Improving nutrition investments through cost-effective feeding models

Decision-maker’s challenge

Undernutrition remains a pressing issue in the Philippines. According to the 2023 Expanded National Nutrition Survey, 23.6 % of Filipino children under 5 years old are stunted, 5.6% are wasted, and 15.1% are underweight. Among school-aged children, 17.9% are stunted, 8.4% are wasted, and 21.3% are underweight. These figures reflect modest improvement over the last 2 years. However, the prevalence of stunting among children under five remains at a level considered to be of high public health significance based on World Health Organization (WHO) standards.

To address this challenge, the Philippine government implements three dietary supplementation programs that reach children from birth through elementary school, aiming to help them grow healthy and stay in class. Tutok Kainan targets nutritionally at-risk pregnant women and young children (6-23 months) in select communities, the Supplementary Feeding Program provides meals to preschoolers in childcare centers, and the School-Based Feeding Program targets severely malnourished students from kindergarten through sixth grade, with plans to expand to universal coverage. Together, these programs aim to improve health and educational outcomes, but the government faces a tough problem: gaps in who gets help, sky-high costs, and programs that work well in some places but fail in others.

Without clear evidence, government officials cannot determine which program designs deliver meaningful improvements in child nutrition or identify where resources are being used inefficiently. The World Food Programme and The Department of Economy, Planning, and Development (DEPDev) partnered with IDinsight to address this critical gap: generate actionable evidence on program implementation, identify barriers to reaching the most vulnerable children, and understand how resources can be better deployed to combat child undernutrition in the Philippines.

Impact opportunity

These three programs reach millions of Filipino children and thousands of pregnant women annually. This represents a massive opportunity to improve nutrition outcomes and educational success at scale. Yet without evidence-driven optimization, resources may not reach those who need them most or deliver maximum impact per peso spent.

By generating this actionable evidence, our work enables the government to strengthen program design, improve operational efficiency, build local capacity, and deliver more consistent and cost-effective feeding programs. Our work guides high-level discussions on refining policy frameworks, maximizing budget allocations and identifying concrete synergies among the government’s major nutrition programs. These findings are also being used by key implementing agencies to assess design consistency and inform revisions to operational guidelines scheduled for release later this year.

This evaluation supports the Philippine government in transforming substantial investments into measurable improvements in child health, school attendance, and long-term development outcomes across the country’s largest nutritional investments.

Our approach

IDinsight worked closely with the Department of Education (DepEd), Department of Social Welfare and Development (DSWD), National Nutrition Council (NNC), and local government units to assess how the three feeding programs are functioning in practice. We began with a comprehensive review of existing frameworks, policies, and reports from all three programs, alongside a global evidence review of government-supported feeding programs. This included synthesizing international evidence on beneficiary targeting approaches, nutritional requirements for different age groups, and the documented impact of feeding programs on health, nutrition, and education outcomes.

We then facilitated Theory of Change workshops with each stakeholder to align on program objectives, implementation pathways, key assumptions for success, and the most critical questions requiring investigation.

Our team travelled to 20 cities and municipalities across Luzon, Visayas, Mindanao, and Metro Manila, engaging directly with the people implementing these programs on the ground. We conducted key informant interviews with local government officers and program leads, and focus group discussions with frontline implementers: child development workers, teachers, barangay health workers, and parents of beneficiaries. We analyzed administrative data to assess budget allocation, program coverage, and nutrition outcomes. 

This hands-on approach helped us see where programs are reaching the right children and where gaps exist, and identify what’s working well and what’s breaking down in implementation. The recommendations developed from this study will help strengthen the programs that currently serve over 4 million Filipino children, with the potential to benefit many more as the government considers significant program expansion. They will also inform changes to the policy and legal frameworks that institutionalize these interventions, while guiding the effective use of the government’s $320 million budget to ensure investments go to the right programs and to improve the operational capacity of government to deliver them efficiently. This will ensure millions of Filipino children get the nutrition support they need to grow healthy and succeed in school.