causes of diarrhoea in rural China affecting the nutritional status of rural children.

Hien and Hoa (2006), in their study entitled Nutritional Status and Determinants of Malnutrition in Children under Three years of Age in Nghean, Vietnam said that socioeconomic, environmental factors and feeding practices are significant risk factors in determining malnutrition among children under three years old. Specifically, they found out that the region of residence, ethnic, mothers occupation, mothers BMI, household size, number of children in the family, weight of child at birth, time of initiation of breastfeeding, and duration of exclusive breast-feeding were significantly related to malnutrition. The same study was conducted by Nguyen and Sin (2008) also on Nghean, Vietnam but covered children five years of age. They found out that the region of residence, the mothers level of education and occupation, household size, number of children in the family, weight at birth, and duration of exclusive breastfeeding were significantly related to malnutrition.

Mahgoub, Nnyepi, and Bandeke (2006) also determined Factors affecting the prevalence of malnutrition among children under three years of age in Botswana. They said that sex of child is one determinant, and that malnutrition is higher among male children than among female children. Also, children brought up by single parents suffered from underweight to a significantly higher level than children living with both parents. Meanwhile, underweight was less prevalent among children whose parents worked in the agricultural sector than among children whose parents were involved in informal business. The prevalence of underweight decreased significantly as the family income increased. Also, the prevalence of underweight became lower as the level of the mothers education became higher. Breastfeeding was also found to reduce the occurrence of underweight among children less than three years of age.

The Department of Census and Statistics in Sri Lanka (2003) undertook a methodological study entitled Nutritional Status of Pres-School Children in Sri Lanka with the aim of investigating the prevalence of malnutrition in children under five years of age, and the factors contributing to such situation. They stressed that although food intake influences the nutritional status of an individual to a great extent, it is not the only critical factor responsible for malnutrition, specifically in the case of children under five years of age. According to them, living standards, water and sanitation, birth weight, birth interval, parity, sex of child, weaning practices and mothers education are few of the important contributory factors which have been identified from recent studies. However, the dietary inadequacy is certainly a basic cause of malnutrition, and so they included it in their study. They have found out that the determinants of underweight among children were number of children in the family, age of child, sector of residence, work status of mother, access to media by mother, mothers educational level, mother washes her hands with soap after child defecated, and the type of latrine.

Locally, a study conducted by Molano et al. (2007) regarding the determinants of underweight, underheright, and thinness of Filipino children aged 0-5 years old, which is based on the 6th NNS, revealed that childs food insecurity, number of appliances, per capita income, total carbohydrate and protein intakes were the variables that found to predict the likelihood of being underweight among children. She further interpreted this as: a child is less likely to be underweight if he/she is food-secure, belongs to household with per capita income lying in the

fourth quartile and has a high number of varied appliances, and has a high intake of carbohydrates and protein.

Huelgas (2007), in her study entitled Disparities in Household Food and Nutrition Intake and Nutritional Status of Children in Male and Female Headed Households found out six significant predictors of being underweight among children aged 6 months to 5 years old. These include the level of education of the household head, household size, number of earners, and ownership of refrigerator, gas range and/or television. III. THEORETICAL FRAMEWORK

A. Test of Independence

In testing the independence of categorical variables, the usual test is the Pearson 2 test of independence. This test assumes the use of a simple random sample. However, most of the surveys conducted have a more complex design such as the NNS, which uses the multi-stage stratified sampling design. Therefore, a correction for the Pearson 2 test statistic should be employed. The Rao-Scott test statistic is then given by Equation (1.1).

2 RS

2 P = D

(1.1)
2 P

where is the Pearson 2 which is the sum of the squared differences of the observed and expected all over the expected totals and D is the design correction which is estimated by Equation (1.2).

D=

( (1 Prc )DEFF ( Prc ) (1 Pr. )DEFF (Pr. ) (1 P. c)DEFF (P. c))

r c r c

( R 1)(C 1)
(1.2)

.The where DEFF (Prc ) = (Prc ) / SRS (Prc ) null hypothesis is stated as A and B are independent, and the alternative hypothesis is A and B are not independent, where A and B are categorical variables. The decision rule then is to reject the null hypothesis if 2RS 2,(a-1)(b-1); otherwise, fail to reject the null hypothesis.

Furthermore, to measure the strength of association of A and B, Chi-square based measures can be used such as the Cramers V coefficient and is estimated by Equation (1.3)

V=

2 RS n( q 1)

(1.3)

where 2RS is the Rao-Scott 2 value; n is the sample size, and; q is the minimum of the number of rows and columns in the contingency table. The value of V ranges from 0 to 1 and can be interpreted by the following:

0 < V 0.10 0.11 < V 0.30 0.31 V < 1.00

weak association moderate association strong association

B. Weights

For complex design surveys, weights are assigned to inflate or deflate the influence of each observation according to the sampling design. Instead of the usual frequencies of observations, total weighted frequencies should be obtained (Agresti, 1990). Weighting is a process that attempts to make the estimates from the survey representatives of the total population that was sampled. Survey weights should be used in order to produce valid estimates of population parameters. These weights are needed to compensate for the unequal selection probabilities used in the sampling design and for non-response. 6 C. Odds

The odds of an event, say a child being underweight, is the ratio of the probability of its occurrence to the probability of its non-occurrence, that is, the ratio of the probability of a child being underweight to the probability of a child not being underweight.

D. Multinomial Logistic Regression Model

Logistic regression analysis, specifically binary logistic regression analysis, is a technique used to find the best fitting, yet reasonable model to describe the causal relationship between a categorical binary response variable Y and a set of k explanatory variables or regressors X1, X2, , Xk which may be discrete and/or continuous variables (Solivas, 2004).

For dependent variables which take three or more outcome categories, the multinomial logistic regression analysis can be used as an extension of the binary logistic regression.

