National Nutrition Council - Local Nutrition Planning

You might also like

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 38

Republic of the Philippines

Department of Health

NATIONAL NUTRITION COUNCIL


Region III

RNC of Central Luzon


Resolution No. 1, Series of 2014

Adopting the National Policy on Nutrition Management in Emergencies and Disasters

WHEREAS, the country is among the Asian Countries most at risk to natural disasters and
among the top five countries with most number of victims and death due to geophysical,
hydrological and meteorological hazards;

WHEREAS, human-induced emergencies like technological, societal and biological


emergencies similarly posed public health risks;

WHEREAS, these emergencies disrupt the lives of the population affected, putting them at risk
of developing various undesirable health and related conditions, including those that threaten the
nutritional status of individuals, especially the most vulnerable groups: infants, children,
pregnant women and breastfeeding mothers, older persons, people with disabilities and people
living with debilitating conditions;

WHEREAS, the risk of a deteriorating in the nutritional status of the population likewise
threatens the gains achieved in improving the nutrition situation, which could reverse the high
likelihood of achieving direct nutrition-related targets of the Millennium Development Goal
(MDG) # 1 and the targets of the other MDGs indirectly;

WHEREAS, such a threat could be mitigated through the delivery of various nutrition and
related interventions, which are best identified and implemented through processes that allow
the maximum participation of those affected;

WHEREAS, the delivery of quality nutrition and related services could be facilitated through
clear and practical quality standards;

NOW THEREFORE, BE IT RESOLVED AS ITS HEREBY RESOLVED, in consideration


of the above premises, we the Regional Nutrition Committee, Regional Nutrition Cluster and
Regional Bantay Asin Task Force of Central Luzon hereby adopt the National Policy on
Nutritional Management in Emergencies and Disasters, as per attached.

RESOLVED FURTHER, for member agencies of the Regional Nutrition Committee of Central
Luzon to issue the appropriate policy instrument on the adoption of this policy.
RESOLVED FURTHER, for the Regional Nutrition Cluster to adopt or formulate or reproduce
and disseminate the appropriate guidelines, manual of operations, and other user-friendly
materials to implement the policy.

Approved this _______ day of _____________________ 2014.

Certified Correct by:

Approved by:

Attested by:
CONFORME:
Republic of the Philippines
Department of Health
NATIONAL NUTRITION COUNCIL
Region III

RNC of Central Luzon


Resolution No. 2, Series of 2014

Adopting the Guidelines on Local Nutrition Planning

WHEREAS, malnutrition is a condition resulting due to lack, or excess or imbalance in one or


more of the nutrients;

WHEREAS, based on the national nutrition surveys, the nutrition situation of the Philippines is
described as experiencing the double burden of malnutrition;

WHEREAS, undernutrition is largely prevalent among young children and women while
overnutrition is also prevalent among adults and increasing among schoolchildren;

WHEREAS, undernutrition has far-reaching consequences on the child growth and development
and the capacity to learn and maximize investments in education and to become economically
productive and socially active as future adults;

WHEREAS, overnutrition has been established to be a risk factor for developing non-
communicable diseases;

WHEREAS, both undernutrition and overnutrition can result to preventable mortality and both can
hold back development;

WHEREAS, there is a need for strategic and purposive action to address this twin nutritional
problem; and with devolution, local government units play a pivotal role in reversing the trend in
both under and overnutrition and in ensuring good nutrition among the population;

WHEREAS, the formulation of local nutrition action plans and their integration in the local
development plan and annual investment plan will help ensure that nutrition action at the local level
is strategic and purposive;

NOW THEREFORE, BE IT RESOLVED AS ITS HEREBY RESOLVED, in consideration of


the foregoing, we the Regional Nutrition Committee, Regional Nutrition Cluster, Regional Bantay
Asin Task Force of Central Luzon hereby adopts the National Guidelines on Local Nutrition
Planning (please see attachment) as a guide to local nutrition committees in formulating a nutrition
action plan that would address nutritional problems in their locality and thus, contribute to a better
quality of life of Filipinos.

RESOLVED FURTHER, that we commit our departments or agencies or organizations to


advocate and support the use of the Guidelines on Local Nutrition Planning within the scope of our
influence to the local nutrition committees in coordination with the NNC Region 3 Secretariat;
RESOLVED FURTHER, for the National Nutrition Council Region 3 Secretariat to ensure that the
Guidelines on Local Nutrition Planning is disseminated as widely as possible to all stakeholders to help
local nutrition committees in their strategic and purposive local nutrition planning;

RESOLVED FURTHER, for the Regional Nutrition Committee of Central Luzon to lead the conduct of
monitoring to ensure that this resolution is fully implemented.

Approved this ______ day of _____________ 2014.

Certified Correct by:

Approved by:

Attested by:
Republic of the Philippines
NATIONAL NUTRITION COUNCIL

NNC GOVERNING BOARD


Resolution No. 3, Series of 2014

Approving and Adopting


the Guidelines on Local Nutrition Planning

WHEREAS, malnutrition is a condition in the body due to lack, or excess, or imbalance in one or
more of the nutrients;

WHEREAS, based on national nutrition surveys, the nutrition situation of the Philippines can be
described to be experiencing the double burden of malnutrition;

WHEREAS, while undernutrition is largely prevalent among young children and women,
overnutrition is also prevalent especially among adults;

WHEREAS, undernutrition has far-reaching consequences on child growth and development and
the capacity to become economically productive and socially active adults;

WHEREAS, overnutrition has been established as one of the risk factors for developing non-
communicable diseases;

WHEREAS, both undernutrition and overnutrition can result to preventable mortality and both can
hold back development;

WHEREAS, there is a need for strategic purposive action to address this twin nutritional problem;
and with devolution, local government units play a pivotal role in reversing the trend in both under
and overnutrition and in ensuring good nutrition among the population;

WHEREAS, the formulation of local nutrition action plans and their integration into the local
development plan and annual investment plan will help ensure that nutrition action at the local
level is strategic and purposive;
NOW THEREFORE, BE IT RESOLVED AS IT IS HEREBY RESOLVED, in consideration of the foregoing,
we the NNC Governing Board do hereby approve and adopt the Guidelines on Local Nutrition
Planning as a guide to local nutrition committees in formulating a nutrition action plan that would
address nutritional problems in their locality and thus, contribute to a better quality of life of
Filipinos,

