The Nutrition Program in the Municipality of Sto.

Tomas, Davao del Norte

Winning the CROWN Intro/Background The municipality of Sto. Tomas was created by virtue of Executive Order No. 352 signed on August 14, 1959 and is composed of 19 barangays. Its original name is Tibalog, once a forested area inhabited mainly by Aetas and now home to a culturally diverse melting pot of various indigenous people as well as Cebuanos, Ilonggos, Boholanos and Ilocanos. The word Tibal-og was derived from the body of water transversing the settlement towards the municipality of Kapalong. It is classified as first class municipality. Its total population is 84,024 and 16,891 households based on BNS survey results for the year 2002 and a land area of 32,041 hectares. The LGU is substantially dependent on agriculture. The records of the Department of Agriculture revealed that 14,225.74 hectares or 44.31% of the total land area is devoted to agricultural and inland fish production. The common illnesses afflicting the residents are either water-borne or air-borne. In 1994, bronchitis ranked topmost (1,303 cases) among the illnesses, followed by pneumonia (1,093), and finally diarrhea (1,002 cases). It was also noticed that the aforementioned diseases were likewise the top three affliction which hit infants in 1994 and 1995 (MHO). A yearly Operation Timbang (OPT) was conducted by the Rural Health Unit and Municipal Nutrition Office through its barangay health and nutrition workers. The activity involves the weighing of all children from 0 to 6 years old. Based on the 2002 baseline OPT result the total number of preschoolers is 12,641 and out of this, the mildly underweight preschoolers is 1,410, while the moderately and severe underweight preschoolers is 245. On the other hand, total number of school children weighed is 14,314. Of this total, 2,360 are mildly underweight while the moderately and severely underweight is 127. The top ten unmet minimum basic needs of the constituents of the municipality of Sto. Tomas based on the SRA-MBN June 13, 2000 are the following: No. of Households 4,968 4,552 3,934 3,498 3,153 2,683 2,096 2,084 1,774 1,584

1. Family income below threshold level 2. No access to potable water 3. Households no compost pit 4. Households no livestock raised 5. Households no backyard garden 6. 3-5 years old not in preschool 7. No access to sanitary toilets 8. Couples not practicing family planning 9. House not owned but rented or shared 10. No 18 years old and above employed

The abovementioned health, nutrition and environmental condition affected the overall socio economic impact of the municipality. Thus, the municipal governments vision is: To have an educated, health-conscious and empowered community enjoying a better quality of life in a peaceful and sound environment through economic

productivity, food sufficiency and access to basic services that will complement the progressive thrust of every community leader towards progress and excellence. In pursuit of this vision, the Sto. Tomas Municipal Nutrition Committee (MNC) through its municipal nutrition program, committed to improve the nutritional status of its constituents through promotion of nutrition in every home anchored on positive Filipino values of industry and resourcefulness. The LGU is Region XIs entry to the national competition for Consistent Regional Outstanding Winner on Nutrition (CROWN). The CROWN award is given to a municipality, city or province that has been adjudged by the interagency regional nutrition evaluation team as outstanding in the region in the implementation of its nutrition plan for three (3) consecutive years. Description of the Practice The Municipal Nutrition Program is being implemented to address the malnutrition problem that afflicts the vulnerable groups particularly preschool, school children, pregnant women and lactating mothers and other contributory factors that affects the health and nutrition condition of the community as whole. It focused on the implementation of the impact programs of the Philippine Plan of Action for Nutrition to wit: Home, School and Community Food Production, Micronutrient Supplementation, Nutrition Education, Food Assistance and Food Fortification. Generally, the program aims to reduce the prevalence rate of malnutrition among moderate and severe preschoolers and school children from 1.93% to 0.90% and from 3.97% to 1.0% respectively by the end of December 2002. Specifically, it aims to: provide food supplements to 245 moderate and severe preschoolers and 127 moderate and severe school children through LGU feeding program; provide micronutrient supplements like vitamin A to 9,000 (12-59 months old) preschool children and 2,300 nursing mothers; provide iron to 245 moderate and severe preschoolers and 2,000 pregnant mothers; provide assorted seeds to 1000 households with malnourished children; promotion on the use of iodized salt to all households; increase awareness on health and nutrition to 2,000 parents through Nutrition Education Classes; update knowledge, acceptance and practice of nutrition implementers through attendance in trainings, seminars, congress, conventions and regular consultative conferences; provide P300,000.00 for the honorarium of 25 Barangay Nutrition Scholars (BNS) at P1,000.00 per month for the reduction of malnourished cases in every barangay.