In fitting such multinomial logistic models, assume that an individual or response unit belongs to one of the three mutually exclusive categories, say A, B, and C. In context of the study, and taking the weight-for-age indicator as the response variable Y, category A is the event that a child is underweight; category B is the event that a child is overweight, and; category C is the event that a child is normal. The set of values Y can take may be defined to be Y=1 if a child is in category A; Y=2 if a child is in category B, and; Y=0, also called as the reference category, if a child is in category C. Normal will be the reference category since the focus of this study is the likelihood of being malnourished. As such, there will be two logit equations which are linear functions of the explanatory variables (x1, x2,..., xk). With Y=0 as the reference category, the two logit equations are given by Equations (1.4) and (1.5).

P (Y = 1) = 1 + 11X 1 + 12X 2 + ... + 1k X k P (Y = 0) P (Y = 2) L2 ( x) = ln = 2 + 21X 1 + 22X 2 + ... + 2k X k P (Y = 0) L1 ( x) = ln

(1.4)

(1.5)

where is the regression constant and js are the regression coefficients, j = 1,2, , k. Moreover, the logit equation for comparing Y=1 to Y=2 is obtained by taking the difference between L1(x) and L2(x). From the logit equations, the probabilities of the Y outcomes can be computed and are given by Equations (1.6), (1.7), and (1.8).

P ( =0) = Y

1+e

L1 (x )

1 + e

L 2(x )

e L1 (x ) P( = = Y 1) ) 1 + e L1 (x+ e e L2 (x ) P ( =2) = Y ) 1 + e L1 (x+ e

(1.6)
L 2(x )

L 2(x )

(1.7)

(1.8)

It is also of interest to compute the odds ratio. For a continuous variable, it represents the factor by which the odds of the event, say the odds of Y=1 to Y=0, changes for every one-unit change in the independent variable, computed as e 1i (Solivas, 2004). 7 E. Estimation of the Regression Coefficients i For logistic regression, the iterative procedure called the Newton-Ralphson Method is one method which can be used to obtain the maximum likelihood estimates of the regression coefficients (Agresti, 1990). This method uses a preliminary estimator such as the Ordinary Least Squares (OLS) estimator =(XX)-1(XY). Let the response variable Y be a row vector with n rows where n is the total number of responses. Each value of y represents the category for which a child belongs, that is for the weight-for-age indicator, underweight, normal, or overweight. On the other hand, let X be a matrix of independent variables which contains n rows and k+1 columns where k is the number of independent variables. The first column of each row is 1 which represents the intercept. is then a matrix with k+1 rows and 2 columns such that each column contains the regression constant and the regression coefficients.

The maximum likelihood method seeks to maximize the log likelihood which reflects the odds that the observed values of the dependent variables may be predicted given the observed values of the independent variables (Garson, 2010).

F. Testing the Significance of the Logistic Regression Coefficients This aims to test the null hypothesis in logistic regression that a particular logit coefficient is zero (Ho: i = 0), that is, a particular independent variable does not affect the probability of the event occurring. In testing the significance of the individual logistic regression coefficients, the Wald statistic is usually used. It is computed as the squared ratio of the logistic regression coefficient and its standard error. The null hypothesis will be rejected if the computed Wald statistic is greater than the tabular value of 2,(1) and conclude that the particular independent variable affects the probability of the event occurring; otherwise, fail to reject Ho. A researcher may want to drop independent variables from the model when their effect is not significant (Garson, 2010).

G. Evaluation of the Adequacy of the Model

In evaluating the adequacy of the model, the usual test is the Pearson 2 Goodness-of-fit test. But for this study, it evaluates the adequacy of the model by examining the models predictive ability using the observed data the rate of correct classification (Solivas, 2004). It

tallies the correct and incorrect estimates (Garson, 2010). Sensitivity is the proportion of an event to be observed and predicted to be an event, while specificity is the proportion of a non-event to be observed and predicted to be a non-event (Solivas, 2004).

IV. METHODOLOGY

A. Data Source

Secondary data were used in this study which was based on the results of the 7th NNS conducted in 2008 was used in this study. NNS is a survey conducted once every 5 years by the Food and Nutrition Research Institute (FNRI) with the aim of updating the official statistics on the Philippine food, nutrition, and health situation. It adopted the sample, with 4 replicates, from the Labor Force Survey (LFS) developed by the National Statistics Office (NSO). The survey employed a three-stage stratified sampling which consisted of all the regions and provinces in the Philippines. The primary sampling unit consisted of barangays or contiguous barangays with at least 500 households; secondary sampling unit or the enumeration areas consisted of contiguous areas within the barangays with at least 150-200 households, and; the tertiary sampling unit or the ultimate sampling unit consisted of households which are randomly selected from the enumeration area (Philippine Facts and Figures, 2008). Only children aged 0-5 years old were included in the data file. From 191,438 individuals taken from 36,633 households, 18,088 children within the country comprised the study. The anthropometric measurements of the children, such as their weight and height, were determined. From these, their weight-for-age index were computed and compared with the World Health Organization Child Growth Standards (WHO-CGS). A child is considered as underweight if his/her weight-for-age index is below the median of the CGS reference population minus 2 standard deviations. On the other hand, a child is considered as overweight if his/her weight-for-age index is above the median of the CGS standards 2 standard deviations.

B. Data Analysis

The data set from NNS was weighted to conform to the multi-stage sampling design of the survey. The final survey weight assigned to each observation was computed based on three preliminary weights, i.e. the sampling weight, weight for unequal selection probability or the base weight, and the weight for sample non-response adjustment.

Weighted percentage distributions of the variables were done in describing the demographic and socio-demographic, and nutritional status of children aged 0-5 years. The nutritional status of children was cross tabulated with independent variables age of child, sex of child, age of household head, sex of household head, civil status of household head, highest educational attainment of household head, region, household size, presence of appliances, presence of electricity, and programs Dewormization and Growth Monitoring.