RESOLVED FURTHER, that we commit our departments or agencies or organizations to advocate


and support the use of the Guidelines on Local Nutrition Planning within the scope of our
influence to the local nutrition committees in coordination with the NNC Secretariat;

RESOLVED FURTHER, for the National Nutrition Council Secretariat to ensure that the Guidelines
on Local Nutrition Planning is disseminated as widely as possible to all stakeholders to help local
nutrition committees in their strategic and purposive local nutrition planning;

RESOLVED FURTHER, for the National Nutrition Council Secretariat to ensure that the Guidelines
on Local Nutrition Planning is disseminated as widely as possible to all stakeholders to help local
nutrition committees in their strategic and purposive local nutrition planning;

RESOLVED FURTHER, for the National Nutrition Council Secretariat to monitor and to ensure that
this resolution is fully implemented.

RESOLVED FURTHER, to renew or update this Guidelines when needed.

Approved this 24th day of February 2014.

Attested by:
Republic of the Philippines
Department of Health
NATIONAL NUTRITION COUNCIL

GUIDELINES ON LOCAL NUTRITION PLANNING

Background

Malnutrition is a condition due to lack, or excess, or imbalance in one or more of the


nutrients. Based on national nutrition surveys, the nutrition situation of the Philippines
can be described to be experiencing the double burden of malnutrition. Thus, while
undernutrition is largely prevalent among young children and women, overnutrition is
also prevalent especially among adults.

Undernutrition has far-reaching consequences on child growth and development and


the capacity to learn and maximize investments in education as well as the capacity to
become economically productive and socially active adults. On the other hand,
overnutrition has been established to be one of the risk factors for developing non-
communicable diseases. Both undernutrition and overnutrition can therefore hold back
development.

Thus, there is a need for strategic and purposive action to address this twin nutritional
problem. With devolution, local government units play a pivotal role in reversing the
trend in both under and overnutriton and in ensuring good nutrition among the
population.

Based on the aforementioned premises, the following guidelines for local nutrition
planning are being adopted to help ensure that nutrition action at the local level is
strategic and purposive. The guidelines update those adopted in the 1980s.

Guidelines objectives

1. To define processes and tools that will facilitate the formulation of a


provincial, city and municipal nutrition action plan that is harmonized with
national and local development planning.

2. To guide local nutrition committees in formulating a nutrition action plan


that would address the existing nutritional problems in their locality.
Guidelines on local nutrition planning

Local nutrition planning defined

Local nutrition planning is deciding in advance actions that would be taken to address
prevailing nutritional problems. Its output is a three-year (coinciding with the term of
local elective officials) local nutrition action plan, i.e. Provincial/City/Municipal Nutrition
Action Plan (P/C/MNAP). It also outputs an annual investment plan for nutrition to help
ensure that the plan is funded and implemented.

The three-year plan should contain various sections that will include an assessment of
the situation; the objectives; workplan for programs, projects and activities to be
implemented, monitoring and evaluation scheme, budgetary requirements and
arrangements for organization and coordination. Panel A shows a simple outline for a
local nutrition action plan.
Panel A. Sample outline for the local nutrition action plan

3-Year Local Nutrition Action Plan


(Inclusive years)

LGU: ___________________

1. Introduction
2. The nutrition situation
a. What forms of malnutrition exist?
b. How many are malnourished?
c. Who are malnourished?
d. Where are the malnourished?
e. What are the causes of malnutrition?
f. What have been done to address malnutrition?
How effective have these been?
g. What are the resources available to address
malnutrition?
h. What constraints could affect the effective
implementation of interventions?
3. Goals and objectives
4. Workplan to implement programs, projects and activities
5. Monitoring and evaluation scheme
6. Budgetary Requirements
7. Arrangements for organization and coordination

The annual investment plan should provide information on specific activities and targets for the year as well as
funding requirements for the implementation of these activities.
Guidelines on local nutrition planning

Importance of local nutrition planning

1. Determines integrated, synchronized, coordinated and focused actions for nutrition


improvement

2. Promotes sectoral, community and private sector involvement

3. Allocates budget and other resources to achieve set objectives

4. Ensures efficient and effective utilization of resources

5. Prevents overlaps and duplication during program implementation

6. Minimize negative impact of other development programs on nutrition

7. Links nutrition with local development planning and budgeting

8. Provides the local nutrition committee (LNC) with a guide for implementing nutrition
projects, assessing and evaluating efforts and generating resources.

Timing of plan formulation

The LNAP is best prepared in the first semester of an election year. This will help ensure that the
nutrition agenda is integrated in the Executive Legislative Agenda of the local government unit.
It is to be noted that per guidelines on harmonized local development unit, the ELA for a term of
local elective officials should be completed by 31 July of the election year and is the basis for the
local development plan that is in turn the basis of the annual investment plan used for local
budgeting.

If for some reason or another, the local government unit has been unable to formulate its LNAP
before the formulation of the ELA, such can still be formulated covering the remaining period of
the current administration. However, the local nutrition action officer should coordinate with
the local planning and development office to ensure that the LNAP can still be considered in
formulating the annual investment plan.

On the other hand, the annual investment plan for nutrition should be formulated within the
first semester of the year prior to the year of implementation since heads of offices or
department heads of LGUs are required to submit budget proposals by 15 July. Preparing the
annual investment plan for nutrition early in the year will help facilitate the inclusion of
budgetary requirements in the overall local budget proposal, either as part of sectoral (or
department) budget proposals or as a distinct nutrition budget.
Guidelines on local nutrition planning

Once the annual budget has been approved, the annual investment plan for nutrition could be
reviewed and adjusted depending on budgets approved for specific activities.

Activities for plan formulation

Local nutrition planning involves several activities (Table 1) that are undertaken by the local
nutrition committee under the leadership of the local chief executive, with the nutrition action
officer as overall coordinator. It is to be noted that while these activities are listed sequentially,
the process is iterative with the local nutrition committee or its planning core group going back
and forth to certain activities as the plan is being formulated.

