SGD 1. What forms of malnutrition exist? 2 Undernutrition (underweight, stunting, wasting) among...

1

SGD

What forms of malnutrition exist?

2

Undernutrition (underweight, stunting, wasting) among preschool and school children

Overnutrition among preschool children

Anemia

How many are malnourished?

3

Preschool children

Weight-for-age Number

Underweight 6

Severely underweight 4

Overweight 7

Length for age

Severely stunted 3

Stunted 10

Weight-for-length/height

Severely wasted 3

Wasted 1

Obese 3

Who are the malnourished?

4

Preschool children School children

Where are the malnourished?

5

Malnutrition is present in all the puroks of the barangay

What are the causes of malnutrition?

6

Presence of infection (leading causes of illnesses among children are cough, fever, cold, and diarrhea)

Incomplete immunization Not wearing of slippers and under

wears/shorts Untidy playing ground for children Poor environmental sanitation Inadequate sanitary toilet


7

Limited budget for the construction of toilet facility

Limited participation among people towards “Clean and Green Project” of the barangay

Poor transportation infrastructure/facilities

Poor attitude of the people towards availing of health services


8

Limited time among mothers for their children Mother allot more time on vices like playing cards

and bingo. Low income Limited cooperation among targets toward

livelihood programs Absence of home backyard garden Limited participation of household towards program

on establishing vegetable gardens Large family size Non-practice of exclusive breastfeeding


9

Mixed feeding practice as early as one month

Early introduction of complementary foods Inadequate knowledge on what food to

give for complementary foods Buying cooked foods or preparing instant

noodles and canned goods. Poor attendance of mothers on mother’s

classes conducted.


10

Children prefer foods that are fried, e.g., chicken and hotdog, and dislike vegetables

Snack items are usually chips and softdrinks

Allocation of money to non-food items (buying toys among children instead of food item at school)

11

Prioritization of problem

ProblemCRITERIA

TOTAL RankM S E

Malnutrition (underweight, stunting, wasting) among preschool children

5 5 3 13 1st

Anemia 3 4 4 11 2nd

Overnutrition 2 3 3 8 3rd

Rating5 - very high4 - high3 - medium2 - low1 - very low

Legend:M - Magnitude of the problemS - Social concernE - Existing health programs/policies

DeathIllnesses

Poor resistance to

infection

Poor learners in

school

Low functional literacy

Unemployment &

underemployment

• Low food availability in the household • Limited food purchases• Low income• Large family size• Limited takers of family planning

method• Unemployment• declining food production• Low fish catch• Use of illegal fishing method• Water pollution• High cost of agricultural inputs• Pest occurrence• Soil acidity

• Inadequate care for mothers & children

• Poor feeding practices• Low breastfeeding

prevalence • Low prevalence of

exclusive breastfeeding • Early introduction of

bottle feeding• Limited knowledge and

skills on child rearing• Teenage

pregnancy/mothers

• Poor health knowledge among mothers

• Poor hygiene• Congested area• Poor environmental sanitation• Limited supply of potable

water • Burning of garbage (poor solid

waste management)• Unsanitary toilet facility• Limited health staff• Limited health supplies

Food Insecurity Insufficient health services, unhealthy

environment and poor personal hygiene

Inadequate care for mothers and

children

Inadequate food intake Poor health status/ Presence of Illness

Undernourished children, 0-5 years old

What have been done to address malnutrition?

13

Immunization, pre-natal services, growth monitoring, and micronutrient supplementation

Livelihood assistance Water testing Distribution of vegetable seeds Mother’s class Clean and Green Program Free toilets Iodized salt (monitoring)

How effeLivelihood assistance

families do not comply with the repayment scheme

How effective have these been?

14

Program/Project/Activity

Success Difficulty Recommendation

Continue Stop Modify (specify how)

Immunization Some families do not avail of these health services. Some reasons mentioned were laziness and far distance.

√ (satellite

HC)Pre-natal services √

(satellite HC)Growth monitoring

√(satellite HC)

Micronutrient supplementation

√ (satellite

HC)


15




Livelihood assistance

families do not comply with the repayment scheme

√


16




Water testing Regularly done

√

Distribution of vegetable seeds

Almost all families received seeds

very few established vegetable gardens

√

Mother’s class Conducted by the barangay municipality and other barangays

Attendance of mothers is generally poor

√(check

the time; gimmicks)


17




Clean and Green Program

Regularly done in the barangay

Only members of the BNC, Sangguniang Kabataan and some concerned citizens participate

√ (let the community manage their own garbage)


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Free toilets Available at the Municipal Health Office; free

Complain of the lack of budget for toilet construction.

√

Iodized salt (monitoring)

All sari-sari stores in the barangay sell iodized salt.

√

What resources are available to address malnutrition?

19

Presence of supportive barangay leaders

Budget allocation Presence of health center with routine

services Presence of NGOs

What constraints could affect the implementation of nutrition interventions?

20

Lack of support from the community (clean and green program, etc.