Rao-Scott 2 test of independence was done to determine the possible factors associated with the nutritional status of children. All variables that were found to be not associated with the nutritional status of children were not included in fitting the model. Moreover, Cramers V was computed to measure the strength of association between the nutritional status of children and all of the variables that were retained.

To meet the general objective of this study, which is to fit a logistic regression model that could predict the likelihood of a given child aged 0-5 years old in the Philippines to be malnourished, the multinomial logistic regression analysis was used. All of the retained variables were used to fit multinomial logistic regression models for nutritional status of children. Dummy variables were used for regressors that are in the nominal/ordinal scale. For nominal/ordinal 10 variables with two categories, one dummy variable was used; while variables with three categories, two dummy variables were used, and so on. Age of the child, age of the household head, and household size were treated as quantitative variables.

Forward entry procedure was used to find the best fitting models. These models can be used to compute the likelihood that a given child is malnourished. Equations (1.5) and (1.6) can be used in estimating the probability that a given child is malnourished, i.e. being underweight or overweight using the weight-for-age index. Moreover, the adequacy of the logistic regression model in predicting the likelihood of a child being malnourished was assessed by the rate of correct classification.

Table 1 shows the variables used in the study. The nominal variables with three or more values were redefined in order to lessen the number of values for easier analysis. The civil status and highest educational attainment of the household head, the presence of appliances and electricity, and the programs Dewormization and Growth Monitoring were redefined to two categories. Region was redefined to three categories according to what group of island they belong. Quantitative variables were also redefined such as the age of the household head which is redefined to five categories, while the household size was redefined into three categories.

Table 1. List of redefined variables with their corresponding values, 2008 7th NNS Variables AGE_CHILD SEX_CHILD AGE_HH Label Age of child Sex of child Age of Household Head (HH) Values 0 = female 1 = male 1 = less than 22 years old 2 = 22 to 31 years old 3 = 32 to 41 years old 4 = 42 to 51 years old 5 = greater than 51 years old 0 = female 1 = male 1 = married 2 = not married 1 = college graduate or higher 2 = college undergraduate or below 1 = Luzon (Region I-V, NCR) 2 = Visayas (Region VI-VIII) 3 = Mindanao (Region IX-XII, CAR, ARMM, Caraga) 1 = small family (2-5 household members) 2 = medium family (6-10 household members) 3 = big family (greater than 10 household members) 0 = without appliances 1 = with one or more appliances 0 = no 1 = yes 0 = no 1 = yes 0 = no 1 = yes

SEX_HH CV EDUC ISLAND HHSIZE APP ELEC DEWORM GROWTH

Sex of HH Civil status of HH Educational attainment of HH Philippine group of Islands Household size Presence of appliances Presence of electricity Dewormization Growth Monitoring

V. RESULTS AND DISCUSSION

As shown in Table 2, there is no distinct pattern in the proportion of children who were underweight as their ages increase. Also, there is no distinct pattern that can be seen in the proportion of children who were overweight as their ages increase. However, as the age increases, the proportion of children who were normal also increases until they turn five. The highest proportion of children who were underweight was aged 1 year (21.5%), while the highest proportion of children who were overweight was aged 4 years (22.0%). The highest proportion of children was also seen among children who were aged 4 years (22.0%).

Table 2. Weighted percentage distribution of nutritional status of children by age Age 0 Underweight 17.3 Normal 16.9 Overweight 14.2 Total 17.0

1 2 3 4 5 Total

21.5 20.0 20.2 17.5 3.6 100

17.8 18.6 19.5 23.2 4.1 100

20.9 18.3 19.8 22.0 4.9 100

18.6 18.9 19.6 22.0 4.0 100

Figure 1 shows that the proportion of children who were underweight, normal, and overweight was higher in males than in females. About 51.8% of the children who were underweight were males, while 48.2% who were underweight were females. On the other hand, about 55.6% of the children who were overweight were male, while 44.4% of the children who were overweight were female. The proportion of children by sex is almost the same as it moves from one nutritional status to another showing that sex of child is not associated with the nutritional status of children.

Fig. 1 Weighted percentage distribution of the nutritional status of children by sex As shown in Table 3, there is no distinct pattern in the proportion of children who were underweight and overweight as the ages of the household heads increase. The proportion of children who were underweight and normal was highest in household heads aged 31-41 years old, while the highest proportion of overweight children was seen in household heads aged 52 and above. Only 0.3% of the household heads were 21 years old and below. 12 Table 3. Weighted percentage distribution of nutritional status of children by age of the HH Age less than 22 years old 22 31 years old 31 41 years old 42 51 years old greater than 51 years old Total Underweight 0.2 16.4 35.5 23.8 24.1 100 Normal 0.3 15.6 31.5 21.6 31.1 100 Overweight 0.6 13.4 25.3 17.8 43.0 100 Total 0.3 15.7 32.2 22.0 29.8 100

Figure 2 shows that the proportion of children who were underweight was higher in male household heads than in female household heads. About 51.8% of the proportion of underweight

children belong to households whose heads were male, while only 48.2% belong to households whose heads were female showing that females can take care of their children better than male household heads. On the other hand, only 55.6% and 44.4% of the children who were overweight belong to households whose heads are male and female, respectively.

Fig 2. Weighted percentage distribution of the nutritional status of children by sex of household head

As shown in Table 4, the proportion of children who were underweight, normal, and overweight was higher in married household heads than in unmarried household heads. Most of household heads (78.4%) were married. The prorportion of children by civil status of household head is almost the same as it moves from one nutritional status by another. This shows that civil status of household head is not associated with the nutritional status of children.

