Title: An Assessment of the Implementation of Nutrition Education Program at the National and Local Levels
1An Assessment of the Implementation of Nutrition
Education Program at the National and Local
Levels
- Department of Food Science Nutrition
- College of Home Economics
- University of the Philippines
- Diliman, Quezon City
2Project Team
- Demetria C. Bongga, Ph.D.
- (Project Leader)
- Milagros P. Querubin, Ph.D.
- (Study Leader 1)
- Ma. Veritas F. Luna, Ph.D.
- (Study Leader 2)
- Carleneth P. Fernandez
- (Study Leader 3)
- Cecile Leah T. Bayaga, MSN
- (Study Leader 4)
3Objectives of the study
- Describe the key nutrition education programs in
terms of policy directive, support activities,
availability of resources
4Objectives of the study
- Characterize implementation of nutrition
education/activities in terms of
- Level of implementation
- Forms and usage
- Target group
- Messages
- Channels
- Key players or sources of messages
5Objectives of the study
- Describe the essential enabling mechanism for
support activities for the implementation of
nutrition education identified in objective 1.
6Objectives of the study
- Determine the strengths, weaknesses,
opportunities and challenges of nutrition
education activities/programs.
7METHODS
8Conceptual Framework
9Research Design
- Descriptive study and made use of
- qualitative research methodologies
- In-depth interviews
- Focus group discussions
- Records review and inventory checklist
10Schematic diagram of sampling design
11Pre-test Areas
- National Level
- National Nutrition Council
- Local Level
- Province Laguna
- Municipality Pagsanjan
- Barangay Lambak, Pagsanjan
12National Agencies Interviewed
- Department of Health (DOH)
- Food and Nutrition Research Institute (FNRI)
- Department of Social Work and Development (DSWD)
- Department of Education
- Nutrition Center of the Philippines (NCP)
13National Agencies Interviewed
- Nutrition Foundation of the Philippines (NFP)
- Helen-Keller International (HKI)
- Nestle Corporation
- CODHEND Schools (UP-Los Banos, Benguet State
University, Centro Escolar University)
14Provinces Included in the Study
15Content of questionnaire at the National level
- What are the existing nutrition education
activities/programs being implemented? - Were there department orders/memos/directives
issued by these agencies regarding the
implementation of these activities
16Content of questionnaire at the National level
- Who were involved in the planning for such
activities? - Was it a sole initiative of the agency or in
collaboration with other agencies?
17Content of questionnaire at the National level
- What were the sources of the funds to implement
the activities? - What are the available or existing materials
utilized by these agencies to implement such
activities?
18Content of questionnaire at the Local level
- What were the orders/memos/ directives that
emanated from the regional agencies regarding the
implementation of nutrition education activities? - What were your actions in response to the
orders/memos/directives? (it may be through
issuance of a memo, order or ordinances)
19Content of questionnaire at the Local level
- What are the existing nutrition education
activities/programs being implemented in your
region? (Province? Municipality/City? Community/
Barangay?) - Does the Region (municipality, community/barangay)
have the manpower to implement the activity? If
yes, who implement(s) the nutrition activities?
20Content of questionnaire at the Local level
- Does/Do the implementor(s) have the training to
implement the activity? If yes, what capability
building activities were undertaken to train
provincial or city nutrition officers in the
implementation of such activities? Who initiated
or funded the capability building activities?
21Content of questionnaire at the Local level
- What are the available or existing materials
utilized to implement such activities? - Are there facilities/venues available in your
region (or province, municipality,
community/barangay) for the implementation of the
NE activities?
22Content of questionnaire at the Local level
- What types of support were extended to you by the
municipal/city council (or Barangay Nutrition
Committee) for the implementation of such
activities? Please specify the type and nature of
support provided.
23Content of questionnaire at the Local level
- What was the involvement of other sectors (i.e.
schools, NGOs, business enterprise, civic groups,
church organizations, private citizens, etc.) in
the region (or province, municipality,
community/barangay) during the implementation of
the NE activities?
