Monitoring and Evaluation of Local Level Plan Implementation (MELLPI PRO) Nutrition Policies Bella M. Basalong NO III, NNC-CAR OUTLINE OF PRESENTATION Executive Order, Republic Act (RA, EO) Department of Health Policies National Nutrition Council Governing Board Resolutions Department of Education Policies Salt Iodization Board Resolution Executive Order 51 Milk Code EO 51: Milk Code Title: Adopting a National Code of Marketing of Breastmilk Substituted, Breastmik Supplements and related products, penalizing violation thereof, and for other Purposes Purpose: To ensure provision of safe and adequate nutrition for infants by promotion of breastfeeding and ensuring proper use of breastmilk substitutes when these are medically indicated and only when necessary EO 51: Milk Code DOH AO 12 s. of 2006: Revised Implementing Rules and Regulations • Scope and Coverage: The IRR shall apply to the marketing and practices related to the following products: – Breastmilk substitutes and other milk products; foods and beverages when marketed as replacement for breastmilk – Feeding bottles and teats EO 51: Milk Code DOH AO 12 s. of 2006: Revised Implementing Rules and Regulations • No advertising, promotions, sponsorship and marketing of materials and activities for breastmilk substitutes for infants up to 24 months • No financial or material gifts to promote breastmilk substitutes shall be given by milk companies nor accepted by health workers and/or their family members EO 51: Milk Code DOH AO 12 s. of 2006: Revised Implementing Rules and Regulations • Manufacturers/distributors or their representatives are prohibited from DONATING and GIVING SAMPLES of the product to the general public, hospital, health facilities, personnel and members of their family EO 51: Milk Code DOH AO 12 s. of 2006: Revised Implementing Rules and Regulations • Donations of products not covered by the Milk Code given by milk companies (in cash or kind) may only be coursed through the Inter Agency Committee (IAC) which shall determine if the it is accepted or not. EO 51: Milk Code DOH AO 12 s. of 2006: Revised Implementing Rules and Regulations • Other related products such as, but not exclusive of teats, feeding bottles, and artificial paraphernalia are prohibited in health facilities • Neither the container nor the label of milk products shall have pictures of babies/children together with their mothers, fathers, siblings, grandparents, other relatives or caregivers. EO 51: Milk Code DOH AO 12 s. of 2006: Revised Implementing Rules and Regulations • Adulteration and the like is prohibited to prevent quality deterioration and contamination; breastmilk substitutes should not be repacked and sold by distribution outlets by the cup, bag or in any other form EO 51: Milk Code DOH AO 12 s. of 2006: Revised Implementing Rules and Regulations • EO 51 Monitoring Team at the Regional/ Provincial/ City/ Municipal and Barangay Levels ( in collaboration with their respective LGUs): – CHD-CAR Provincial/City/ Municipal/Barangay Health Offices – GOs/NGOs/ Civil Societies EO 51: Milk Code DOH AO 12 s. of 2006: Revised Implementing Rules and Regulations • Role of EO 51 Monitoring Team: – Monitors compliance as well as problems encountered in the implementation of the Milk Code – Reviews/acts on reports of violations of the provisions of the Code – Verifies reports of violations of the Milk Code – Monitors labels of products within the scope of the Code and marketing practices in various distribution centers – Recommends sanctions for violations to FDA – Submits regular reports on the status of the Milk Code implementation to FDA MELLPI PRO PERFORMANCE LEVEL OF 5 • The LGU has activities to implement and monitor compliance to the local ordinance, resolution or EO and provides feedback and penalties to violators as applicable RA 10028 Expanded Breastfeeding Act RA 10028: Expanded Breastfeeding Act • Amends REPUBLIC ACT NO. 7600 (An Act of Providing Incentives to all Government and Private Health Institutions with Rooming-In and Breastfeeding Practices and for other Purposes) RA 10028: Expanded Breastfeeding Act Breastfeeding in the Workplace and Public Places • All establishments whether operating for profit or not, unless exempted by DOLE and CSC shall have lactation stations • Private institutions may avail of tax deduction up to twice the actual amount incurred in establishing the lactation station RA 10028: Expanded Breastfeeding Act Breastfeeding in the Workplace and Public Places RA 10028: Expanded Breastfeeding Act Milk Storage and Milk Banking in Health Institutions • Health institutions are encouraged to establish milk bank RA 10028: Expanded Breastfeeding Act Breastfeeding Integration in the Curriculum Celebration