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1
SGD
What forms of malnutrition exist?
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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?
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Malnutrition is present in all the puroks of the barangay
What are the causes of malnutrition?
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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
What are the causes of malnutrition?
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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
What are the causes of malnutrition?
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
What are the causes of malnutrition?
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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.
What are the causes of malnutrition?
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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?
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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)
How effective have these been?
15
Program/Project/Activity
Success Difficulty Recommendation
Continue Stop Modify (specify how)
Livelihood assistance
families do not comply with the repayment scheme
√
How effective have these been?
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Program/Project/Activity
Success Difficulty Recommendation
Continue Stop Modify (specify how)
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)
How effective have these been?
17
Program/Project/Activity
Success Difficulty Recommendation
Continue Stop Modify (specify how)
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)
How effective have these been?
18
Program/Project/Activity
Success Difficulty Recommendation
Continue Stop Modify (specify how)
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?
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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?
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Lack of support from the community (clean and green program, etc.
Beliefs (colostrum)
Distance
Prepare objective tree
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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
28
n
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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Program/Project/Activity
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