Background:  This study focused on village health system functionality as a social determinant of malnutrition. The primary objective of the study was to village health system functionality with underweight prevalence in selected rural villages.

Methods:  Twenty-four (24) villages in one rural municipality in the Philippines were randomly selected for the study. The study involved interviews of the 24 village heads as chairs of their respective village health committees (BHCs). To assess village health systems, a 12-point scale adapted from the MSH Health Systems Manual, was utilized. Mean functionality scores were then correlated with the prevalence of under-five children who were underweight-for-age as computed from municipal records.

Results:  The majority of the barangays fared poorly on the functionality scale, with only two earning the label “fully functional”. The barangays performed best in “health training” (mean score 2.83) and worst in “availability of pharmaceuticals” (0.47). The Pearson’s r for health system functionality and underweight prevalence was -0.42 indicating a negative moderate association. The overall coefficient of determination (r²) was 0.184 indicating only 18 per cent of the underweight prevalence is approximated by health system functionality. Among the 12 system functionality indicators, “community participation” was the best predictor of underweight prevalence.

Conclusions:  The study demonstrated that the prevalence of underweight children in a community is negatively and moderately correlated with village health system functionality. However, health system functionality only accounts for 18 per cent of the underweight prevalence, which affirms the multifactorial nature of malnutrition.