of Breastfeeding Awareness Month MELLPI PRO PERFORMANCE LEVEL OF 5 • The LGU has institutionalized compliance to the law through issuance of local policy, budget allocation and relevant facilities RA 8976 Philippine Food Fortification Act of the Philippines RA 8976: Philippine Food Fortification Act of the Philippines RA 8976: Philippine Food Fortification Act of the Philippines RA 8976: Philippine Food Fortification Act of the Philippines MELLPI PRO PERFORMANCE LEVEL OF 5 • The LGU has sustained implementation of relevant activities and regularly monitors the implementation including having relevant discussions during C/MNC meetings and adjustments RA 8172 ACT FOR SALT IODIZATION NATIONWIDE (ASIN) RA 8172: ACT FOR SALT IODIZATION NATIONWIDE (ASIN) RA 8172: ACT FOR SALT IODIZATION NATIONWIDE (ASIN) RA 8172: ACT FOR SALT IODIZATION NATIONWIDE (ASIN) SECTION 2. The LGUs shall support the development and sustainability of the salt industry through: formulation of ordinances and information campaigns promoting the availability and use of iodized salt Provision of budget for health and nutrition programs Assistance to other government agencies in the implementation of the salt iodization program Monitoring the quality of salt as provided by law through its respective health officers and nutritionist-dietitians or, in their absence, through the sanitary inspectors; and Establishment and maintenance of a list of salt producers in their respective territorial jurisdiction MELLPI PRO PERFORMANCE LEVEL OF 5 • The LGU has sustained implementation of relevant activities and regularly monitors the implementation including having relevant discussions during C/MNC meetings and adjustments RA 11148 Kalusugan at Nutrisyon ng Mag-Nanay Act RA 11148: Kalusugan at Nutrisyon ng Mag-Nanay Act An Act Scaling Up the National and Local health Nutrition Programs through a Strengthened Integrated Strategy for Maternal, Neonatal, Child Health and Nutrition in the First One Thousand (1,000) Days of life Program Implementers: DOH in coordination with NNC, DA and LGUs RA 11148: Kalusugan at Nutrisyon ng Mag-Nanay Act Specific MCHN services are provided: Prenatal Period Women about to Give Birth Postpartum and Lactating Women Birth and Newborn Period MELLPI PRO PERFORMANCE LEVEL OF 5 • The LGU has sustained implementation of relevant activities and regularly monitors the implementation including having relevant discussions during C/MNC meetings and adjustments DOH AO 10, s. 2010 Revised Policy on Micronutrient Supplementation to Support Achievement of 2015 MDG Targets to Reduce Underfive and Maternal Deaths and Address Micronutrient Needs of Other Population Groups DOH AO 10, s. 2010: Revised Policy on Micronutrient Supplementation • Declaration of Policy – Reiterates the use of Zinc supplement and reformulated oral rehydration salt in the management of diarrhea – Supersedes AO No. 119, s. 2003 on the updated MS Guide issued in December 2003 DOH AO 10, s. 2010: Revised Policy on Micronutrient Supplementation • Role of the RHU – Provide the necessary micronutrient supplements according to protocol (based on the Manual of Operations) – Advocate among LCEs and other local officials to allocate budget for MS MELLPI PRO PERFORMANCE LEVEL OF 5 • The LGU has sustained implementation of relevant activities and regularly monitors the implementation including having relevant discussions during C/MNC meetings and adjustments DOH AO 29, s. 2008 Implementing Health Reforms for Rapid Reduction of Maternal and Neonatal Mortality DOH AO 29, s. 2008: Implementing Health Reforms for Rapid Reduction of Maternal and Neonatal Mortality • Goal: Rapidly reduce maternal and neonatal mortality through local implementation of an integrated MNCHN (Maternal, Neonatal and Child Health and Nutrition) strategy DOH AO 29, s. 2008: Implementing Health Reforms for Rapid Reduction of Maternal and Neonatal Mortality • Local Government Units a. Adopt and implement MNCHN strategy b. Reorganize staff to deliver the integrated MCHN services, in the context of the health sector reform elements and goals c. Invest in the development of facilities and staff d. Ensure adequate financing e. Monitor and supervise implementation f. Ensure sustainability of quality of services DOH AO 29, s. 2008: Implementing Health Reforms for Rapid Reduction of Maternal and Neonatal Mortality • Emphasize the following: – Organization of Service Delivery Network • CEmONC (Comprehensive Emergency Obstetric and Newborn Care) facility • BEmONC (Basic Emergency Obstetric and Newborn Care) facility • Community level service (RHU, health centers, BHS) DOH AO 29, s. 2008: Implementing Health Reforms for Rapid Reduction of Maternal and Neonatal Mortality • MNCHN Services