Table 1. Summary of activities for nutrition planning

Activity Description
1. Mobilization of local Activate core group composed of NAO and representatives
nutrition committee or local from planning office, agriculture, health, social welfare,
nutrition planning core DepEd, DILG, NGOs, and budget office
group
2. Assessment of nutrition Answers the guide questions (below) in conducting nutrition
situation situation assessment
1. What forms of malnutrition exist?
2. How many are malnourished
3. Who are the malnourished?
4. Where are the manlnourished?
5. What are the causes of malnutrition? (prepare a problem
tree)
6. What have been done to address malnutrition? How
effective have these been?
7. What resources are available to address malnutrition?
8. What constraints could affect the implementation of
nutrition interventions?
3. Setting of goals and Determining expected reduction in malnutrition based on
objectives modified problem tree, trends and higher level goals.
1. Define and agree on goals and objectives
2. Identify priority nutrition problem
3. Identify areas for complementation and integration of
the goals and objectives contributing to higher level PPAN and
other comprehensive plans
Guidelines on local nutrition planning

Activity Description
4. Identification and Identification and prioritization of interventions
prioritization of nutrition 1. Identification of intervention based on nutrition
interventions problem and causes
2. Setting of prioritization criteria
3. Rating of projects
4. Ranking of projects
5. Selection of intervention or group of interventions
5. Preparation of work Prepare the details of the work and financial plan
plan or operational plan including targets, interventions, duration, resources
needed
6. Designing of Preparing of monitoring and evaluation plan as part of
monitoring and evaluation the operation plan
7. Plan packaging Preparing of LNAP for submission to different
stakeholders; preparing the write-up
8. Legislation/adoption Includes strategies for adoption of LNAP at local level as
and resource allocation well as financing; submission to the planning office for
integration in the CLDP and AIP

These activities can be undertaken through a series of meetings that progressively develops the
plan. Table 2 shows how these meetings can be designed to achieve specific outputs. The LGU is
encouraged to evolve its own strategy for local nutrition planning.

Activity Outputs
1. LNC planning meeting a. Decisions and agreements the planning process, i.e.,
No. 1 activities to be done and by whom, timetable of activities,
resources needed and source
b. Organization of planning core group
c. Organization of planning secretariat
2. Situational analysis a. Draft nutrition situational analysis to describe the nature
(may be done by a team and magnitude of nutritional problems, past performance of
organized for the purpose) nutrition plan implementation,
b. Recommendations for overall directions for the plan
c. Draft plan and objective
3. LNC planning meeting a. Validation and approval of the results of the nutrition
No. 2 situation analysis
b. Agreement on priority problems, areas and target groups,
specific strategies
c. Initial agreements on key programs and projects
d. Draw up details of the agreed programs and projects
e. Additional tasks to be done, if any
Guidelines on local nutrition planning

Activity Outputs
4. Series of meetings of Draft plan (includes targets, scheme for monitoring and
LNC/LPCG to be evaluation, budget, local agency or NGO in charge) for each of
complemented by individual the programs and projects initially agreed upon by the LNC
assignments or consultation
with key personalities/actors
5. LNC planning meeting a. Approval of draft plan
Nos. 3 and 4 b. Additional task to be done, if any
6. Integration of all Finalized LNAP (write-up with supporting tables and figures, if
comments of P/C/MNC needed)
planning meeting usually by
the P/C/M Nutritional Action
Officer
7. LNC planning meeting a. Approval of the LNAP by way of LNC resolution
No. 5 b. Plans for presentation to the P/C/M Development
Council, and Sangguniang Panlalawigan or Panlungsod or
Sangguniang Bayan
8. Reproduction and Copies of approved LNAP distributed to:
distribution of approved a. all members of the LNC
LNAP b. all members of the P/C/MDC
c. all members of the SP or SB
d. barangays targeted in the LNAP
9. Preparations for a. Visual aids
presentation to P/C/MDC b. Handouts to be distributed
and SP or SB which may
include initial discussions
with some members
10. Presentation of LNAP Approval and allocation of budget needed for plan
to the SP or SB implementation

Mobilization

Mobilization means brining the members of the LNC together, under the leadership of the LCE,
to formulate the LNAP. If the LGU has no organized or active LNC, the nutrition planning process
provides an opportunity to reactivate or organize the LNC. It is to be noted that the LNC also
serves as the local nutrition cluster.

If the LNC has many members, a local planning core group (LPCG) could be organized to make
the planning process manageable.
Guidelines on local nutrition planning

The LCPG could be composed of representatives from the following:

1. LGU agencies or departments or offices involved in delivering nutrition and related


services

a. Agriculture
b. Health
c. Social Welfare and Development

2. P/C/M Planning and Development Office

3. Budget Office

4. National government agencies that have not been devolved

a. Department of Education

b. Department of Interior and Local Government

5. NGOs implementing social development projects that benefit many of the nutritionally-
at-risk or affected groups and communities.

It could also undertake the planning activities to develop a draft plan that should be presented,
deliberated on and eventually approved by the local nutrition committee.

Situational analysis

In this phase the LNC or LPCG, using data available, endeavors to answer the following
questions:

1. What forms of malnutrition exist?


2. How many are malnourished?
3. Who are the malnourished?
4. Where are the malnourished?
5. What are the causes of malnutrition?
6. What have been done to address malnutrition? How effective have these been?
7. What resources are available to address malnutrition?
8. What constraints could affect the implementation of nutrition interventions?