24Content of questionnaire at the Local level
- Who were the attendees/ participants in the NE
activities? - Who monitors and evaluate the implementation of
NE activities?
25Content of questionnaire at the Local level
- What do you think are the strengths of the
nutrition education activities/ programs in your
region (or province, municipality,
community/barangay)? - What do you think are the weaknesses of the NE
programs/ activities in your region (or province,
municipality, community/barangay)?
26Content of questionnaire at the Local level
- What were the challenges encountered in your
region (or province, municipality,
community/barangay) in the implementation of NE
programs/ activities? - How were these challenges addressed?
27Content of questionnaire at the Local level
- What opportunities are available for the
improvement of NE programs/ activities in your
region (or province, municipality,
community/barangay)?
28RESULTS
29National Level
30Types of Nutrition Education Activities
Implemented at the National Level
- Training of implementors and health workers
DOH, HKI - Nutrition counseling and mothers class
CODHEND, DOH - Development of IEC materials CODHEND, DOH,
DSWD, FNRI, HKI, NCP, NFP - Printing of IEC Materials - Nestle
- Distribution of IEC Materials HKI, DOH
31Nutrition Topics Imparted by National Agencies
- Basic nutrition e.g. proper nutrition for the
different life stages, foundations of good
nutrition, and meal planning - Advocacy on healthy lifestyle and nutrition month
theme - Food processing production
- Food safety sanitation
- Others e.g. Nutritional Guidelines
32Sources of Funds of National Agencies
- Own agency funds or National government
allocation - International funding institutions UNICEF, WHO,
USAID, JICA - Civic Organization e.g. Zonta Club of Manila,
Childrens Hour - Industry e.g. Nestle, San Miguel, Unilever,
Wyeth, Colgate-Palmolive
33Partners of National Agencies in Planning
Nutrition Education Activities
- Agency and its subunits e.g. DepEd,
DOH, DSWD, FNRI, NCP - Collaboration with other agencies e.g. DOH with
FNRI/HKI - Collaboration with sub-national units e.g. NCP
with LGUs
34Partners of National Agencies in Implementing
Nutrition Education Activities
- LGUs e.g. HKI, NCP, NFP
- Schools and school teachers e.g. DepEd
- Local Centers e.g. DSWD
- Divisions within agencies e.g. DOH, FNRI
- Other government or agency units e.g. DOH
35Basis of National Agencies for the Conduct of
Nutrition Education Activities
- DOH Has various banner programs and initiatives
such as - Garantisadong Pambata campaign based on DOH
Circular 33-C s2001 - Healthy Lifestyle Promotion through DOH order
- Food Fortification Campaign is intended to step
up implementation of the Asin Law enacted in 1995
and the Food Fortification Act of 2000 - Food safety program is anchored on the WHO
guideline on food safety and operationalizes the
9th message in the Nutritional Guidelines for
Filipinos
36Reasons of National Agencies for the Conduct of
Nutrition Education Activities
- FNRI by mandate it must disseminate nutrition
information and develop IEC materials - DSWD being a member of NNC governing board, it
assists in the communication of relevant
nutrition messages
37Basis of National Agencies for the Conduct of
Nutrition Education Activities
- DepEd intensifies nutrition health education
in public elementary schools through TCPA (based
on DECS Memorandum No. 211 series 1991) - NCP one of its major thrust is to develop IEC
materials on health nutrition
38Basis of National Agencies for the Conduct of
Nutrition Education Activities
- NFP based on the directives of the Board, one
of these is establishment of nutrition health
kiddie classes - HKI undertakes nutrition education activities
to enhance the implementation of DOH programs
39Basis of National Agencies for the Conduct of
Nutrition Education Activities
- Nestle doesnt implement nutrition education
activities its role is limited to provision of
funds for printing of materials - CODHEND part of its curriculum (nutrition
education and practicum)
40Local Level
41Types of Nutrition Education Initiatives
- Integration in existing programs in response to
national directives - Health agriculture, social services
- Elementary school curriculum
- Part of the implementation of selected MTPPAN
programs - Special projects of incumbent President
42Types of Nutrition Education Initiatives
- Special events
- Local Initiatives
- LGU special programs
- Stand-alone nutrition education activities
- Specific health and nutrition campaigns
- Advocacy Activities
- Orientation and training of support personnel