Table 4. Weighted percentage distribution of nutritional status of children by civil status of the HH Civil status Not married Married Total Underweight 22.2 77.3 100 Normal 21.4 78.6 100 Overweight 20.5 79.5 100 Total 21.6 78.4 100 13 Table 5 shows that the proportion of children who were underweight was higher in household heads that did not finish college than those household heads who at least finished

college level. It shows that education plays an important to ones life. It illustrates that a high educational attainment leads to a dining table full of foods which then may improve the nutritional status of a child. Only about 19.0% of the household heads have at least finished college level.

Table 5. Weighted percentage distribution of nutritional status of children by highest educational attainment of the HH Educational attainment College undergraduate or below At least college level Total Underweight 89.2 10.8 100 Normal 79.3 20.7 100 Overweight 59.0 41.0 100 Total 81.0 19.0 100

As shown in Table 6, more than half of the children were in Luzon (54.2%). It is also in Luzon where the highest proportion of children who were underweight, normal, and overweight can be seen. About half of the children who were underweight were in Luzon (49.2%). Moreover, the proportion of children who were underweight was higher in Mindanao than in Visayas. Visayas showed the lowest proportion of children who were overweight (12.9%).

Table 6. Weighted percentage distribution of nutritional status of children by island Island Luzon Visayas Mindanao Total Underweight 49.2 22.1 28.6 100 Normal 55.3 19.3 25.4 100 Overweight 67.9 12.9 19.2 100 Total 54.2 19.8 26.0 100

Table 7 shows that about half of the children belong to medium-sized families with 6 to 10 members (49.4%). Also, medium-sized families have the highest proportion of underweight and normal children, 52.9% and 48.6% respectively. Small-sized families with 2 to 5 members have the highest proportion of overweight children (53.7%). Surprisingly, big-sized families with more than 10 members have the lowest distribution of underweight children (6.1%).

Table 7. Weighted percentage distribution of the nutritional status of children by household size Household size small family medium family big family Total Underweight 41.0 52.9 6.1 100 Normal 46.3 48.6 5.1 100 Overweight 53.7 42.8 3.5 100 Total 45.3 49.4 5.3 100

As shown in Table 8, about 71.5% of the children who were underweight belong to households that have varied number of appliances. On the other hand, about 28.5% of the children who were underweight belong to households that do not have a single appliance. The proportion of children who were overweight was higher among children who belong to households with one or more appliances than those who belong to households that do not have any appliances at all. Moreover, most of the households (81.8%) have one or more appliances. 14 Table 8. Weighted percentage distribution of the nutritional status of children by presence of appliances of household Presence of appliances Without appliances With one or more appliances Total Underweight 28.5 71.5 100 Normal 15.7 84.3 100 Overweight 6.6 93.4 100 Total 18.2 81.8 100

As shown in Table 9, the proportion of children who were underweight was higher in households that do not have electricity than those households that have electricity. Also, the proportion of children who were overweight was higher in households that do not have electricity than those who belong to households that have electricity. Moreover, about 79.0% of the households have one or more appliances.

Table 9. Weighted percentage distribution of the nutritional status of children by presence of electricity of household Presence of electricity Yes No Total Underweight 30.8 69.2 100 Normal 18.6 81.4 100 Overweight 9.7 90.3 100 Total 21.0 79.0 100

As shown in Table 10, the nutritional status of children using the weight-for-age indicator was found to be associated with the age of child, age of household head, sex of household head, educational attainment of household head, island of residence, household size, presence of appliances, presence of electricity, and programs Dewormization and Growth Monitoring. Using the Rao-Scott 2 test of independence, the nutritional status of children was found to be not associated with the sex of the child and the civil status of the household head. Moreover, Cramers V indicates that weak association exists between the nutritional status and all of the significant variables except for the educational attainment of household head, presence of appliances, and presence of electricity. There is a moderate association between nutritional status of children and the education attainment of the household head. A moderate association can also be seen between the nutritional status of children and the presence of appliances and presence of electricity.

Table 10. Measure of association between nutritional status of children by all of the variables Variables Age of child Sex of child Age of household head Sex of household head Civil status of household head Education of household head Island of residence Household size Presence of appliances Presence of electricity Dewormization Growth Monitoring Rao-Scott 2 66.8603 2.0084 73.1605 8.6816 2.4853 169.6814 56.0849 139.6377 321.4919 251.1380 6.3019 23.8570 Cramers V 0.04 0.01 0.05 0.02 0.01 0.10 0.04 0.06 0.13 0.12 0.02 0.04

Since all of the independent variables were found to be significantly associated with the 15 nutritional status of children, except for the sex of child and civil status of the household head, all of these variables were fitted in the multinomial logistic regression model. Dummy variables were used for all the predictors that are in the nominal level, that is, sex of the household head, highest educational attainment of the household head, island of residence, presence of appliances, presence of electricity, and programs Dewormization and Growth Monitoring. Age of the household head, and the household size were treated as quantitative variables.

Among the variables that were fitted in the logistic regression model, the age of the household head, the highest educational attainment of the household head, the household size, the presence of appliances, the presence of electricity, and the participation of a child in the Growth Monitoring program were found to be significant in estimating the likelihood of being underweight among children. Table 11 shows the estimates of the parameters of the logistic regression model of underweight with normal as the reference category. Based on the model, a child whose household head did not finish college has a positive effect on the likelihood of the child being underweight. Also, if a child belongs to a household that has no appliances and has no electricity, positive effect on the likelihood of being underweight can be observed. On the program participation of a child, not participating in the Growth Monitoring program has a positive effect on the likelihood of the child being underweight. Among the significant quantitative variables, the age of the household head has a negative effect on the likelihood of being underweight, which means that as the age of the household head increases, the likelihood of a child being underweight decreases. On the other hand, household size has a positive effect on the likelihood on the likelihood of a child being underweight, which means that as the household size, the likelihood of the child being underweight also increases. The age of the child, sex of the household head, island of residence and the participation of a child in the Dewormization program were found to be not significant in estimating the likelihood of being underweight among children.