To answer these questions, the LNC or LPCG could collect and analyze data from various sources
(Table 3). It could also conduct focus group discussions with various groups especially the
intended targets to also generate their inputs on problem identification as well as on measures
to undertake to address identified problems.
Guidelines on local nutrition planning

Table 3. Guide to answering the eight questions on nutrition situation assessment

Guide Question Data to be collected and suggested analysis Possible Source


What forms of 1. Nutritional status (weight and Local Health Office,
malnutrition exist? length/height) of preschool and school children Local Nutrition
2. Nutritional status (weight and height) of Office, DepEd
pregnant and lactating women, adolescents and
older persons
3. Cases of deficiencies in Vitamin A, iron and
iodine
4. Infants with low birth weight
5. Compare with previous years and identify
the most prevalent form, get the average, then
rank
How many are 6. Actual number Local Health Office,
malnourished? 7. Prevalence (%) e.g., number of underweight Local Nutrition
0-5 year old children Office, DepEd
8. Prevalence of underweight among
preschool and school children by age group and
sex
9. Prevalence of underweight and overweight
pregnant and lactating women, adolescents and
elderly
10. Prevalence of deficiencies in Vitamin A,
iron and iodine (if date are available)
11. Prevalence of infants with low birth weight
Who are the 12. Is the prevalence of underweight children Local Health Office,
malnourished? higher in boys? Or in girls? In what age and age Local Nutrition
group is it high? Office, DepEd
13. What is their age group/physiological
classification?, i.e., infants preschool, school
children, pregnant, lactating, elderly, adolescents
14. What type of households do they belong
to?
Where are the 15. Identify the specific areas (purok/sitio, Local Health Office,
malnourished? barangays, municipalities, cities) or type of Local Nutrition
ecologic zone (upland, inland, lowland, coastal, Office
rural or urban) that have the most number of
malnourished children, adolescents, elderly,
pregnant, and lactating women
16. Malnutrition clusters in certain areas can
be determined by preparing a spot map at
barangay level or mapping for municipality
Guidelines on local nutrition planning

Guide Question Data to be collected and suggested analysis Possible Source


What are the The LNC including the NAO should discuss the Local Nutrition
causes of causes that lead to malnutrition. They should Committee
malnutrition? arrive at a list of causes and agree on how these
factors interact with each other. These should be
validated with actual date by comparing with
higher level data or comparing across barangays.
a. Immediate – inadequate food Special studies
intake and diseases
b. Underlying – food insecurity, poor
care, inadequate health services
c. Basic – education, economic
condition
17. Morbidity cases according to illness Local Health Office
18. Morbidity rate for diarrhea, measles and
acute respiratory tract infections
19. Decreasing pattern of food production Local Health Office
20. Low wages Local Planning
Office
21. Increasing population, family size and Local Planning
growth rate; Analysis to include is high or low Office
compared to national requirement
22. Qualitative data (when available) Special studies,
a. Eating patterns Observations
b. Variety of diet
c. Caring practices for women and
children
23. Low literacy rate Local Planning
24. Female highest educational attainment Office, CBMNS
What have been 25. Check the nutrition programs Local Health Office,
done to address implemented in the community and the extent to Local Nutrition
malnutrition? How which programs have reached and improved the Office
effective have lives of the malnourished and nutritionally-at-risk
these been? 26. Successes can be determined by
looking into the accomplishment of targets based
on reports, reaching out to the truly needy
population, mobilizing community participation,
among others.
27. Depending on the results of the review,
the LNC can decide whether to CONTINUE, STOP
or MODIFY the nutrition
programs/projects/activities.
What resources are 28. Resources in the LNAP can be in terms
available to of human, e.g., volunteer workers and technical
address experts material/equipment or physical, e.g.,
malnutrition? food commodities and health center financial,
eg., funding or local budget natural, e.g., water,
fuel, and land
29. In assessing resources, be guided by:
a. What kinds of resources are
available?
b. How much resources are
available?
c. How adequate are the
resources?
What constraints 30. Constraints are factors that can affect National and local
could affect the the implementation of nutrition government
implementation of programs/projects/activities (socio-economic, agencies, NGOs
nutrition political, cultural, ecological/environmental) A and private entities
interventions? concern that should be looked into as a with past and
constraint is the possibility of natural disasters. present nutrition
31. Difficulties may also be along inadequate and nutrition-
funds, uncooperative community and lack of related programs
coordination among LNC members. and projects in the
LGU

The situational analysis should also involve the development of a problem tree (one for each
identified nutrition problem) that will show the linkage of the chain of factors that affect the
nutritional problem. The problem tree is a useful tool to understand how various factors affect
malnutrition.

In constructing a problem tree, the specific nutrition problem should be identified and agreed on
by the local nutrition committee. This can be followed by a brainstorming session on the possible
causes of the problem. These causes are then arranged and organized in to a tree.

As a rule, the topmost past of the tree contains the consequences of not attending to the chosen
nutritional problem. The layer under the box of the problem being considered is the immediate
cause of the problem. A series of whys can be answered to identify causes. For instance, “why are
children malnourished? Because food production is low. Why is food production low? Because
good seeds are inadequate”, etc.

In constructing the problem tree, the LNC may consider using the local dialect. This could allow a
better understanding and appreciation of the causality of the problem.

Figures 1 and 2 show sample problem trees. However, it is a modified problem tree and all
potential causes at the lower part of the tree are all listed in a box. Since this is a sample tree, the
LNC should review the causes in the list, and identify which ones are applicable in the LNC’s unique
situation. Those that are not applicable should be taken out of the list. Causes in addition to those
in the list may also be identified.
Guidelines on local nutrition planning

The results of the situational analysis should be used in prioritizing nutritional problems to be
addressed, areas and population groups to be targeted. It should also guide the selection and
design of nutrition interventions.

Figure 1. A sample modified problem tree

Increased
mortality/morbidity
Poor quality of life
Death Illnesses Poor Poor Low
resistance learners in functional Unemployment and
to infection school literacy underemployment

Underweight
children, <5 years
old

Inadequate food Poor health status/


intake Presence of illness

Food insecurity Inadequate care for Insufficient health services,


mothers and children unhealthy environment

-Inadequate food -Poor infant and young child -Limited health supplies
production feeding practices
-Congested area
-Limited money to buy -Limited knowledge on child
food LGUs may remove or add item/s
care and maternal care
depending on their specific
LGUs may remove or LGUs may remove or add situation
add item/s depending item/s depending on their
on their specific specific situation
situation
Guidelines on local nutrition planning

Figure 2. A sample modified problem tree for iodine deficiency among pregnant women

Slow socio-economic development


of community and country

High unemployment/
underemployment

Poor school
performance

Congenital hypothyroidism, Lower IQ,


Cretinism (stunted growth, mental
retardation, deaf-mutism, gait
disturbances, spasticity (tight or stiff
muscles and inability to control these Pregnancy wastage
Goiter muscles (miscarriage, stillbirth)

Iodine deficiency,
pregnant women

Low use of adequately-


iodized salt

Low supply of Low demand for


adequately-iodized salt adequately-iodized salt

 Producers not know  Consumers not aware of importance


how to iodize well of use of iodized salt
 Poor monitoring of  Consumers cannot distinguish
salt supply at point of adequately-iodized salt from non-
sales iodized salt
 Others (Specify)  High cost of iodized salt
 Others (specify)
Guidelines on local nutrition planning

Set the plan’s goals and outcome objectives

The next step is on setting the plan’s goal and outcome objectives.