in the following period: Pre-pregnancy Services Antenatal Care Care During Delivery Postpartum and Postnatal Care MELLPI PRO PERFORMANCE LEVEL OF 5 • The LGU has sustained implementation of relevant activities and regularly monitors the implementation including having relevant discussions during C/MNC meetings and adjustments NNC GB No. 2, s. 2012 Approving the Revised Implementing Guidelines on Operation Timbang Plus NNC GB No. 2, s. 2012: Approving the Revised Implementing Guidelines on Operation Timbang Plus Inclusion of length and height measurement in the annual mass weighing of preschool children Length Less than 2 years (0-23 months) Child who are weak to stand Height 2 years and older Children capable of standing up MELLPI PRO PERFORMANCE LEVEL OF 5 • LGU maintains an inventory of weight and height measuring equipment and allocates budget for maintenance and/or replacement NNC GB No. 6, s. 2012 Adoption of the 2012 Nutritional Guidelines for Filipinos NNC GB No. 6, s. 2012: Adoption of the 2012 Nutritional Guidelines for Filipinos MELLPI PRO PERFORMANCE LEVEL OF 5 • LGU has implemented more than 2 activities in support to the resolution with multi-stakeholder participation NNC GB No. 3, s. 2014 Approving and Adopting the Guidelines on Local Nutrition Planning NNC GB No. 3, s. 2014: Approving and Adopting the Guidelines on Local Nutrition Planning Plan Preparation and Adoption (Assessment, Analysis, Adoption, and Allocation) 1.1 Mobilization of LNC or planning core group 1.2 Assessment of Nutrition Situation 1.3 Setting of goals and objectives 1.4 Identification and prioritization of nutrition intervention 1.5 Preparation of plan of operation 1.6 Designing of monitoring and evaluation 1.7 Plan packaging 1.8 Legislation/adoption and resource allocation NNC GB No. 3, s. 2014: Approving and Adopting the Guidelines on Local Nutrition Planning MELLPI PRO PERFORMANCE LEVEL OF 5 • LGU updated LNAP has been approved, budgeted, implemented with a C/MNC review conducted at least once in the last 3 years NNC GB No. 4 s. 2012 Adopting the Underfive Age Group to describe child Undernutrition in the Philippines NNC GB No. 4 s. 2012 “Adopting the Underfive Age Group to describe child Undernutrition in the Philippines” Child undernutrition will be expressed and reported in terms of situation of children underfive years old, i.e. 0-59 months Height and weight of children 60-71 months old will be measured for determination of those needing interventions NNC GB No. 1, s. 2017 Approving and Adopting the Philippine Plan of Action for Nutrition 2017-2022 NNC GB No. 1, s. 2017 : Approving & Adopting the Philippine Plan of Action for Nutrition 2017-2022 PPAN 2017-2022 (3 Major Programs) • Nutrition Specific Programs • Nutrition Sensitive Programs • Enabling Mechanisms NNC GB No. 1, s. 2017 : Approving & Adopting the Philippine Plan of Action for Nutrition 2017-2022 Nutrition-specific programs – Address immediate causes of malnutrition 1. 2. 3. 4. 5. 6. 7. 8. Infant and Young Child Feeding Integrated Management of Acute Malnutrition National Dietary Supplementation Program National Nutrition Promotion Program for Behavior Change Micronutrient Supplementation Mandatory Food Fortification Nutrition In Emergencies Overweight and Obesity Management and Prevention Program NNC GB No. 1, s. 2017 : Approving & Adopting the Philippine Plan of Action for Nutrition 2017-2022 Nutrition sensitive programs 1. Farm-to-market roads and child nutrition 2. Target Actions to Reduce Poverty and Generate Economic Transformation (TARGET) and child nutrition 3. Coconut Rehabilitation Program 4. Gulayan sa Paaralan 6. Family development sessions for child and family nutrition project 7. Mainstreaming nutrition in sustainable livelihood 8. Public works infrastructure and child nutrition 9. Adolescent Health and Nutrition Development 10. Sagana at Ligtas na Tubig sa Lahat (SALINTUBIG) and other programs on water, sanitation and hygiene NNC GB No. 1, s. 2017 : Approving & Adopting the Philippine Plan of Action for Nutrition 2017-2022 Enabling Programs Mobilization of Local Government units Policy Development for food and nutrition Strengthened support to PPAN MELLPI PRO PERFORMANCE LEVEL OF 5 • LGU monitors the implementation of nutrition activities funded by the LGU, through regular C/MNC meetings, program reviews of activities throughout the year by majority of the members NNC GB No. 2, s. 2009 Adopting the National Policy on Nutrition Management in Emergencies and Disasters NNC GB No. 2, s. 2009: Adopting the National Policy on Nutrition Management in Emergencies and Disasters Local Nutrition Clusters should be organized The Nutrition Cluster Global Nutrition Cluster National Level • National Nutrition