Table 11. Estimated parameters in the multinomial regression model of underweight with

normal as the reference category Weight-for-age Underweight Parameter estimates Variables s.e.( ) p-value

Intercept -1.808 0.105 <0.000 Age of child -0.018 0.015 0.232 Age of household head -0.014 0.002 <0.000 Sex of household head Female 0.089 0.076 0.241 Education of household head College undergraduate or below 0.649 0.064 <0.000 Region Luzon 0.002 0.047 0.974 Visayas 0.127 0.057 0.025 Household size 0.072 0.009 <0.000 Presence of appliances Without appliances 0.439 0.060 <0.000 Presence of electricity No 0.243 0.059 <0.000 Dewormization No -0.005 0.043 0.911 16 Growth Monitoring No 0.112 0.042 0.007 Table 12 shows the estimated increases/decrease of being underweight instead of being normal among variables that were found to be significant in estimating the likelihood of being underweight, i.e. the age of the household head, the highest educational attainment of the household head, the household size, the presence of appliances, the presence of electricity, and the participation of a child in the Growth Monitoring program. As the age of the household head increases, the odds of a child being underweight instead of being normal decreases multiplicatively by 0.986. On the other hand, as the number of household members increases, the odds of being underweight instead of being normal increases multiplicatively by 1.074. The odds of being underweight is higher by a factor of 1.913 among children whose household heads did not finished college than those whose household head are at least college graduate, indicating that high education is indeed important. The estimated odds of a child being underweight is higher by a factor of 1.551 if he/she belongs to a household that has no appliances than a household that has a varied number of appliances. Also, the odds is higher by a factor of 1.275 if he/she belongs to a household that has no electricity than a household who has electricity. On the program participation of a child, the odds of being underweight instead of being normal is higher by a factor of 1.119 among children who did not participate in the Growth Monitoring program than those who participated.

Table 12. Estimated increase/decrease of odds of being underweight instead of being normal Variables Effect e

Age of household head Household size College undergraduate or below Without appliances No electricity No participation in Growth Monitoring

decrease increase increase increase increase increase

0.986 1.074 1.913 1.551 1.275 1.119

Of all the variables that were fitted in the logistic regression model of overweight, only the age of the household head, the highest educational attainment of the household head, and the household size were found to be significant in estimating the likelihood of being overweight among children. Table 13 shows the estimates of the parameters of the logistic regression model of overweight with normal as the reference category. Based on the model, a child who belongs to a household whose head did not finish college level has a negative effect on the likelihood of the child being overweight. Among the significant quantitative variables, age of the household head has a positive effect on the likelihood a child being overweight, which means that as the age of the household head increases, the likelihood of being overweight also increases. On the other hand, the household size has a negative effect on the likelihood a child being overweight, which means that as the number of household member increases, the likelihood of being overweight decreases. The age of the child, age of the household head, sex of the household head, island of residence, presence of appliances, presence of electricity, and the programs Dewormization and Growth Monitoring were found to be not significant in estimating the likelihood of being overweight among children.

17 Table 13. Estimated parameters in the multinomial regression model of overweight with normal as the reference category Weight-for-age Overweight Parameter estimates Variables Intercept Age of child Age of household head Sex of household head Female Education of household head College undergraduate or below Region -4.011 0.005 0.030 -0.402 -0.912 s.e.( ) 0.326 0.053 0.005 0.238 0.148 p-value <0.000 0.920 <0.000 0.091 <0.000

Luzon Visayas Household size Presence of appliance Without appliances Presence of electricity No Dewormization No Growth Monitoring No

0.410 -0.141 -0.116 -0.450 -0.238 0.231 -0.335

0.169 0.241 0.037 0.338 0.296 0.143 0.140

0.015 0.559 0.002 0.184 0.421 0.107 0.011

Table 14 shows the estimated increases/decrease of being overweight instead of being normal among variables that were found to be significant in estimating the likelihood of being overweight, i.e. the age of the household head, highest educational attainment of the household head, and the household size. As the age of the household head increases, the odds of a child being overweight instead of being normal increases multiplicatively by 1.030. On the other hand, as the number of household member increases, the odds of a child being overweight instead of being normal decreases multiplicatively by 0.869. Also, the estimated odds of being overweight is higher by a factor of 0.433 among children whose household heads did not finished college than those whose household head are at least college graduate.

Table 14. Estimated increase/decrease of odds of being overweight instead of being normal Variables Age of household head Household size College undergraduate or below Effect increase decrease decrease e 1.030 0.891 0.402

18 Based on Tables 4.1 and 4.3, the multinomial logistic regression models of underweight and overweight with normal as the reference category are then given by Equations (2.1) and (2.2), respectively.

L1(x) = -1.808 0.014AGE_HH + 0.072HHSIZE + 0.0649EDUC + 0.439APP + 0.243ELEC + 0.112GROWTH

(2.1)

L2(x) = -4.011+ 0.030AGE_HH 0.116HHSIZE 0.912EDUC

(2.2)

Table 15 shows that the multinomial logistic model classified 75.6% of the children according to their nutritional status correctly. This shows that the multinomial logistic model can predict malnutrition among children aged 0-5 years in the Philippines with high accuracy. This implies that the government, private sectors, and other concerned institutions may create programs that focus on these determinants of malnutrition with an adequate information to back it up.

Table 15 Percentage of correct classification of the multinomial logistic regression model Observed Underweight Normal Overweight Overall Percentage Underweight 2 4 0 0% Predicted Normal Overweight 3316 0 10961 0 214 0 100% 0% Percent 0.1% 100% 0% 75.6%

VI. SUMMARY AND CONCLUSION

The main objective of this study is to fit a logistic model that would predict the likelihood of being malnourished among children 0-5 years old in the Philippines. Specifically, this study was conducted to describe the demographic and nutritional status of children using the weightfor-age index and to determine the possible factors influencing the nutritional status of children 05 years old in the Philippines. Using the weight-for-age index, the nutritional status of a child can be classified into three being underweight, normal, and overweight. Twelve possible determinants of malnutrition were considered in this study which were the following: age of child, sex of child, age of household head, sex of household head, civil status of household head, highest educational attainment of household head, island of residence, household size, presence of appliances and electricity, and programs Dewormization and Growth Monitoring.

