Introduction

• The Philippine Plan of Action for Nutrition (PPAN) 2017-2022 is an integral part of the
Philippine Development Plan 2017-2022
• It factors in and considers country commitments to the global community as embodied
in the 2030 Sustainable Development Goals, the 2025 Global Targets for Maternal,
Infant and Young Child Nutrition, the 2014 International Conference on Nutrition
• It consists of 12 programs and 46 projects serving as a framework for actions that could
be undertaken by member agencies of the National Nutrition Council(NNC)
o 8 are nutrition-specific, one is nutrition-sensitive and three are enabling support
programs

Nutrition problems to be addressed

• High levels of stunting and wasting among children under-five years of age, with levels
that have remained unchanged over the years (Figure 1). Also stunting is relatively low
among infants 0-11 months old, but is significantly higher among one year olds (Figure 2)

"Prevention Strategies need lo address both the immediate and underlying causes of stunting"

Stunting

• Stunting is the impaired growth and development that children experience from poor
nutrition, repeated infection, and inadequate psychosocial stimulation. Children are
defined as stunted if their height-for-age is more than two standard deviations below
the WHO Child Growth Standards median

Wasting

• Wasting is defined as low weight for height:

• Globally, wasting accounts for 476 of all deaths or children aged under 5 years
• Acute Malnutrition

Vitamin A Deficiency

• Vitamin A deficiency is the leading cause of preventable blindness in children and

increases the risk of disease and death from severe infections such as diarrhoeal disease
and measles.
• An estimated 250,000 to 500,000 children become blind every year
o Vison change
o Cornia dryness
o Skin changes

Anemia

• Anemia is defined as a hemoglobin level of less than the 5th percentile for age. Causes
vary by age. Most children with anemia are asymptomatic, and the condition is detected
on screening laboratory evaluation
• Iron deficiency commonly causes decreased RBC production. Risk factors include
prematurity, poor diet consumption of more than 24 oz of cow's milk per day, and
chronic blood loss
 Daily Iron Requirements for Infants and Young Children

Age Daily requirement Source

Up to 4 to 6 months (full term 0.27 mg Breast milk or iron-fortified
infants) formula
4 to 6 months to 1 year (full- 11 mg Breast milk or formula plus
term infants) iron-rich foods
1 month to 1 year (premature 2 to 4 mg per kg Iron-fortified preterm formula
or low-birth weight infants) iron supplementation (2 mg
per kg per day) plus belle milk
and iron rich foods
1 to 3 years 7 mg Iron rich foods

IDD

• Iodine Deficiency Disorders (IDD) are one of the biggest worldwide public health problem of
today. Their effect is hidden and profoundly affects the quality of human life.
• When iodine requirements are not met, the thyroid may no longer be able to synthesize
sufficient amounts of thyroid hormone.
o Lowering of IQ levels in school-aged children
o mental retardation
o Brain damage
• About 90% of iodine intake is obtained from food consumed and the remainder from water.
Iodine is available in traces in water, food and common salts.

FOOD INSECURITY

o Hunger and food insecurity with 68.3% of Filipino households not meeting their caloric
requirements. While this level is lower than that recorded in 1989 (74.1%) it is higher than
the level reported in 1998 (57%) and 2008 (67%).
o At the same time, overweight and obesity among various population groups should be
addressed, especially among adults
o Prevalence of Nutritionally At-Risk Pregnant Women by Age. Educational Attainment, Place
of Residence and Wealth Index

Challenges

o Poor infant and young child feeding in the first two years of life coupled with bouts of
infection can explain the high levels of stunting,
o Exclusive breastfeeding (EBF) in the first six months of life continues to be a challenge. EBF
increased from 48.9% in 2011 to 52.3% in 2013 but went back to 48.8% in 2015.
o However, a look at EBF rates by single age group within the 0-5 months old band would
show declining EBF with the lowest rate among the 5-month olds (Table 3)
o The low rate of EBF together with the rate of never breastfed represent sub optimal
breastfeeding practice. These low rates deprive the infant of needed nutrients for optimum
growth at the time when his or her growth is most rapid
o MYTH
o If you have small breasts, you won't produce enough milk for your baby
o TRUTH
o It doesn't matter! Breast tissue for nursing babies grows regard in
Causal framework of child and maternal under nutrition

1. Maternal and child undernutrition and death

a. Inadequate dietary intake
b. Household food in security
c. Disease
d. Inadequate care
e. Unhealthy household environment poor health services
2. Income poverty employment, self-employment. drawing assets. remittances, payments,
transfer etc.
a. Lack of capital Financial, human, physical, social, and natural
b. Social, economic, and political complex

Goal

o To improve the nutrition situation of the country as a contribution to:

o a. The achievement of Ambisyon 20402 by improving the quality of the human
resource base of the country
o b. Reducing inequality in human development outcomes
o c Reducing child and maternal mortality

Objectives

o PPAN 2017-2022 has two layers of outcome objectives, the outcome targets and the sub
outcome or intermediate targets. The former refers to final outcomes against which plan
success will be measured. The latter refers to outcomes that will contribute to the
achievement of the final outcomes.
o To reduce levels of child stunting and wasting

Strategic Thrusts

o Focus on the first 1000 days of life. The first 1000 days of life refer to the period of
pregnancy up to the first two years of the child. This is the period during which key health,
nutrition, early education and related services should be delivered to ensure the optimum
physical and mental development of the child. This is also the period during which poor
nutrition can have irreversible effects on the physical and mental development of the child,
consequences of which are felt way into adulthood.

Complementation of nutrition-specific and nutrition-sensitive programs

o This strategic thrust recognizes that malnutrition has immediate, underlying, and basic
causes, which should be addressed to achieve targeted nutritional outcomes. Thus,

Program

o Infant and young child feeding

o Integrated Management of Acute Malnutrition
o National Dietary Supplementation Program

Nutritional sensitive

1. Farm-to-market roads and child nutrition

2. Target Actions to Reduce Poverty and Generate Economic Transformation (TARGET) and
child nutrition
3. Coconut Rehabilitation Program
4. Gulayan sa Paaralan
5. Diskwento caravans in depressed areas