43Types of Nutrition Education Initiatives
- Other forms of nutrition education
- Broadcast media
- Development and distribution of IEC materials
44Characterization of Nutrition Education Activities
45Integration of Nutrition Education in Health
Services
46School-based nutrition education
47Integration of nutrition in agricultural programs
48Integration of nutrition education in social
services
49Part of MTPPAN Impact Programs
50Part of MTPPAN Impact Programs
51Part of MTPPAN Impact Programs
52Special Government Project
53Nutrition Month Celebration
54Nutrition Month Celebration
55Local Government Unit Initiatives
56Local Government Unit Initiatives
57Local Government Unit Initiatives
58Local Government Unit Initiatives
59Advocacy
60Orientation and training of support personnel
61Other Forms of Nutrition Education
62Summary
- Nutrition education activities in response to
directives of national agencies involved with the
MTPPAN. - Nutrition education initiatives of LGUs as part
of local health campaigns or part of a special
program of the LCE.
63- The provincial level provides the directions of
the nutrition education activities in terms of
form and focus, planning was done at the
municipal level but implementation was always at
the barangay level.
64- Provincial level personnel seldom go down to the
barangay to directly teach the primary target
groups (e.g. mothers, preschool children, school
children). - Interaction with primary groups only during
special events (e.g. specific health campaigns,
Nutrition Month Celebration)
65- Frequency of conduct of nutrition education
activities varies
e.g. Yearly - information dissemination
drive Quarterly or monthly nutrition counseling
during home visits Weekly group lectures to
clients of the health center
66- Nutrition education activities were always
intensified during the Nutrition Month celebration
67- Forms of nutrition education
- Provision of nutrition information during
- health campaigns
- Nutrition counseling during home visits
- Group lectures for mothers of
- undernourished children and other target
- groups
- Distribution of flyers
- Posting of signages
68- Channels used were interpersonal communication,
print and broadcast media
69- Nutrition education activities could be community
based, school based or health center based
70- Nutrition counseling during home visits done by
BNS and BHWs
Group lectures usually done by midwives or other
guest lecturers from municipal or provincial
offices
71- Target group of most nutrition education
activities was mainly mothers of undernourished
children - Other target groups
- whole family
- elderly
- school children
- preschool children
- General public
72- High profile nutrition education activities were
usually part of special events (i.e. Nutrition
Month, launching of new health and nutrition
programs)
73- Advocacy activities allowed them to get support
for nutrition programs (i.e. PNAO or MNAO
informing the LCEs about the result of annual OPT)
74Nutrition Education Messages
- Nutrition education messages or topics are often
related to, in support of or complement nutrition
activities or projects (i.e. OPT, micronutrient
supplementation, food production)
75Messages and Target Groups
76Mothers of undernourished children
- Wastong pagkain para sa undernourished na bata
- Dagdag pagkain para sa sa undernourished na bata
- Consumption of green leafy vegetables
- Addition of oil
77Mothers/Parents
- Messages related to nutritional care
- 3 basic food groups
- Importance of breastfeeding
- Micronutrient supplementation
- Significance of Vitamin A
- Importance of supplementary feeding
- Use of iodized salt
- Utilization of products with SPS
78Mothers/Parents
- Messages related to improving food availability
- Income generating projects
- Backyard gardening
- Livestock raising
- Messages related to promotion of health practices
- Family planning
- Ligtas buntis
- Dengue awareness
- Clean and green
- Immunization
79Elderly
- Different lifestyle diseases
- Nutrition for the elderly
- Information on diabetes and how it can be managed
80School children
- 3 basic food groups
- Nutritional Guidelines for Filipinos
- Use of SPS and Diamond Seal Product
- Use of iodized salt
- Proper food choices
- Vegetable gardening
- Importance of vitamins and minerals
- Basic nutrition as related to nutrition month
theme
81Preschool children
- 3 basic food groups
- Food pyramid
- Importance of vitamins and minerals
82Farmers
- Skills training farming/gardening
- Food production
- Nutritious fruits and vegetables
83Other primary target groups
- Highschool students