It was estimated that 20.8% and 1.6% of the whole population was underweight and overweight, respectively. The highest proportion of children who were underweight was seen in the following characteristics: aged 1 year old; males; belong to households whose heads are aged 31 to 41 years, males, married, and did not finish college level; living in Luzon, and; belong to households whose number of members is 6 to 10, with one or more appliances, and has no electricity. On the other hand, the highest proportion of overweight children was seen in the following characteristics: aged 4 years; males; belong to households whose heads are aged 52 and above, males, married, and did not finish college level; living in Luzon; belong to households whose number of members is 2 to 5, with one or more appliances, and has no electricity.

The Rao-Scott 2 test of independence shows that the nutritional status of children is associated with all of the variables, except for the sex of child and civil status of the household head. Moreover, Cramers V shows that there is a weak association between the nutritional status and all of the significant variables except for the educational attainment of the household head, the presence of appliances, and the presence of electricity. There is a moderate association between the nutritional status of children and the educational attainment of the household head, the presence of appliances, and the presence of electricity.

A multinomial logistic model was fitted to conform to the general objective of the study. Only the significant variables were included in fitting the multinomial logistic model. A child who does not participate in the Growth Monitoring program, who belongs to household that has no appliances and has no electricity and whose head did not finished college level is more likely to be underweight. In addition, as the number of household member increases, the likelihood of a child being underweight also increases, but as the age of the household head increases, the likelihood of a child being underweight decreases. On the other hand, a child who belongs to a

household whose head did not finish college level is less likely to be overweight. In addition, as the age of the household head increases, the likelihood of a child being overweight also increases, but as the number of household members increases, the likelihood of a child being overweight decreases. The multinomial logistic model classified 75.6% of the children according to their nutritional status correctly.

ACKNOWLEDGEMENT

The completion of this study would not be possible without the help of several people who, in one way or another, stand beside me in times of my ups and downs. It is from the deepest of my heart to say thank you.

I thank the Lord Jesus Christ for everything. I thank Him for constantly blessing me with abundant life. I thank Him for constantly giving me wisdom, knowledge, and strength that I needed every day. There is no point in my SP-life that I doubted whether I can finish this or not. I finished my SP because of Him. It is all because of Him.

Roy and Olive Esquivel. God blessed me with wonderful and loving parents. Thank you for raising such an awesome son. I mean, thank you raising me with a fear in God. Thank you for loving me unconditionally. Thank you for always believing in me. Thank you for telling me everything that I need to know. Thank you for supporting me emotionally, spiritually, and financially. I will be forever in debt for all the things youve done for me. I love you Ma and Pa! Also, thank you Jayson for reminding me to be not afraid to ask for money to our parents whenever I no longer have.

Janine. They call it distraction, I call it inspiration. My college life became more colorful when I met you. You, my dear, are one of the reasons why waking up is a beautiful thing do. I thank God for giving me a princess who is fun to be with, loves to eat, and most of all, a Christian. Though not well-blessed with height, she definitely has a pure heart. Hindi ko na papahabain pa, mahal na mahal kita! Mwuah!

07 Stat Batch mates - Francis, Joseph, Kim, Chad, Ronald, Jared, Mau, Rocky, Ramon, Josh, Neale, Carl, Carlo, David, Robie, Bjorn, Alvin, Janine, Camille, Hannah, Raq, Maricris, Cory, Ate Feriz, Cath, Precious, Arra, Bern, Mel, Joy, Jeb, Nyka, Ham, Lei Isabel, Lei Ann, Nadine, Lady, Jessa, Angel, and Marby. Sana wala akong nakalimutan. May iba pa bang batch ng Stat na mas cool kesa sa atin? Wala na. Matatalino pero hinding hindi rin naman papahuli pagdating sa kalokohan. Hindi naman sasabihin ni Maam Zita na magaling ang batch natin ng walang dahilan di ba? Tayo na ang batch ng Stat na apat ang laude. Sorry, hindi ako nakahabol sa laude, ang bilis kasi. Magkakahiwalay man tayo, alam ko na ang matinding pagkakaibigang ating ipinundar ng apat na taon ay hindi mawawala sapagkat habang buhay na tayong mananatili sa puso ng bawat isa. Yon! Mahal ko kayo batch mates! Sa mga maiiwan, LABAN lang! Salamat rin kina Ate Jesselle, Ate Jewel, Ate Mica, Ate Obet, at lalo na sa iyo Ate Jara sa walang sawang pagtulong sa akin sa aking SP. Sa puso ko, 07 na rin kayo. Hanggang sa muli nating pagkikita.

New Dorm Room mates - Francis, Datu, LA, Edzel, Nathan, and Von. Game na mga sir! I will never trade the moments we spent laughing, eating, playing basketball, and doing stupid things. Real friends do not let their friends do stupid things alone. You guys are my real friends. They say laughter is the best medicine, I say Room 111 is the best medicine. If there is one thing I will miss the most in my college life, those are the nights when all we can do is to laugh. I will surely miss you guys! Mahal ko kayo mga sir! Hanggang sa muli nating pagkikita.

Dr. Consorcia E. Reao and Prof. Imee Zhella A. Morrante. Thank you for guiding me in my SP, for telling me what and what not to do. I also thank Dr. Zita Albacea for giving me some clarifications and to Prof. Nancy Tandang teaching me some of my data analysis. I also 21 thank Maam Jhoanne Ynion for the advices that made my SP better. I also thank Maam Ida for being a friend more than an instructor. In general, I thank all of my professors/instructors in Statistics for imparting valuable knowledge that will never be taken away from me by anyone.