The goal is a statement of what the LNC wants to achieve when the main problem is solved and the
consequences of the problem are lessened. An example of a goal is “Improved quality of life through
improved nutritional well-being”

The outcome objective(s) is a quantified statement of the desired change in the main problem
identified. In nutrition planning, improving the topmost box of the problem tree is selected as the
outcome objective.

The following matrix could be used for the purpose:

Indicator Baseline Targeted change


(specify year) Year 1 Year 2 Year 3
Prevalence of
underweight-for-age
children less than 5
years old
Prevalence of stunted
children less than 5
years old
Prevalence of wasted
children less than 5
years old
Prevalence of school
children with low BMI
Prevalence of
overweight school
children

In setting targets, the LNC can look at trend (percent decrease or increase) in the indicator in the past
three to five years and apply the trend in projecting the targeted prevalence. In some instances, the
trend in percentage decrease could be assumed to move faster as a result of the planned
interventions.
Guidelines on local nutrition planning

Select interventions and develop the workplan

Based on the situational analysis and the set goal and objectives, the LNC or LPCG should identify
what interventions will be implemented. Attachment 1 lists a range of interventions that can be
implemented to achieve certain objectives.

The LNC or LPCG could also prioritize the interventions using processes described in the nutrition
program management manual.

Program/ Obje Ba Target Loca Sector/ Sche Estimated


Project/ ctive sel Group Y1 Y2 Y3 tion Person- dule funding
Activity ine in- needed
No. No. No. charge

After the prioritization exercise, the LNC or LPCG should then develop the workplan for the selected
interventions using the matrix below.

Prepare the monitoring and evaluation plan

Monitoring is the regular follow-up of the implementation of planned activities. It also involves
documentation of activities vis-à-vis the LNAP. It is also the systematic and continuous process of
following and keeping track of indicators in order to ensure that the project is proceeding according
to plan and provide basis for modifying the plan as necessary.

On the other hand, evaluation is the systematic assessment of effectiveness and efficiency of the
project achievements based on the set objectives.

Monitoring and evaluation are important processes in the nutrition program management cycle.
These processes provide information that will help make informed decision on program design and
adjustments to increase the chances of achieving set objectives.

However, in most instances, monitoring and evaluation are forgotten in the planning stage. Thus, the
LNC or LPCG should ensure that the LNAP includes plans for monitoring and evaluation. The matrix
below can be used for the purpose.
Guidelines on local nutrition planning

Province/City/Municipality: _________________________________

Level Data Source How to collect Person-in- Frequency of


data (Method) charge data collection

The following table lists sample indicators that can be considered for the monitoring and evaluation
system.

Monitoring and evaluation indicators commonly used for C/MPANs

Situation/aspect Indicator Possible data source


to be monitored
Achievement of Percent change in the prevalence of Annual conduct of OPT and
objectives underweight children under 5 years school weighing results
old/6-10 years old
Percent change in the prevalence of Annual conduct of OPT and
stunted children under 5 years old/6-10 school weighing results
years old
Percent change in the prevalence of Annual conduct of OPT and
wasted children under 5 years old/6-10 school weighing results
years old
Accomplishment Percent of targets actually reached or Routine accomplishment
of output served for each impact program, e.g. % repots but based on records
of target children receiving 2 doses of maintained in the process of
vitamin A during the year implementation
Percent of nutritionally needy reached Routine accomplishment
by each program reports but based on records
maintained in the process of
implementation
Utilization of Percent of nutritionally needy reached Financial records
resources by each program
Percent of released funds use Financial records
Time difference between the availability Special studies, using
of resources and time when needed administrative records
Percent households with kitchen garden Special studies
or raising small animals or fish.
Achievement of Percent of infants exclusively breastfed
intermediary within the first six month of life
outcomes Percent of infants 6-8 months old given
complementary foods
Percent of children 6-23 months old
receiving complementary foods from at
least 4 food groups and at the
prescribed frequency complementary
foods
Percent of households with adequate
calorie and nutrient intake

Plan packaging

At this stage the write-up of the plan is prepared following the outline. The matrices form part of the
plan and are integrated in the appropriate section with the appropriate write-up that should provide
more information on the contents of the matrices.

Approval of the plan

The plan should be approved by LNC through a resolution that indicates such approval as well as a
commitment to translate the plan into action. All members of the LNC should sign the resolution as
an indication of ownership and commitment to operationalize the plan.

The plan can then be presented to the incoming local chief executive and the Sanggunian for the
approval as well.

Translating the LNAP into an Annual Investment Plan

To ensure that the LNAP is implemented, it should get the appropriate funding from the local
government. Along these lines, the Annual Investment Plan for Nutrition should be developed using
the form on the next page. Its entries should be based on the LNAP.
Guidelines on local nutrition planning

Annual Investment Program (AIP)


According to Program/Project/Activity by Performance Area

Province/City/Municipality: ______________________________________________
Performance Area: _____________________________________________________
AIP Program/ Lead Period of Expected Source Period of Implementation and Project Cost
Reference Project/ Agency Implementation Result of
Code Activity Starting Ending Funds Personnel MOOE Capital TOTAL
Date Date Services Outlay

Submission to the Local Planning and Development Office

The LNAP and AIP should be submitted to the LPDO for inclusion in the overall local development
plan, ELA, and AIP.

Setting the plan to action

The plan should then be implemented by the LGU departments or offices, national agencies or
entities concerned. It may be adjusted in response to the evolving situation.

The plan should also be used as a tool for advocacy in engaging partners in its implementation.

