Ravenholt A.
PIP: In the Philippines poverty and pervasive malnutrition are not limited to families of deprived seasonal workers. Undernourishment is endemic and increasing throughout most of this archipelago of some 7100 islands, and is compounded by the prevalence of intestinal parasites and gastrointestinal diseases which health workers estimate deprive youngsters of at least 5-10% of the nutritional value in food they do consume. This problem is particularly prevalent in rural villages and city slums where many people eat with their fingers. According to the Philippine Ministry of Health, nearly 1/2 of all reported deaths are among infants and children through age 4, and about 1/2 of the accelerated death rate among those age 5 and younger is related to malnutrition, compounded by diarrhea, measles, and malaria which is returning to areas where it once was almost eradicated. 3 factors critically affect a newborn's survival prospects: the family size he or she is born into; the time or spacing between the mother's pregnancies; and the child's birth order. Evidence indicates that, during the 1970s, as US aid and other family planning assistance became available, they were used most among families in the 2 highest income classes, where reduction of family size is under way. Poverty is the most fundamental cause of malnutrition, although many other factors contribute. Land reform has brought security of tenure and increasingly is transferring ownership of fields to former tenants of rice and corn lands. For the former tenants enhanced security brings greater income and better eating for the farm families retain more of the crop. The undernourished and truly poor of the Philippines number about 1/2 of the population. Although dispersed throughout most of the archipelago, there are important regional differences. These related to marked geographic patterns that affect fertility of the soil, length of the dry season, fortunes of