OPT PLUS Form 1A.

Barangay Tally and Summary Sheet of Preschoolers with Weight & Height Measurement by Age Group, Sex and Nutritional Status
Philippine Plan of Action for Nutrition
Page 1 of 3
Barangay: _____________________ Estimated Number of Preschoolers: 0-59 months old1/ ______ 0-71 months old2/ ______ CY20 ____ Total Population of Barangay: _______________ Source_________
City/Municipality: _______________ Actual Number of Preschoolers Weighed: 0-59 months old ______ 0-71 months old ______ Year/Period of Measurement: _________
Province: ______________________ Percent OPT Plus Coverage: 0-59 months old ______ 0-71 months old ______ CY20 _____ Prevalence Rate UW & SUW³´ _____________
Region: _______________________ Number of Indigenous PS measured: 0-59 months old ______ 0-71 months old ______ Prev Rate of UW & SUW: 0-59 mos. old_________ 0-71 mos. old _________
Indigenous group (specify if applicable): ___________________
Age Group Weight for Age Status Total, by age group
Normal (N) Underweight (UW) Severely Underweight (SUW) Overweight (OW) TOTAL N UW SUW OW
Boys Girls Boys Girls Boys Girls Boys Girls Boys Girls Total No Prev No Prev No Prev No Prev
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) (22) (23) (24) (25) (26) (27) (28)
0-5 months

(R1)
6-11
months
(R2)
12-23
months
(R3)
24-35
months
(R4)
36-47
months
(R5)
48-59
months
(R6)
60-71
months
(R7)
Total (R8)
0-59 mos.
0-71 mos.
Prev (R9)
0-59 mos.
0-71 mos.
Note: a) R1 means Row No.1, R2 means Row 2, etc. b) Total (R8) - refers to the sum of preschoolers by nutritional status and by age group c) Prev (R9)- refers to the prevalence rate by sex, by nutritional status for age group 0-59 monthsand 0-71 months
d) Prev (C22, 24, 26, 28)- refers to the prevalence rate by total by age group 1/ 0-59 months = 13.5% x Total Population 2/ 0-71 months = 16.2% x Total Population 3/ Refer to previous year prevalence rate of the area
Use WEIGHT-FOR-LENGTH or WEIGHT-FOR-HEIGHT to correctly determine overweight and obesity

Prepared by: ______________________________________________ Checked: _________________________________________________ Approved: _________________________________________________

Name and Signature of Barangay Nutrition Scholar Name and Signature of Midwife/Nurse/ Name and Signature of Barangay Captain,
District/City Nutrition Program Coordinator BNC Chairperson
Date: ________________ Date: ________________ Date: ________________
OPT PLUS Form 1A. Barangay Tally and Summary Sheet of Preschoolers with Weight & Height Measurement by Age Group, Sex and Nutritional Status
Philippine Plan of Action for Nutrition
Page 2 of 3
Barangay: _____________________ Estimated Number of Preschoolers: 0-59 months old1/ ______ 0-71 months old2/ ______ CY20 ____ Total Population of Barangay: _______________ Source_________
City/Municipality: _______________ Actual Number of Preschoolers Weighed: 0-59 months old ______ 0-71 months old ______ Year/Period of Measurement: _________
Province: ______________________ Percent OPT Plus Coverage: 0-59 months old ______ 0-71 months old ______ CY20 _____ Prevalence Rate UW & SUW³´ _____________
Region: _______________________ Number of Indigenous PS measured: 0-59 months old ______ 0-71 months old ______ Prev Rate St & SSt: 0-59 mos. old_________ 0-71 mos. old _________
Indigenous group (specify if applicable): ___________________
Age Group Length/Height for Age Status Total, by age group
Normal (N) Stunted/Short (St) Severely Stunted (SSt) Tall (T) TOTAL N St SSt T
Boys Girls Boys Girls Boys Girls Boys Girls Boys Girls Total No Prev No Prev No Prev No Prev
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) (22) (23) (24) (25) (26) (27) (28)
0-5 months