- - Basic nutrition concepts incorporated in the
school curriculum and as related to Nutrition
Month theme - College students
- - Importance of food
- - Proper food choices
- - Use of iodized salt
- - Use of SPS products
- Out-of-school youth
- - Basic nutrition
84Pregnant/Lactating Mothers
- Nutritional Guidelines for Filipinos
- 3 Basic Food groups
- Importance of breastfeeding
- Importance of colostrum
- Proper selection of low cost nutritious foods
85Would-be-couples
- Importance of breastfeeding
- Family planning
- Roles of couples in nurturing a healthy family
86Hospital personnel
- Fortified flour utilization
- Iodized salt and products with SPS utilization
- Milk Code implementation
- Baby friendly hospitals
87Salt producers
- How to iodize salt
- Health importance of iodized salt
88General Public
- Nutrition Month theme
- Waste segregation
- Proper garbage disposal
- Promotion of Garantisadong Pambata
- Promotion of iodized salt and SPS products
- Benefits of iodized salt utilization
89IEC Materials developed by National Agencies
found at the Local Levels
90FNRI IEC Materials
91FNRI IEC Materials
92NCP IEC Materials
93HKI IEC Materials
94HKI IEC Materials
95DOH IEC Materials
96DOH IEC Materials
97Enabling Mechanisms
98Enabling Mechanisms
- Manpower Support
- Capacity Building
- Physical Facilities
- Funding Support
- Political Commitment and Support
99Key Persons in the Implementation of NE Program
(Provincial Level)
100Key Persons in the Implementation of NE Program
(Municipal Level)
101Selection of Key Persons Implementing NE Programs
- Appointing or Selecting Authority
- Governor
- Mayor
- Head of Local Offices
- Basis of Selection
- Educational background Nutritionist
- Physician
- Nurse
- Work experience
- Choice of Local Chief Executive
102Roles of Key Persons Implementing NE Programs
(Provincial Level)
- Coordination of NE activities
- Advocates for NE activities
- Echoes and initiates training of local level
implementors - Orients local level implementors on national
programs that will be implemented at the
municipal and barangay levels - Serves as resource person of nutrition
information - Prepares syllabi for NE in mothers classes
103Roles of Key Persons (Provincial Level),Winner
v.s. Non-winner
104Roles of Key Persons Implementing NE Programs
(Municipal Level)
- Implementor - trainors, resource person,
counselors, lecturers - Plan NE activities
- Coordinate
- Monitor
- Evaluate
- Advocate
105Roles of Key Persons ( Municipal Level)Winner
v.s. Non-winner
106Roles of Support Personnel
107Capacity Building
108Trainings on Knowledge enhancement attended by
Key NE Implementors
109Trainings on Skill-building enhancement attended
by Key NE Implementors
110Facilities Available for NE Activities
- Venue government, private and commercial
establishments spaces - AV equipment OHP, LCD, Slide projector, sound
system, TV, VCD/DVD Player - Computer desktop, laptop
111Sources of Funding
- LGU allocation
- NGOs and Religious organizations
- International Funding Institutions
- Private Donors
- Civic organizations
- Industry and local businesses
- Local Clubs and Cooperatives
112Budget Allocation for NE Program Activities
- 10 to 23 of social development fund used for
nutrition program - Actual cost for NE activities not indicated in
action plans
113Political Support
114Types of Political Support
115Focus Group Discussions
116Nutrition Education Activities at Local Levels
- 1. Stand alone activities
- Mothers classes
- Pabasa
- Bench conferences
- One-on-one counseling during home visits
- Teacher-Child-Parent Approach
117Nutrition Education Activities at Local Levels
- 2. Integrated into existing programs
- - Center-based supplementary feeding programs
- - Pre-marriage counseling
- - GP campaigns
- - OPT or growth monitoring
- - Elementary school curriculum
- - Milk feeding programs
- - Parenting Effectiveness Service
118Nutrition Education Activities at Local Levels
- 3. Special events
- - Nutrition month celebration
- (nutrition quiz, essay writing, radio TV
guesting, - - Patak Day
119Common Messages Disseminated at Local levels
- Basic nutrition
- Eating a balanced diet
- Preparing nutritious but cheap dishes
- Importance of breastfeeding
- Why fortified foods
120Limitations to Successful Implementation of NE
Activities
- Lack of or no political support
- Lack of funds
- Lack of volunteers/ personnel
- Inadequate IEC materials
- Lack of food supplies and nutrient supplements
121Limitations to Successful Implementation of NE
Activities
- IEC materials not in the dialect
- Lack of interest among target clients
- People have no money to apply what is learned.