Attachment 1

List of interventions that can be implemented to achieve nutrition objectives

Program/project/activity Key decision points


Promotion of infant and young child 1. Who will be the peer counselors?
feeding 2. Are they ready to be peer counselors? If not, what
capacity building efforts will be undertaken?
3. Are there IYCF peer support groups? If none what
will be done to organize these groups? If there are
peer support groups, what should be done to help
them to be more effective?
4. What other activities will be done to promote
optimum infant and young child feeding practices in
the community? Health facility? Workplace? Public
places? Other places?
Nutrition education 1. What strategy or mix of strategies will be used?
Nutrition counseling during clinic visits and home
visits? Nutrition classes? Cooking demonstrations?
Special community campaigns? Localized mass media
campaigns? Other special events?

Consider that Nutrition Month, as celebrated every


year in July, should be used maximally for nutrition
education

2. What specific messages will be promoted?

Consider that these messages should be along the


Nutritional Guidelines for Filipinos, but adapted to the
specific needs of the targets. Consider too the need to
promote the consumption of iodized salt and fortified
food staples specifically iron-fortified rice, iron and
vitamin A fortified flour, vitamin A-fortified sugar and
cooking oil

What other complementary services will be provided,


e.g. home gardening-related, micronutrient
supplementation?
5. What will be complementary activities to ensure
the proper use of the supplements, e.g. close
monitoring and supervision, nutrition education?
Home, school and community food 1. What specific food items will be promoted?
production
Consider or give priority to green, leafy and yellow
vegetables and fruits; as well as small animals like
chicken especially those that can lay eggs

2. What technology of production will be promoted,


e.g. bio-intensive gardening (BIG), magic square
garden, etc.
3. Materials to be given and sources, e.g. seeds,
planting materials, planting tools, small animals, etc.
4. Mechanism for roll-back or expanding to other
beneficiaries
5. What will be complementary activities, e.g. training
on the gardening technology, supplementary feeding,
nutrition education, micronutrient supplementation,
etc?

Supplementary feeding 1. Type of food commodity used, indigenous ones or


prepared food formulations like the Nutripak or the
inclusion of milk
2. Center-based or wet feeding vs. home-based or dry
ration; if center-based, location of the center
3. Quantity of ration, preferably taking off from a
targeted percent of RENI for calories and protein for
supplementation
4. Mechanism for community mobilization and
participation, including parents
5. What will be complementary activities or services
for targets, e.g. marketing or procurement of food,
procurement of cooking pans and utensils and
storage/safe keeping of food supplies, preparation of
cycle menus, nutrition education, home food
production, livelihood assistance, etc.
Food for work 1. What food commodities will be used?? Just rice? Or
something more like cooking oil?
Livelihood assistance 1. What types of livelihood projects will be prioritized?
2. Will the assistance be in cash or in kind?
3. Will the assistance be given to individuals or to
organized groups?
4. What will be the level of assistance per beneficiary?
5. What payment scheme will be used?
6. What other complementary services will be
provided, e.g. skills training, nutrition education, food
assistance?
Guidelines on local nutrition planning

Attachment 2
Workshop Forms

Level Expected result Baseline (specify year)

Goal

General or
outcome objective

Nutrition problem/cause Internvention


Guidelines on local nutrition planning

Program/ Objective Target Location Sector/ Schedule Estimated Source Expected


Project/ 2015 2016 Person- fund reqt. of Result
2014
Activity in- Fund
charge

Intervention/ Output Baseline Target


Program/ objectives (2013)
Project/ 2014 2015 2016
Activity
Guidelines on local nutrition planning

ANNUAL INVESTMENT PLAN

AIP Program/ Lead Period of Expected Source Period of Implementation and Project
Reference Project/ Agency implementation Result of Cost
Code Activity Starting Ending Funds Personnel MOOE Capital TOTAL
Date Date Services Outlay

MONITORING AND EVALUATION PLAN

Objective/Indicator Data Source How to collect Person in-charge Frequency of


data (Method) data collection
General Objective

Specific/ Output
Objective 1

RE-ENTRY PLAN

Activity In-charge Schedule Budgetary Remarks


requirements
CENTRAL LUZON REGIONAL NUTRITION COMMITTEE
Resolution No. 1 Series of 2019

ADOPTING THE CENTRAL LUZON


REGIONAL PLAN OF ACTION FOR NUTRITION, 2019-2022

WHEREAS, the Philippine Plan of Action for Nutrition (PPAN), 2017-2022 is the country’s framework for
nutrition action;

WHEREAS, the PPAN 2017-2022 contributes to the attainment of the goals of the Philippine
Development Plan, the Sustainable Development Goals, and ultimately Ambisyon Natin.

WHEREAS, one of the strategies to fully operationalize the PPAN 2017-2022 is the formulation of a
Regional Plan of Action for Nutrition (RPAN);

WHEREAS, the Central Luzon RPAN contains key elements expected to contribute to the attainment of
the PPAN 2017-2022 national goals and targets;

WHEREAS, the levels of undernutrition in the region have been continuously high throughout the years,
and based on the Updating of the Nutritional Status of Filipino Children and Other Population Groups
conducted by the Food and Nutrition Research Institute of the Department of Science and Technology
(FNRI-DOST) in 2015, the prevalence of underweight in Central Luzon is at 16.6%, stunting at 23.1% and
wasting at 7.5%. The Central Luzon RPAN 2019-2020 aims to address the key manifestations of
malnutrition such as undernutrition, overnutrition, micronutrient deficiencies and their causes following
the ASEAN Conceptual Validate Framework of Malnutrition;

WHEREAS, in full recognition of the nutritional problems and their dimensions during the planning
process, the Central Luzon RPAN, 2019-2022 identified a mix of interventions appropriate for the region
consisting of three distinct but complementing types of programs, such as nutrition-specific, nutrition-
sensitive and enabling management programs as defined in the PPAN program framework;

WHEREAS, the CL RPAN provides estimated budget requirements for each of the identified program and
projects cognizant to the actual GOP budget process. It also anticipates risks and threats by factoring
mitigating strategies and program adjustments, defines the institutional accountabilities to deliver
outputs and outcomes to include accountability for coordination with the rest of the RNC. It also lays
out the monitoring, reporting and evaluation mechanism necessary to determine progress of
implementation and extend of outcome targets achievement.
CENTRAL LUZON REGIONAL NUTRITION COMMITTEE
Resolution No. 1 Series of 2019

NOW THEREFORE, BE IT RESOLVED AS IT IS HEREBY RESOLVED, in consideration of the foregoing we,


the Central Luzon Regional Nutrition Committee do hereby approve and adopt the Central Luzon
Regional Plan of Action for Nutrition 2019-2022;

RESOLVED FURTHER, that we commit our departments or agencies or organizations to translate our
commitments into concrete activities and shall initiate efforts to implement these programs, projects
and activities within our respective agencies and include in our plans, budget for its implementation in
2019 and onwards.

