The House committee on appropriations chaired by Rep. Karlo Nograles (1st District, Davao City) has approved a substitute bill seeking to strengthen the national and local health and nutrition programs for pregnant and lactating women, adolescent girls, infants and young children in the first 1,000 days.
The committee approved the unnumbered substitute bill titled “Kalusugan at Nutrisyon ng Mag-Nanay Act” after amending the measure’s appropriations provision.
Nograles said the amended section on appropriations provides that the amount necessary to carry out the provisions of the Act shall be charged against the current year’s appropriation of the Department of Health (DOH). Thereafter, such sums as may be necessary for the continued implementation of the Act shall be included in the annual General Appropriations Act.
Rep. Sandra Eriguel, M.D. (2nd District, La Union) sponsored the unnumbered substitute bill during the hearing in behalf of Rep. Angelina Tan (4th District, Quezon), chairperson of the committee on health. Eriguel is a vice chairperson of the health committee.
Eriguel said the bill generally aims to provide a policy environment conducive to nutrition improvement and the more comprehensive, sustainable and multi-sectoral approach to address health and malnutrition.
The bill seeks a refocusing of the intervention program on malnutrition to pregnant and lactating mothers, including adolescent girls, women of reproductive age and children from zero to two years old; provide specific nutrition services and interventions for target clientele; mandates the DOH to provide age-appropriate vaccines, oral health services, antihelminthic drug for deworming; assess the nutrition status and identification of nutritionally at risk adolescent girls; and amends the composition of the National Nutrition Council (NNC) governing board.
“Poor nutrition in the early teens results in stunting, wasting, low birth weight and micro-nutrient deficiency which create irreversible damages to children during the crucial days when their bodies and minds are developing. It is worthy to note that the extent of malnutrition among Filipino children and pregnant women in the country, based on the 2015 national survey is enough cause for alarm,” said the lady legislator.
The lawmaker who is also a medical doctor said that the Philippines is one of the 10 countries in the world with the most stunted children. Eriguel further said it is a fact that 95 Filipino children die every day due to malnutrition.
“The state of malnutrition among mothers and children has become an urgent public and social concern,” the congresswoman said.
The bill covers all Filipinos who are nutritionally at risk, giving priority to women of reproductive age, most especially adolescent girls, pregnant and lactating women, particularly teen-age mothers, and all Filipino children from birth to age 24 months.
Priority shall be given to those who reside in disaster-prone and geographically isolated and disadvantaged areas (GIDA) such as those areas that are isolated due to distance, inaccessibility to transportation, and weather conditions, unserved and underserved communities and other areas identified to have incidence of poverty, presence of vulnerable sector, communities in or recovering from situation of crisis or armed conflict and recognized as such by a government body.
The DOH and the NNC shall formulate a comprehensive and sustainable strategy to address the health, and nutrition problems in the country affecting pregnant and lactating women, adolescent girls, infants and young children.
The DOH and NNC shall develop this as a program to operationalize the Phippine Plan of Action for Nutrition (PPAN) which integrates short, medium and long term plans of the government in response to the global call to eradicate hunger and malnutrition.
The strategy shall be formulated in cooperation with other agencies, local government units (LGUs), the civil society and non-government organizations, private sector, relevant health professional organizations, within three months from the effectivity of the Act.
Among the health and nutrition services and interventions to be offered during the first 270 days of conception and pregnancy are: prenatal services at the barangay level of each LGU such as prenatal tracking and enrollment in prenatal care services, and provision of antihelminthic drugs deworming and assessment of risk for parasites; for women about to give birth and immediate postpartum period, the services include provision of respectful care at the time of admission at the facility, and monitoring of progress of labor and conditions of both the mother and the fetus, among others; and for postpartum and lactating women, the services include follow-up preventive care visits to health facilities where they gave birth, and home visits for women in difficult to reach communities, among others.
For the 180 days, health and nutrition services shall be provided at the facility and community levels during birth and newborn period and the first six months of infancy. Among the services are the provision of continuous support for mother and her infant for exclusive breastfeeding, including referral to trained health workers on lactation management and treatment of breast conditions; counselling household members on handwashing, environmental sanitation and hygiene; provision of appropriate and timely immunization services integrated with assessment of breastfeeding growth and development promotion and infant and young child feeding (IYCF) counselling; and provision of routine newborn care services such as eye prophylaxis and vitamin K, birth doses of Hepatitis B and BCG vaccines after completion of the first breastfeeding.
For the 550 days covering infants six months up to two years of age, health and nutrition services at the community level shall be provided, such as management of childhood illnesses, including moderate and severe acute malnutrition; provision of deworming tablets for children one to two years old; provision of oral health services, including application of fluoride varnish to prevent dental carries; and livelihood assistance for parents of families belonging to the poorest of the poor, among others.
Meanwhile, for health and nutrition services for adolescent girls, these shall include among others, referral to medical specialists for menstruation irregularities or abnormalities that contribute to anemia and blood loss; referral to higher-level facilities to manage moderate or severe acute malnutrition; promotion on the use of iodized salt and fortified foods; and provision of ready-to-use supplementary food (RUSF) or ready-to-use therapeutic food for nutritionally-at-risk adolescent girls.
Lastly, the bill amends Executive Order 234 by expanding the composition of the National Nutrition Council Governing Board to 17 from the present 13, and replacing the Secretary of Social Welfare and Development with the Secretary of Health as chairman of the board.
The bill substituted 16 bills and is authored by Tan, Eriguel and Reps. Emmeline Aglipay-Villar, Rogelio Espina, Angelina Tan, M.D., Anna Marie Villaraza-Suarez, Luis Villafuerte, Bellaflor Angara-Castillo, Teodoro Montoro, Teddy Brawner-Baguilat, Maximo Rodriguez, and Michelle Antonio.