122Recommendations for Improving Implementation of
NE Activities
- Advocacy among political leaders or LGU
officials - Health and Nutrition program included in DILG
seminars for new local chief executives - Use of multi-media
- IEC available in the local dialect
- Make food available in the home through home
gardening
123Recommendations for Improving Implementation of
NE Activities
- Training on nutrition education delivery
- Adequate IEC materials
- Training guide for use of trainers and resource
persons - Additional trained manpower support
- More supplies (food, nutrient supplements)
- Restore home economics in Dep Ed curriculum.
124Key roles of NE Implementers
- Resource person / lecturer
- Advocate
- Monitor/supervisor
- Prepare IEC materials
- Give advice or counseling (during home/bgy
visits) - Organizing women for classes and other community
activities.
125KNOWLEDGE, ATTITUDES AND SKILLSFOR EFFECTIVE NE
IMPLEMENTATION
- Knowledge about (or mastery of)
- Basic nutrition
- Breastfeeding
- Proper feeding of young children
- Different DOH programs
- The (attributes) of target client
126KNOWLEDGE, ATTITUDES AND SKILLSFOR EFFECTIVE NE
IMPLEMENTATION
- Attitudes
- Patience
- Sense of humor
- Integrity
- Commitment
- Confidence to face large groups
- Friendly, approachable
- Sincerity
- Must give time
127KNOWLEDGE, ATTITUDES AND SKILLSFOR EFFECTIVE NE
IMPLEMENTATION
- Skills
- Communication skills
- Peoples skills
- Ability to convince or mobilize
128CONCLUSIONS
- Types of NE activities
- A number of NE activities or programs are
initiated at the national level (e.g. Pabasa,
PES, GP) - Selective implementation of some national NE
activities at local level - Many IEC materials developed at national
agencies - Copies of IEC materials developed have limited
availability at local level or for end users
129CONCLUSIONS
- Several messages emanating from national
agencies - Messages recalled at local level are limited
130CONCLUSIONS
- Presence of NE activities initiated at local
level - Most NE activities are integrated in existing
programs (health, school curriculum, agriculture,
PES)
131CONCLUSIONS
- Policy instruments
- Mandates or policies re- NE activities clear at
national level - National policy directives not clearly
articulated at local level - NE activities often not part of NAP at local
level
132CONCLUSIONS
- Enabling mechanisms
- Inadequate manpower capability to implement NE
activities at local level (both in number and
competence) esp. at bgy level) - Inadequate funding support for NE activities)
- Basic nutrition concepts the mainstay of NE
messages
133CONCLUSIONS
- Funding support for NE at local level are
considered inadequate - Other sources of logistical support at local
level (NGOs, IFIs, private or commercial
institutions, civic religious organizations,
etc) are available - Facilities, equipment and venue generally
available at local level
134CONCLUSIONS
- Political support or commitment for NE activities
(or nutrition in general) need strengthening at
local level - Definition of what constitutes nutrition
education activity not clear-cut at local level
135Thank You!