RESOLVED FURTHER, for the National Nutrition Council Secretariat to coordinate and monitor the
actions leading to the implementation of this resolution and provide status report to the CL RNC
members during its quarterly meeting and to its NNC Central Office.

Approved this 9th day of January 2019.

Attested by:
CENTRAL LUZON REGIONAL NUTRITION COMMITTEE
Resolution No. 1 Series of 2019

CONFORME:
CENTRAL LUZON REGIONAL NUTRITION COMMITTEE
Resolution No. 2 Series of 2019

ADOPTING THE POLICY STATEMENT ON


NUTRITION PROGRAMS FOR GOVERNMENT WORKERS

WHEREAS, the NNC Governing Board in its meeting on 21 February 2017 considered the government
workers on its nutrition programs pursuant to the Philippine Plan of Action for Nutrition 2017-2022.
Improved nutritional status among government workers will contribute to the efficiency in the
bureaucracy;

WHEREAS, the recommendation of the Governing Board is supported by the findings of the 7th and 8th
National Nutrition Surveys of the Department of Science and Technology-Food and Nutrition Research
Institute (DOST-FNRI) which showed that working adults with occupation categorized as officials,
professionals, and clerks, had high prevalence of overweight and obesity, hypertension, high fasting
blood glucose and high cholesterol; and with low physical activity as compared to other occupational
groups;

WHEREAS, research has shown that promoting health in the workplace provides benefits both to the
employees and to the organization which include increased productivity and reduced absenteeism,
enhanced self-esteem and improved morale, lower healthcare cost and improved positive image of the
employer organization;

WHEREAS, a nutrition program for government workers is consistent with the objectives and strategies
of the Philippine Plan of Action for Nutrition 2017-2022 particularly the nutrition specific programs on
Nutrition Promotion for Behavior Change Program and Overweight and Obesity Prevention and
Management Program; along with other existing policies and programs including the Pilipinas Go 4
Health program, National Occupational Health and Safety Policy Framework, Civil Service Commission
(CSC) Memo Circular No. 4, Series 2003 (Promotion of Good Nutrition in the Bureaucracy), among
others.

NOW THEREFORE, BE IT RESOLVED AS IT IS HEREBY RESOLVED, and in consideration of the foregoing,


we the Central Luzon Regional Nutrition Committee adheres to the National Nutrition Council
Governing Board Resolution No. 4 Series 2018: Adopting the Policy Statement on Nutrition Programs for
Government Workers, as follows:

“The National Nutrition Council recommends the provision of nutrition programs


to government workers as part of healthy workplaces as a strategy of the
Philippine Plan of Action for Nutrition to improve the nutritional status of state
workers thereby contributing to the reduction in the prevalence of overweight
and obesity and non-communicable diseases.

The nutrition program shall be integrated in existing organizational wellness


programs to promote healthy lifestyle and employee welfare, The NNC shall work
with relevant government agencies to see to it that enabling policy instruments
and mechanism shall be in place to implement this recommendation.”
CENTRAL LUZON REGIONAL NUTRITION COMMITTEE
Resolution No. 2 Series of 2019

RESOLVED FURTHER, that

1. The Department of Health Central Luzon Center for Health Development, together
with the NNC Secretariat shall facilitate the convening of an Inter-Agency Technical
Working Group (TWG) composed of:

a. Civil Service Commission Regional Office (RO) III


b. Department of Agriculture Regional Field Unit III
c. Department of the Interior and Local Government RO III
d. Department of Labor and Employment RO III
e. Presidents of Central Luzon Nutrition Federations [Central Luzon Association of
Nutrition Action Officer (CLANAO), Association of Central Luzon District/City
Nutrition Program Coordinators (ACL DCNPCs), Central Luzon Association of
Barangay Nutrition Scholars, Inc. (CLABI) ] and local media group called Central
Luzon Advocates and Regional Nutrition Information Network (CLARINET)
f. Other relevant agencies and professional organizations such as, but not limited
to Nutritionist-Dietitians Association of the Philippines – Pampanga Chapter,
Philippine Medical Association – Pampanga Chapter, among others.

The TWG shall finalize the design of the nutrition program and develop appropriate
guidelines and cause the approval and integration of such within the bureaucracy.

2. As members of the Central Luzon Regional Nutrition Committee, we shall initiate and
observe the four components of the nutrition programs for government workers, such
as:

a. Nutrition promotion which includes actions that provides an enabling


environment for healthy preference learning, such as nutrition education
classes for employees; and regular assessment of nutritional status (waist and
hip circumference, Body Mass Index or BMI) to monitor weight increase or
reduction and risk to non-communicable diseases as basis for additional
interventions;

b. Healthy food and work environment, which include actions that provide a
healthy food and work environment and to enable healthy preferences such as
serving of healthy food and beverages in canteens, during on-site and off-site
meetings, seminars, events and other activities. Further, it will enable
employees have access to affordable and fresh farm produce such as
vegetables, fruits, dairy products and other items through collaboration with a
group of local farmers near the office; make safe drinking water freely
available in the workplace; establish and maintain food gardens as source of
fresh fruits and vegetables for employees;
CENTRAL LUZON REGIONAL NUTRITION COMMITTEE
Resolution No. 2 Series of 2019

c. Implement RA 10028 (Expanded Breastfeeding Promotion Act of 2009) to


promote and sustain breastfeeding practices among working mothers by
having breastfeeding or lactation stations;

d. Behavior modification strategies, which include actions to encourage healthy


behaviors to be sustained such as:

i. sustain physical activity among employees by integrating short 5


minute exercises within regular working hours for them to have a
minimum of 30 minute daily for 5 days of moderate intensity aerobic
activity to accumulate a minimum of 150 minutes of physical activity in
a week;

ii. encouraging brisk walking or running within the office or going to and
from the office. The office may provide inexpensive gadgets that have
pedometers to implement the “10,000 steps a day” initiative; and

iii. enforcement of CSC Memorandum Circular No. 17 series of 2009 and


Executive Order No. 26 series of 2017 implementing 100% Smoke-Free
Policy and Smoking Prohibition in all areas of government premises,
buildings, except for designated smoking areas; and

e. Food system interventions, which are the complementary efforts to improve


the food system as a whole.