Cluster Regional Level • Regional Nutrition Cluster Provincial/City Municipal/ Barangay Level • Local Nutrition Cluster Nutrition in Emergency (NIE) TRAINING PACKAGES PACKAGES TRAINING FOR HEALTH FOR HEALTH EMERGENCIES 05\ 05\ 85 Components of NiE: Nutrition assessment IYCF protection, support and promotion Management of acute malnutrition Micronutrient supplementation Other food and non-food interventions 86 MELLPI PRO PERFORMANCE LEVEL OF 5 • Nutrition Cluster has been formulated with clarified relational link with the local DRRMC during emergencies, NiEm Plan formulated and clear fund resource NNC GB No. 3, 2012 Approving the Guidelines on the Fabrication, Verification and Maintenance of Wooden Height Board NNC GB No. 3, 2012: Approving the Guidelines on the Fabrication, Verification and Maintenance of Wooden Height Board NNC GB No. 3, s. 2018 Approving the Guidelines on the selection of Non-Wood Height and Length Measuring Tool NNC GB No. 3, s. 2018: Approving the Guidelines on the selection of Non-Wood Height and Length Measuring Tool - NNC GB on motion of the DA (Vice-Chair), instructed the secretariat to explore other materials apart from wood in view of the country’s policy on total log ban Aluminun-acrylic height board, fiberglass, and plastic are acceptable measuring tools MELLPI PRO PERFORMANCE LEVEL OF 5 • LGU uses verified height and length measuring tools of wooden/ nonwooden material as prescribed in the guidelines and available in all barangays Deped Memo 233, s. 2016 Strengthening Gulayan sa Paaralan Deped Memo strengthening Gulayan sa Paaralan DM 233, s. 2016 DepED Order 10, s. 2016 Water, Sanitation & Hygiene in Schools (WinS) Program DepED Order 10, s. 2016: Water, Sanitation & Hygiene in Schools (WinS) Program • Water – Regular supply of safe drinking water in school – Regular supply of clean water for handwashing Regular monitoring of water quality – Rainwater catchment systems shall be installed in schools – Daily cleaning & regular maintenance activities as well as water supply facilities DepED Order 10, s. 2016: Water, Sanitation & Hygiene in Schools (WinS) Program • Sanitation – Access to functional toilets with individual handwashing facilities with soap for boys and girls – Safe water shall be supplied in school canteens – Adequate water treatment facility – Proper waste management – Eliminate breeding grounds for insects – Food preparation and handling in schools meet the standards of the Food Safety Manual – Practice of school canteen management on food safety DepED Order 10, s. 2016: Water, Sanitation & Hygiene in Schools (WinS) Program • Health Education – Build capacity of school personnel and other stakeholders for effective management of WinS – Key concepts of WinS program are integrated in the curriculum DepED Order 10, s. 2016: Water, Sanitation & Hygiene in Schools (WinS) Program • Deworming – Deworm all students twice a year – Parent/Guardian’s consent are obtained – Deworming is done on a full stomach to avoid adverse events DepED Order 13, s. 2017 Policy and Guidelines on Healthy Food and Beverage Choices in Schools and in DepED Offices DepED Order 13, s. 2017: Policy and Guidelines on Healthy Food and Beverage Choices in Schools and in DepED Offices DepED Order No. 59, s. 2017 Weekly Iron & Folic Acid Supplementation for Female Adolescents DepED Order No. 59, s. 2017: Weekly Iron & Folic Acid Supplementation for Female Adolescents • WIFA (Weekly Iron and Folic Acid Supplementation is a nationwide routine activity in all public schools targeting females in Grade 7-10 and those in ALS • Conducted every July to September (1st round) and January to March (2nd round) DepEd Order NO. 39, s. 2017 Operational Guidelines for School based Feeding Program DepEd Order NO. 39, s. 2017: Operational Guidelines for School based Feeding Program Objective: To address undernutrition among public school children MELLPI PRO PERFORMANCE LEVEL OF 5 • The LGU has sustained implementation of relevant activities and regularly monitors the implementation including having relevant discussions during C/MNC meetings and adjustments Salt Iodization Board Resolution No. 1: Adopting the Strategic Plan of the NSIP 2018-2022 • The plan emphasized ASIN law enforcement at the local and regional levels • Local government units (LGUs) are responsible for issuing local ordinances, monitoring the presence of iodine in all local salt, maintaining a list of salt producers, importers, and distributors, and allocating budget for implementation of the ASIN law MELLPI PRO PERFORMANCE LEVEL OF 5 • The LGU has sustained implementation of relevant activities and regularly monitors the implementation including having relevant discussions during C/MNC meetings and adjustments