FNRI. The completion of my SP would not be possible without the data set that the Food and Nutrition Research Institute, specifically the Nutritional Assessment and Monitoring Division, had provided. Though going back and forth at FNRI to run results seems to be expensive and very tiring, it is worth it. Thank you to Dr. Jocelyn Juguan and Chief Corazon Cerdea for being very accommodating every time we go to your division. Thank you Maam Beth for being my summer practicum adviser. Thank you Ate Aiza and Ate Lynell for not being tired replying to my somewhat repetitive questions and for making me feel like we are all just batch mates, and to Kuya Glen.

Again, I thank the Lord Jesus Christ for everything. He will be the first one I will be thanking of, and he will also be the last one I will be thanking of. If not for Him, this SP would not be possible. A page of this acknowledgement would not be enough to express how much I am thankful. Now, I gave you back all the glory, all the honor, and all of the praises, for you alone deserves it, in Jesus name, AMEN.

I have fought the good fight. I have finished the race, I have kept the faith. 2 Timothy 4:7

Dan Oliver Villaluz Esquivel 07 BS Statistics

APPENDICES

23 Appendix Table 1. List of variables with their corresponding values, 2008 7th NNS Variables Nutritional status (weight-for-age indicator) Age of child Sex of child Age of household head Sex of household head Values 1 = underweight 2 = normal 3 = overweight 1 = male 2 = female 1 = male 2 = female

Civil status of household head

Highest educational attainment of household head

Region

1 = single 2 = married 3 = widowed 4 = divorced/separated 5 = live-in 1 = no schooling 2 = elementary 3 = high school 4 = college level 5 = above college level 6 = daycare/prep/nursery 7 = double degree 8 = special education 9 = Arabic Education 10 = NA (not applicable) 1 = Region I Ilocos Region 2 = region II Cagayan Valley 3 = Region III Central Luzon 41 = Region IVA CALABARZON 42 = Region IVB MIMAROPA 5 = Region V Bicol Region 6 = Region VIII Western Visayas 7 = Region VII Eastern Visayas 8 = Region VIII Central Visayas 9 = Region IX Zamboanga Peninsula 10 = Region X Northern Mindanao 11 = Region XI Davao 12 = Region XII - SOCCSKSARGEN 13 = NCR (National Capital Region) 14 = CAR (Cordillera Administrative Region) 15 = ARMM (Autonomous Region of Muslim Mindanao) 16 = Caraga Region 1 = without appliances 2 = with one or more appliances

Household size Presence of appliances

24 ..continued Presence of electricity 0 = no 1 = yes 2 = no electricity in the area 3 = no electricity but with generator 4 = others 0 = no 1 = yes, government

Dewormization

Growth Monitoring

2 = yes, private 8 = no data 9 = not a target group 0 = no 1 = yes, government 2 = yes, private 8 = no data

Appendix Table 2. Weighted frequencies and percentage distribution of nutritional status of children by age
Status normal 1377629 16.9% 1444885 17.8% 1509776 18.6% 1582627 19.5% 1886706 23.2% 330384 4.1% 8132007 100.0%

Age of child

0 1 2 3 4 5

Total

Count % within Count % within Count % within Count % within Count % within Count % within Count % within

Status Status Status Status Status Status Status

underweight 375867 17.3% 467546 21.5% 434146 20.0% 438137 20.2% 380451 17.5% 78189 3.6% 2174336 100.0%

overweight Total 24202 1777698 14.2% 17.0% 35748 1948179 20.9% 18.6% 31365 1975287 18.3% 18.9% 33778 2054542 19.8% 19.6% 37535 2304692 22.0% 22.0% 8364 416937 4.9% 4.0% 170992 10477335 100.0% 100.0%

Appendix Table 3. Weighted frequencies and percentage distribution of nutritional status of children by sex
Status normal 3960474 48.7% 4171532 51.3% 8132006 100.0%

Sex of child

female male

Total

Count % within Status Count % within Status Count % within Status

underweight 1048618 48.2% 1125716 51.8% 2174334 100.0%

overweight 76005 44.4% 94988 55.6% 170993 100.0%

Total 5085097 48.5% 5392236 51.5% 10477333 100.0%

25

Appendix Table 4. Weighted frequencies and percentage distribution of nutritional status of children by age group of household head

Age group of HH

less than 22 y/o 22 to 31 y/o 32 to 41 y/o 42 to 51 y/o greater than

Total

Count % within Count % within Count % within Count % within 51 y/o Count % within Count % within

Status Status Status Status Status Status

underweight 3933 .2% 341381 16.4% 738131 35.5% 493844 23.8% 500901 24.1% 2078190 100.0%

Status normal 22269 .3% 1218480 15.6% 2459430 31.5% 1686203 21.6% 2429678 31.1% 7816060 100.0%

overweight Total 1003 27205 .6% .3% 21901 1581762 13.4% 15.7% 41418 3238979 25.3% 32.2% 29076 2209123 17.8% 22.0% 70360 3000939 43.0% 29.8% 163758 10058008 100.0% 100.0%

Appendix Table 5. Weighted frequencies and percentage distribution of nutritional status of children by sex of household head
underweight 196506 9.0% 1977828 91.0% 2174334 100.0% Status normal 875019 10.8% 7256987 89.2% 8132006 100.0% overweight 23225 13.6% 147767 86.4% 170992 100.0% Total 1094750 10.4% 9382582 89.6% 10477332 100.0%

Sex of HH

female male

Total

Count % within Status Count % within Status Count % within Status

Appendix Table 6. Weighted frequencies and percentage distribution of nutritional status of children by civil status of household head
underweight 492706 22.7% 1681628 77.3% 2174334 100.0% Status normal 1737811 21.4% 6394196 78.6% 8132007 100.0% overweight 35004 20.5% 135989 79.5% 170993 100.0% Total 2265521 21.6% 8211813 78.4% 10477334 100.0%