RESOLVED FURTHER, that as members of the Central Luzon Regional Nutrition Committee, we
shall initiate efforts to implement the nutrition program within our respective agencies and
include in our plan, budget for its implementation in 2019 and onwards.

RESOLVED FURTHER, for the National Nutrition Council Secretariat to coordinate and monitor
the actions leading to the implementation of this resolution and provide status report to the
CL RNC members during its quarterly meeting and to its NNC Central Office.

Approved this 9th day of January 2009.

Attested by:

CONFORME:
CENTRAL LUZON REGIONAL NUTRITION COMMITTEE
Resolution No. 3 Series of 2019

ADOPTING THE POLICY STATEMENT ON FAD DIETS

WHEREAS, the NNC issues policy statements in aid of legislation or to clarify prevailing issues
in nutrition and define the stand of the NNC in addressing such issues;

WHEREAS, one issue that has been identified by the NNC is the proliferation of fad diets, also
known as a crash diet or diet cult, that claim to result to rapid weight loss cause concern as
these may pose health and nutrition concern among Filipinos;

WHEREAS, several studies have proven that fad diets are nutritionally-imbalanced, challenging
to comply with in the long-run, induce stress, cause disease to certain organs, lack focus on
physical activity, and may have psychological implications;

WHEREAS, studies have shown that following a short dietary regimen is medically unsuitable
and unsustainable with many dieters failing in their dietary adherence and long-term
behavioral change, and may pose potential health risks;

WHEREAS, the Central Luzon Regional Nutrition Committee desires to protect the general
public against fad diets and provide guidance to nutrition and health practitioners in dealing
with people adhering to fad diets;

NOW THEREFORE, BE IT RESOLVED AS IT IS HEREBY RESOLVED, and in consideration of the


foregoing, we the Central Luzon Regional Nutrition Committee adheres to the National
Nutrition Council Governing Board Resolution No. 4 Series 2018: Adopting the Policy
Statement on Fad Diets, as follows:

“Fad diets are not recommended for weight loss as it may pose potential health risk
and dangers. Instead, the NNC recommends the adherence to holistic, sustainable,
adequate, and nutritionally-balanced diet, complemented by an active lifestyle and
lifelong behavioral modifications. It is also the position of the NNC that individual
efforts to address overweight and obesity must complemented with population-
based interventions, particularly on the promotion of healthier food environments
and food systems and public awareness through behavior-change communications,
to prevent further increase in overweight and obesity prevalence in the country.”

RESOLVED FURTHER, that recommendations for a safe, healthy and holistic dietary, exercise,
and behavioral plan as key to long-term weight loss and improvement of overall health must
be advocated by nutritionist-dietitians ad other health professionals, both in private and public
practice in Central Luzon;

RESOLVED FURTHER, that to ensure that this policy statement is disseminated as widely as
possible to the general public, practitioners and health and nutrition workers and those in the
medical and allied professions in Central Luzon, the following commitments shall be adhered
to:
CENTRAL LUZON REGIONAL NUTRITION COMMITTEE
Resolution No. 3 Series of 2019

RESOLVED FURTHER, that to ensure that this policy statement is disseminated as widely as
possible to the general public, practitioners and health and nutrition workers and those in the
medical and allied professions in Central Luzon, the following commitments shall be adhered
to:

1. All members of the RNC shall:

a. post in its websites and social media a copy of the policy statement on fad
diets;

b. issue memorandum circular to all their staff and all other concerned on the
potential health risks that fad diets pose; and

c. provide venue for discussion of the policy statement among its staff during
general assembly or as part of the agency-wide health and nutrition promotion
program.

2. Department of Education shall issue a Regional Memorandum to all School Division


Superintendents and School Division Supervisors on the potential health risks that fad
diets pose;

3. Department of Health Central Luzon Center for Health Development shall:

a. issue a Regional Memorandum to all DOH retained hospitals,


Provincial/City/Municipal Development Management Officers and health
workers to warn the public and its clients on the potential health risk that fad
diets pose; and

b. design a weight-management program that is sustainable and utilizes


behavior-change approach/es to be shared among its staff and RNC member
agencies and those interested to adopt the said program.

4. Department of the Interior and Local Government shall issue a Memorandum Circular
to all provincial governors, city/municipal mayors, DILG provincial and city directors,
cluster heads, City Local Government Operations Officers (LGOOs), Municipal LGOOs
and all other concerned to disseminate the policy statement and warn the public on
the potential health risk that fad diets pose;

5. National Economic and Development Authority shall include in the agenda of the
Regional Development Council meeting discussion on the policy statement on fad
diets; and for the Sub-Committee on Social Development to issue similar resolution for
adoption of its members;
CENTRAL LUZON REGIONAL NUTRITION COMMITTEE
Resolution No. 1 Series of 2019

6. National Nutrition Council Region III, as CL RNC Secretariat shall:

a. disseminate the policy statement to the Central Luzon Association of Nutrition


Action Officers, Association of Central Luzon District/City Nutrition Program
Coordinators, Central Luzon Association of Barangay Nutrition Scholars and
Central Luzon Advocates and Regional Nutrition Information Network for
widest dissemination;

b. organize a speakers bureau, in partnership with the DOH Central Luzon Center
for Health Development, composed of nutritionist-dietitians and other health
professionals who will be tapped as speakers on topics such as health,
nutrition, fad diets and related-topics during fora organized by agencies,
private organizations, among others; and

c. lead the monitoring of the dissemination of the policy statement and provide
status report to the RNC members during its quarterly meeting and to its NNC
Central Office.

Approved this 9th day of January 2019.

Attested:

CONFORME:

You might also like