Folic Acid and Neural Tube Defect Prevention in the Philippines: What Every Family Needs to Know

Spina bifida and other neural tube defects are among the most common serious birth defects in the Philippines. A large proportion of these cases are preventable — through adequate folic acid intake before and during early pregnancy. This article explains what neural tube defects are, why folic acid matters, what the current situation looks like in the Philippines, and what you can do.

What Are Neural Tube Defects?

Neural tube defects occur when the neural tube — the structure in a developing embryo that eventually becomes the brain and spinal cord — fails to close properly during the first 28 days of pregnancy. This window often passes before a woman even knows she is pregnant.

The most common NTDs include spina bifida, which is incomplete closure of the spinal column ranging from mild to severe; anencephaly, in which major portions of the brain and skull do not develop; and encephalocele, the protrusion of brain tissue through an opening in the skull.

Why Folic Acid Matters

Folic acid is a B vitamin (B9) essential for the proper development of the neural tube in early pregnancy. Adequate folic acid intake before conception and during the first trimester significantly reduces the risk of NTDs — by as much as 70% in some studies.

Because the neural tube closes in the first four weeks of pregnancy — often before a woman realizes she is pregnant — waiting until pregnancy is confirmed to start folic acid is already too late for preventing NTDs. The standard recommendation is 400 micrograms daily for all women of reproductive age; 4,000 mcg (4mg) daily for women with a previous NTD-affected pregnancy or other elevated risk factors, under medical guidance.

The Situation in the Philippines

Folic acid supplementation rates among Filipino women of reproductive age remain lower than recommended. A significant proportion of pregnancies in the Philippines are unplanned, meaning the neural tube closure window passes without any supplementation. The Philippines does not yet have mandatory folic acid fortification of staple foods at scale — a policy that in many countries raises the baseline intake of the entire population. Awareness gaps persist among women and some healthcare providers about the timing requirements for supplementation.

Folic Acid for All PH: Advocacy for National Change

The Spina Bifida Support Group Foundation, Inc. is one of the most active voices pushing for mandatory folic acid fortification in the Philippines through its Folic Acid for All PH campaign. The foundation's advocacy targets national policy: requiring that staple foods be fortified with folic acid at levels sufficient to meaningfully reduce NTD incidence — an approach proven effective in the United States, Canada, and Chile.

In November 2025, members of the SBSG Foundation engaged directly with the Department of Health — including then-Assistant Secretary Gloria J. Balboa (now DOH Undersecretary) — to discuss NTD prevalence data and the case for mandatory fortification.

What You Can Do Right Now

Women of reproductive age should talk to their doctor or midwife about starting a daily folic acid supplement (400 mcg) now, regardless of whether they are currently planning a pregnancy. If you are pregnant, confirm with your OB-GYN what supplementation is appropriate for your specific situation. If you have had a previous NTD-affected pregnancy, inform your healthcare provider before your next pregnancy — higher-dose supplementation (4mg daily) is recommended beginning at least one month before conception. Healthcare providers should provide routine folic acid counseling for all women of reproductive age. Those who want to support systemic change can follow, share, and amplify the Folic Acid for All PH campaign.

Supporting the Foundation's Work

To support the Folic Acid for All PH campaign and the foundation's broader programs: Phone (02) 731 2771 local 201 or 0917 144 2636. Bank transfer to Security Bank, Account Name: Spina Bifida Support Group Foundation, Inc., Account Number: 0000020130850. In person at Room 201, Hospital of the Infant Jesus, 1556 Laong Laan Rd., Sampaloc, Manila.

Visit spinabifidaph.com to learn more about the campaign, access educational resources, or support the foundation's advocacy work.