The Municipal Nutrition Committee (MNC) started the implementation of the program with the following activities, to wit:

The Nutrition Program in the Municipality of Sto. Tomas, Davao del Norte Winning the CROWN

pursued the construction of farm to market roads improved post harvest and public market facilities as well as the municipal nursery and livestock breeding centers to support agricultural productivity sustained the implementation of the Department of Agricultures Ginintuang Masaganang Ani Program on grains and crops that resulterd to increased production of farmers and the level of food supply in the municipality Implemented agri-based projects for nutritionally-at-risk families such as establishment of vegetable gardens in homes, schools and communities, distribution of small animals to families with severely and moderately underweight children; adoption of the Plant Now Pay Later scheme, and provision of loans to rice farmers procured medicine for the indigent members of the community provided water pumps and constructed artesian wells in the depressed barangays of New Katipunan, La Libertad, Bobongon and San Jose, and implemented the urban drainage system to ensure a sanitary environment in the community. Other Development Interventions Other projects/activities spearheaded by MNC to sustain nutrition improvement: Pangkalusugan and Nutrition Post in Barangays Pantaron and Casig-ang Supplemental feeding for severely and moderately underweight children in Barangay Poblacion, San Jose and Kinamon through the Share a Food Program sponsored by the Council of Women Barya Mo, Kalusugan Ko Project - the project is a resource generation activity of the MNC where containers like cans and boxes were distributed in offices, stores and other accessible sites where the general public voluntarily drop coins and small amounts of money. Search for the Modelong Magsasaka Project - a model farmer is chosen from among the families in the municipality. A cash prize and trophy is provided. This strategy served as incentive as well as a venue to promote household food security in the municipality. Provided funds for the purchase of food commodities for a two-month feeding of all moderately and severely underweight preschoolers under the Para sa Mga Bata na Kulang sa Timbang Processes/Responsible Persons/Entities The following are the processes implementation of Nutrition Program: and people/entities involved in the

The LCE appointed a Nutrition Action Officer (NAO). The NAO is the right hand person of the LCE for matters about nutrition and nutrition programs. The NAO ensures that the nutrition committee is functional and sustain its functionality by initiating the regular conduct of nutrition committee meeting and others for consultation and dialogues, lead the planning core group within the MNC in formulating the Nutrition Action Plan (NAP), ensures that the NAP is integrated in the local development plan , coordinate the implementation of nutrition interventions and initiate periodic inter-agency visits to barangays to assess the progress of implementation and provide technical assistance on managing nutrition programs to BNCs
3

The Nutrition Program in the Municipality of Sto. Tomas, Davao del Norte Winning the CROWN

organization of Municipal Nutrition Committee (MNC)

LCE

Nutrition Action Officer (NAO)

AgriCulture

Health

Social Welfare

DepEd

DILG

ABC Pres.

NGOs/ POs/PS

The MNC is an intersectoral committee chaired by Local Chief Executive (LCE) with members coming from GOs/GAs and POs/PS. Its task is to formulate, implement, coordinate, monitor and evaluate the local plan of action. The NGOs and POs/PS are active partners of the LGU who provide assistance in the implementation of the nutrition programs through feeding, in kind and cash. LCE mandates the MNC the formulation of the local plan of action LCE calls for regular meetings to keep tract of what is going on and presides over the meetings. Barangay and home visitations were conducted regularly especially to the nutritionally depressed areas. This is to conduct dialogue with the community and one way of knowing their needs and how else the community and government can work together. LGU generate more resources to fund the nutrition programs. If needed, appear before the Sanggunian to defend the budget for nutrition programs and projects. LCE is in constant touch with his NAO to know what is going on so he can exercise his executive power and responsibility. LCE is on touch base with NGOs and convince them to match the resources the LGU is investing in nutrition program

Helps and Hindrances The following are the factors that contributed to the success of nutrition program implementation in municipality: Strong Local Government Unit support led by its dynamic chief executive, Mayor Dario G. Romano in terms of financial and manpower support Collaborative efforts among allied groups such as the non-governmental organizations, community and private sectors Policy makers who feel that malnutrition can be solved faster if the approach is unified, well-coordinated and considered as an integral part of the development plan

The success of the implementation can not be obtained without experiencing the following obstacles that are contributory in achieving the goal of program:
The Nutrition Program in the Municipality of Sto. Tomas, Davao del Norte Winning the CROWN 4