Civil status of HH

not married married

Total

Count % within Status Count % within Status Count % within Status

26 Appendix Table 7. Weighted frequencies and percentage distribution of nutritional status of children by educational attainment of household head
Status underweight normal 1940449 6450173 89.2% 79.3% 233886 1681833 10.8% 20.7% 2174335 8132006 100.0% 100.0% overweight 100824 59.0% 70168 41.0% 170992 100.0% Total 8491446 81.0% 1985887 19.0% 10477333 100.0%

Educational attainment of HH Total

college undergraduate or below at least college level

Count % within Status Count % within Status Count % within Status

Appendix Table 8. Weighted frequencies and percentage distribution of nutritional status of children by the Philippine group of islands
underweight 1070501 49.2% 481054 22.1% 622779 28.6% 2174334 100.0% Status normal 4494323 55.3% 1569129 19.3% 2068554 25.4% 8132006 100.0% overweight 116052 67.9% 22079 12.9% 32861 19.2% 170992 100.0% Total 5680876 54.2% 2072262 19.8% 2724194 26.0% 10477332 100.0%

Philippine group of islands

luzon visayas mindanao

Total

Count % within Count % within Count % within Count % within

Status Status Status Status

Appendix Table 9. Weighted frequencies and percentage distribution of nutritional status of children by household size group

Household size group

small family medium family big family

Total

Count % within Count % within Count % within Count % within

Status Status Status Status

underweight 892253 41.0% 1150021 52.9% 132060 6.1% 2174334 100.0%

Status normal 3767364 46.3% 3951981 48.6% 412662 5.1% 8132007 100.0%

overweight 91742 53.7% 73242 42.8% 6008 3.5% 170992 100.0%

Total 4751359 45.3% 5175244 49.4% 550730 5.3% 10477333 100.0%

27 Appendix Table 10. Weighted frequencies and percentage distribution of nutritional status of children by presence of appliances
underweight 620101 28.5% 1554234 71.5% 2174335 100.0% Status normal 1277688 15.7% 6854319 84.3% 8132007 100.0% overweight 11367 6.6% 159625 93.4% 170992 100.0% Total 1909156 18.2% 8568178 81.8% 10477334 100.0%

Presence of appliances

without appliances with one or more appliances

Count % within Status Count % within Status Count % within Status

Total

Appendix Table 11. Weighted frequencies and percentage distribution of nutritional status of children by presence of electricity

Presence of electricity no yes Total

Count % within Status Count % within Status Count % within Status

underweight 669086 30.8% 1505249 69.2% 2174335 100.0%

Status normal 1511434 18.6% 6620572 81.4% 8132006 100.0%

overweight 16638 9.7% 154355 90.3% 170993 100.0%

Total 2197158 21.0% 8280176 79.0% 10477334 100.0%

Appendix Table 12. Weighted frequencies and percentage distribution of nutritional status of children by the program Dewormization
underweight 747258 39.7% 1133308 60.3% 1880566 100.0% Status normal 2617796 40.8% 3793598 59.2% 6411394 100.0% overweight 66285 48.8% 69665 51.2% 135950 100.0% Total 3431339 40.7% 4996571 59.3% 8427910 100.0%

Dewormization

no yes

Total

Count % within Status Count % within Status Count % within Status

Appendix Table 13. Weighted frequencies and percentage distribution of nutritional status of children by the program Growth Monitoring
underweight 1316705 61.3% 830666 38.7% 2147371 100.0% Status normal 4609318 57.2% 3443176 42.8% 8052494 100.0% overweight Total 81682 6007705 48.7% 57.9% 86193 4360035 51.3% 42.1% 167875 10367740 100.0% 100.0% 28

Growth Monitoring

no yes

Total

Count % within Status Count % within Status Count % within Status

Appendix Table 14. Weighted frequencies and percentage distribution of nutritional status of children (weight-for-age index)
Frequency underweight 2174335 normal 8132006 overweight 170993 Total 10477333 Percent 20.8 77.6 1.6 100.0 Valid Percent 20.8 77.6 1.6 100.0 Cumulative Percent 20.8 98.4 100.0

Valid

Appendix Table 15. Pearson 2 test statistic and Design Corrections of the variables

Variables Age of child Sex of child Age of household head Sex of household head Civil status of household head Education of household head Region Household size Presence of appliances Presence of electricity Dewormization Growth Monitoring

Pearson 2 74.5894 2.2727 94.6185 12.5432 3.1436 285.1835 66.3428 100.8603 352.9981 288.2562 7.6562 30.3867

D 1.1156 1.1316 1.2933 1.4448 1.2649 1.6807 1.1829 0.7223 1.098 1.1478 1.2149 1.2737

Rao-Scott 2 66.8603 2.0084 73.1605 8.6816 2.4853 169.6814 56.0849 139.6377 321.4919 251.1380 6.3019 23.8570

Appendix Table 17. Likelihood Ratio Tests

Model Fitting Criteria AIC of Reduced Model 16816.204 16813.658 16902.607 16885.315 16816.900 16968.569 16825.523 16867.699 16830.172 16814.819 16826.667 BIC of Reduced Model 16998.165 16980.455 17069.404 17052.112 16983.697 17135.366 16977.157 17034.497 16996.969 16981.616 16993.464 -2 Log Likelihood of Reduced Model 16768.204 16769.658 16858.607 16841.315 16772.900 16924.569 16785.523 16823.699 16786.172 16770.819 16782.667 Likelihood Ratio Tests

Effect Intercept age_child age_HH hhsize sex_HH educ_HH island appliance electricity dewormization growth

Chi-Square .000 1.454 90.403 73.111 4.695 156.365 17.319 55.495 17.968 2.615 14.463

df 0 2 2 2 2 2 4 2 2 2 2

Sig. . .483 .000 .000 .096 .000 .002 .000 .000 .271 .001

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