Beliefs (colostrum)

Distance

Prepare objective tree

22

Prioritization

ProblemCRITERIA

TOTAL RankU H E

Improved food insecurity 5 4 4 13 2nd

Enhanced/adequate care for mothers and children 5 5 4 14 1st

Sufficient health services, healthy environment and improved personal hygiene

4 4 4 12 3rd

Rating5 - very high4 - high3 - medium2 - low1 - very low

Legend:U - Urgency of the problem being addressed by the objectiveH - How strong the LNC thinks the problem should be solvedE - Existence of a solution for which resources are available

DeathIllnesses

Poor resistance to

infection

Poor learners in

school

Low functional literacy

Unemployment &

underemployment

• Low food availability in the household • Limited food purchases• Low income• Large family size• Limited takers of family planning

method• Unemployment• declining food production• Low fish catch• Use of illegal fishing method• Water pollution• High cost of agricultural inputs• Pest occurrence• Soil acidity

• Improved feeding practices

• Increased breastfeeding prevalence

• Increased prevalence of exclusive breastfeeding

• Managed early introduction of bottle feeding

• Increased knowledge and skills on child rearing

• Decreased teenage pregnancy/mothers

• Poor health knowledge among mothers

• Poor hygiene• Congested area• Poor environmental sanitation• Limited supply of potable

water • Burning of garbage (poor solid

waste management)• Unsanitary toilet facility• Limited health staff• Limited health supplies

Food InsecurityInsufficient health

services, unhealthy environment and poor

personal hygiene

Enhanced/Adequate care for mothers

and children

Inadequate food intake Improved health status

Reduced prevalence of undernutrition among 0-5

years old children

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Goals and Objectives

Goal Healthy children, healthy community in progressive Dalisay

General/Outcome

At the end of three years, the prevalence of undernutrition among 0-5 years old willdecrease from 27% to 20%

Problem/Cause InterventionsPoor child feeding practices Infant and young child feeding

(IYCF)Limited knowledge and skills on child rearing

Behavior change communication on child rearing (counseling)

Teenage pregnancy/mothers Nutrition advocacyPoor health knowledge among mothers

Behavior change communication on health

Identification of interventions for Barangay Dalisay

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Prioritization of Interventions for Barangay DalisayProblem: Underweight among 0-5 years old childrenMethod: Prioritization by Ranking

Interventions Relevance Feasible Cost-effectiveness Targeting Effectiven

ess Total Rank

Infant and young child feeding (IYCF) 5 4 5 1 5 20 1

Behavior change communication on child rearing (counseling) 4 3 1 4 3 15 2

Behavior change communication on family planning 2 2 3 2 2 11 4

Health and nutrition advocacy 3 1 2 5 3 14 3

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Rating5 - very high 4 - high3 – medium 2 – low 1 - very low

Formulation of Output Objectives and Targeting for Intervention in Barangay Dalisay

Program/ Project/Activity

Output Objectives Baseline Target

Year 1 Year 2 Year 3

Infant and young child feeding (IYCF)

To conduct 12 sessionson IYCF for (wouldbe) mothersyearly

120Mothers

150Mothers

180Mothers

BehaviorChangecommunicationon child rearing (counseling)

To counsel 27mothers of undernourished children onchild rearing andHouseholdmanagement ofundernutrition in three years

27 undernourished children

27Mothers

27Mothers

27mothers

Household management of undernutrition

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Target Location

Sector person-in-charge

Schedule

EstimatedFund. Req’t

Source of fund

Estimated resultYear

1Year 2

Year 3

Grp

No

Grp

No

Grp

No

Counseling of mothers on IYCF

Mothers

120

Mothers

150

Mothers

180

Dalisay

BNS/BHWs

Once a month

10,000 a year

Dalisay funds

All target mothers are counseled on IYCF

Prepared by : Dalisay Nutrition Committee

Goals and Objectives Type of Indicator Data Source How to collect data

PersonIn

charge

Frequency of

data collection

GoalHealthy children, healthy

community in progressive Malinao

Impact indicatorUnder-five

mortality rate RHU health statistics documentation MHO Monthly

General Outcome/ Outcome Objective

At the end of three years, the prevalence of underweight among 0-5 years old will decrease from 27% to 20%.

Outcome indicatorPrevalence ofunderweight BNS/MNAO

NutritionOffice

OPTRHMBNSMNAO

Quarterly

Specific / Output Objective 1To conduct 12 training

sessions on IYCF for (would be) mothers yearly

Output indicator12 trainingconducted per year Training/ Project

reportReporting /Documentation MNAO

EveryScheduledtraining

M & E indicators based on the causes of malnutritionPreparing an M and E Plan for the Barangay Dalisay

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Preparing an M and E Plan for the Barangay DalisayM & E indicators based on the causes of malnutrition

Intervention 1IYCF

Input indicator-Funds for

training-trained staff-materials for

training

Training/ Project report

ReportingDocumentation MNAO

EveryScheduled

training

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Thank you

Janice Palad Feliciano, RND, [email protected] Escolar UniversitySchool of Nutrition and Hospitality Management

SGD 1. What forms of malnutrition exist? 2 Undernutrition (underweight, stunting, wasting) among...

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