(R1)
6-11
months
(R2)
12-23
months
(R3)
24-35
months
(R4)
36-47
months
(R5)
48-59
months
(R6)
60-71
months
(R7)
Total (R8)
0-59 mos.
0-71 mos.
Prev (R9)
0-59 mos.
0-71 mos.
Note: a) R1 means Row No.1, R2 means Row 2, etc. b) Total (R8) - refers to the sum of preschoolers by nutritional status and by age group c) Prev (R9)- refers to the prevalence rate by sex, by nutritional status for age group 0-59 monthsand 0-71 months
d) Prev (C22, 24, 26, 28)- refers to the prevalence rate by total by age group 1/ 0-59 months = 13.5% x Total Population 2/ 0-71 months = 16.2% x Total Population 3/ Refer to previous year prevalence rate of the area

Prepared by: ______________________________________________ Checked: _________________________________________________ Approved: _________________________________________________

Name and Signature of Barangay Nutrition Scholar Name and Signature of Midwife/Nurse/ Name and Signature of Barangay Captain,
District/City Nutrition Program Coordinator BNC Chairperson
Date: ________________ Date: ________________ Date: ________________
OPT PLUS Form 1A. Barangay Tally and Summary Sheet of Preschoolers with Weight & Height Measurement by Age Group, Sex and Nutritional Status
Philippine Plan of Action for Nutrition
Page 3 of 3
Barangay: _____________________ Estimated Number of Preschoolers: 0-59 months old1/ ______ 0-71 months old2/ ______ CY20 ____ Total Population of Barangay: _______________ Source_________
City/Municipality: _______________ Actual Number of Preschoolers Weighed: 0-59 months old ______ 0-71 months old ______ Year/Period of Measurement: _________
Province: ______________________ Percent OPT Plus Coverage: 0-59 months old ______ 0-71 months old ______ CY20 _____ Prevalence Rate UW & SUW³´ _____________
Region: _______________________ Number of Indigenous PS measured: 0-59 months old ______ 0-71 months old ______ Prev Rate of UW & SUW: 0-59 mos. old_________ 0-71 mos. old _________
Indigenous group (specify if applicable): ___________________
Age Group Weight for Length/Height Status Total, by age group
Normal (N) Wasted (W) Severely Wasted (SW) Overweight (OW) Obese (Ob) TOTAL N W SW OW Ob
Boys Girls Boys Girls Boys Girls Boys Girls Boys Girls Boys Girls Total No Prev No Prev No Prev No Prev No Prev
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) (22) (23) (24) (25) (26) (27) (28) (29) (30) (31) (32) (33) (34)
0-5
months
(R1)
6-11
months
(R2)
12-23
months
(R3)
24-35
months
(R4)
36-47
months
(R5)
48-59
months
(R6)
60 months

(R7)
Total (R8)
0-59 mos.
0-60 mos.
Prev (R9)
0-59 mos.
0-60 mos.
Note: a) R1 means Row No.1, R2 means Row 2, etc. b) Total (R8) - refers to the sum of preschoolers by nutritional status and by age group c) Prev (R9)- refers to the prevalence rate by sex, by nutritional status for age group 0-59 monthsand 0-71 months
d) Prev (C22, 24, 26, 28)- refers to the prevalence rate by total by age group 1/ 0-59 months = 13.5% x Total Population 2/ 0-60 months = _____% x Total Population 3/ Refers to previous year prevalence rate of the area
Use WEIGHT-FOR-LENGTH for 0-23 months old preschool children and WEIGHT-FOR-HEIGHT for 24-60 months old preschool children.
Use WEIGHT-FOR-LENGTH or WEIGHT-FOR-HEIGHT to correctly determine overweight and obesity

Prepared by: ______________________________________________ Checked: _________________________________________________ Approved: _________________________________________________

Name and Signature of Barangay Nutrition Scholar Name and Signature of Midwife/Nurse/ Name and Signature of Barangay Captain,
District/City Nutrition Program Coordinator BNC Chairperson
Date: ________________ Date: ________________ Date: ________________