Absence of Local Nutrition Action Plan Inadequate budget

Requirements towards Implementing the Practice The requirements for nutrition program implementation is varied. 1. Organization of Municipal Nutrition Committee (MNC) composed of key personalities and relevant sectors spearheaded by the Municipal Mayor as Chairman. The MNC facilitates the planning and management of the Local Nutrition Plan and requires strong leadership from the mayor, commitment of the members to coordinate the local plan for nutrition and a Nutrition Action Officer who can effectively coordinate the plan. The committee should plan and implement activities that would sustain coordination, cooperation and teamwork among its members. To sustain the functionality of the Municipal Nutrition Committee, the mayor as the Chairman of the committee should provide the necessary leadership in the management of nutrition program. The Municipal Nutrition Action Officer must give his/her full commitment and possess certain qualification and personal attributes to effectively coordinate the implementation of the Municipal Nutrition Action Plan and gain the support and cooperation of the members of the Municipal Nutrition Committee. 2. Budgetary Allocation. In order for the nutrition program to be functional, effective and sustainable the municipal government through the approval of the Sangguniang Bayan allotted a budget of P647,387.00 for CY 2000, P888,448.00 for CY 2001, P2,174,649.56.00 for CY 2002 and P2,213,757.24 for CY 2003. The NGOs/POs/PS on the other hand, budgeted P15,000.00 for CY 2000, P50,000.00 for CY 2001, P130,000.00 for CY 2002 and P8,535,000.00 for the program in CY 2003. For the government share, the total percent of funds actually expended for CY 2002 is 99.81% or P2,170,640.00, this can be a good indicator that the program is working well. Figure 1. LGU Budgetary Support for Nutrition Program

647,387 2,213,757.24 2,174,647.56 888,448

2000 2001 2002 2003

The Nutrition Program in the Municipality of Sto. Tomas, Davao del Norte Winning the CROWN

Figure 2. NGOs/POs/PS Budgetary Support for Nutrition Program

10,000,000 8,000,000 6,000,000 4,000,000 2,000,000 0

8,535,000

CY 2000 CY 2001 CY 2002 CY 2003

130,000

50,000
15,000

3. The passage of ordinances and resolutions by the policy makers helped strengthen the program. A total of 6 Resolutions and 1 Ordinance was passed in support to nutrition program particularly resolutions for the adoption of the Barangay Nutrition Action Plan (BNAP); promote rehabilitation of moderate and severe malnourished for the implementation of Share Program, increase barangay budget for BNS and ordinance in support to ASIN Law (RA 8172) on the usage and selling of iodized salt. 4. Conduct of training workshop prior to nutrition program implementation. It involves defining tasks and functions of various agency workers, providing local teams with skills in implementing their tasks and functions, and drawing up common guidelines for coordinated action. The mayor and the Sangguniang Bayan and the Municipal Nutrition Committee members should be oriented on the expansion of projects in another barangay. Parents of the beneficiaries of the feeding program need to be oriented about the specific activities of the project to win their support and eliminate too much expectations.

Conducted Nutrition Education among mothers of moderate malnourished children during supplementary feeding
The Nutrition Program in the Municipality of Sto. Tomas, Davao del Norte Winning the CROWN 6

5. Monitoring and Evaluation. This is to assess the impact of the implementation of the nutrition program at the local level. 6. Documentation of all the experiences over the years is also important for the development of future plans. Benefits/Impact The trend over the years show a very significant reduction in malnutrition among the Preschoolers and School Children as shown in figures 3 and 4. Figure 3. Comparative Nutritional Status of Moderate and Severe (MOSE) Malnourished Preschoolers for four consecutive years

150 100 50 0

123 5

103 0

104 0 66 0

2000

2001

2002

2003

MODERATE SEVERE

Figure 4. Comparative Nutritional Status of Moderate and Severe (MOSE) Malnourished School Children for four consecutive years
128 150 100 75 46 42

3
50 0 CY 2000 CY 2001

MODERATE CY 2002 CY 2003 SEVERE

The Nutrition Program in the Municipality of Sto. Tomas, Davao del Norte Winning the CROWN

Improved delivery of services wherein almost 100% of the households and target beneficiaries were catered. Nutrition is already institutionalized, each sector has already defined package of services as their way of support to the program. Among the basic services given were provision of seeds and seedlings, distribution of poultry, livestock and fingerlings, vitamin A, iron and iodine supplementation and a lot more.

Improved nutrition office in the municipal hall as well as in barangays, where the offices of the Municipal Nutrition Action Officer (MNAO) and Barangay Nutrition Scholar (BNS) are located. It manifested the municipal government support to the nutrition program. A consistent Green Banner Awardee for three consecutive years, the municipality was also awarded the Gawad Pangulo sa Kapaligiran Award, second place category in 2001 and 2002, and the Gawad Saka Award: National Outstanding Farmer.
Meeting the Challenges from Lessons Gained Much more can be done to further improve the nutritional status of the people of Sto. Tomas. The MNC believes that with unified action for nutrition and the untiring support of its dynamic leadership, the vision of a better quality of life through nutrition will soon be achieved. The formulation of appropriate, effective and efficient measures for food and nutrition improvement must therefore require knowledge of the nature, scope and extent of the problem regarding their underlying causes, the resources and the social, political and economic or financial circumstances of the locality. Thus, community-based nutrition programming and planning has long been considered a vital and effective component in the fight against malnutrition.

The Nutrition Program in the Municipality of Sto. Tomas, Davao del Norte Winning the CROWN