MELLPI Pro Form Bgy 20 Feb 2019

WELCOME
LOCAL GOVERNMENT NUTRITION

MONITORING AND EVALUATION
MELLPI PRO FORM CM 1: CITY/ MUNICIPALITY NUTRITION MONITORING
City/Municipality Province
Date of Monitoring Period Covered
PERFORMANCE LEVEL REMARKS/

ELEMENTS DOCUMENT SOURCE RATING
1 2 3 4 5 EVIDENCE
1. VISION AND MISSION
1a Presence and A vision statement A vision statement A vision statement A vision statement A vision statement Local Nutrition
knowledge of vision for nutrition was for nutrition was for nutrition for nutrition for nutrition Action Plan
statement formulated but not formulated and program exists and program exists and program exists and
reflected in the reflected in the known by all stakeholders are stakeholders are
Local Nutrition Local Nutrition stakeholders aware of their aware of their and 1
Action Plan Action Plan contribution to the other stakeholders’
vision contribution to the
vision
1b Presence and A vision statement A vision statement A mission statement A mission statement A mission statement Local Nutrition
knowledge of mission for nutrition was for nutrition was for nutrition for nutrition for nutrition Action Plan
Local Nutrition Local Nutrition stakeholders aware of their aware of their and 3
mission contribution to the
mission
1 2 3 4 5 EVIDENCE
1c Presence of nutrition The ELA and/or AIP The ELA and/or AIP The ELA and/AIP The ELA and/AIP The ELA and/AIP Comprehensive
concerns in the includes includes includes includes for includes for Development Plan
Executive Legislative nutrition-specific nutrition-specific nutrition-specific nutrition-specific nutrition-specific
Agenda (ELA) and/or programs of one programs of two programs of programs and programs and Executive Legislative
Annual Investment office only offices only nutrition unit and operating expenses operating expenses Agenda
Plan (AIP) on nutrition-specific of nutrition unit of nutrition unit
nutrition programs of at and and Annual Investment 3
least two offices nutrition-specific nutrition-specific Plan
programs of at and
more than two nutrition-sensitive Approved Annual
offices programs of more Budget
than two offices

1 2 3 4 5 EVIDENCE
2. NUTRITION POLICIES AND LAWS
2a Adoption, The LGU is aware The LGU has a The LGU allocated The LNC monitors The LNC processes Resolutions
implementation and that a Local resolution, budget for the implementation result of monitoring Ordinances
monitoring of local Nutrition Action ordinance and/or implementation of of the Local and make Executive Order
nutrition plan Plan was agreement the Local Nutrition Nutrition Action adjustments based Approved Annual
formulated adopting the local Action Plan Plan and provides on the results Budget
nutrition plan feedback Local Nutrition
Action Plan
Quarterly
Accomplishment
Report
Minutes of meeting
2b Adoption, The LGU is aware The LGU has a The LGU has The LGU has The LGU has Resolutions
implementation and of the provisions of resolution, activity(ies) to activity(ies) to activity(ies) to Ordinances
monitoring of EO 51 ordinance, implement and implement and implement and Executive Order
national/ regional Executive Order monitor monitor monitor
nutrition and/or agreement compliance to the compliance to the compliance to the Approved Annual
Executive and/or a line local ordinance, local ordinance/ local ordinance, Budget
Order 51: National budget item in the resolution or resolution or resolution or
Code of Marketing Approved Annual Executive Order Executive Order Executive Order Local Nutrition
Breastmilk Budget on EO 51 or and maintains a list and provides Action Plan
Substitutes, related concern of masterlist of feedback and
Breastmilk facilities monitored penalties to
Supplements, and violators as
Other Related applicable
Products
2c Republic Act 10028: The LGU is aware The LGU has a The LGU has Budgeted activities The LGU has Resolutions
Expanded of the provisions of resolution, activity(ies) to are fully institutionalized Ordinances
Breastfeeding RA 10028 and/or ordinance, implement and implemented compliance to the Executive Order
Promotion Act of DILG MC 2011-54 Executive Order monitor pursuant to the law through Approved Annual
2009 and/or agreement compliance to the laws issuance of local Budget
and/or a line local ordinance/ implementation policy, budget Local Nutrition
DILG Memorandum budget item in the resolution allocation and Action Plan
Circular 2011-54 Approved Annual relevant facilities Accomplishment/
Implementation and Budget on RA documentation
Monitoring of the 10028 or related report
National concern Masterlist of
Breastfeeding Policy establishments/
offices with
lactation stations
2d Republic Act 8172: An The LGU is aware The LGU has a The LGU has The LGU allocates The LGU has Resolutions
Act for Salt Iodization of the provisions of resolution, activities to budget for sustained Ordinances
Nationwide (ASIN RA 8172 ordinance, promote year-round implementation of Executive Order
Law) Executive Order compliance with activities relevant activities Approved Annual
and/or agreement the law and regularly Budget
and/or a line item monitors the Local Nutrition
budget in the implementation Action Plan
Approved Annual including having Minutes of meeting
Budget which relevant discussions Accomplishment/
supports R.A. 8172 during C/MNC documentation
meetings and report
adjustments
2e Republic Act 8976: The LGU is aware The LGU has a The LGU has The LGU allocates The LGU has Resolutions
Philippine Food of the provisions of resolution, activities to budget for sustained Ordinances
Fortification Act RA 8976 ordinance, promote year-round implementation of Executive Order
Executive Order compliance with activities relevant activities Approved Annual
supports R.A. 8976 during C/MNC documentation
meetings and report
adjustments
2f Republic Act 11148 The LGU is aware The LGU has a The LGU has The LGU allocates The LGU has Resolutions
First 1000 Days Law of the provisions of resolution, activities to budget for sustained Ordinances
RA 11148 ordinance, promote year-round implementation of Executive Order
Executive Order compliance with activities relevant activities Approved Annual
supports R.A. during C/MNC documentation
11148 meetings and report
adjustments
2g DOH Administrative The LGU is aware The LGU has a The LGU has The LGU allocates The LGU has Resolutions
Orders: of provisions in resolution, activities to budget for sustained Ordinances
1. 2010-0010: either of the DOH ordinance, promote year-round implementation of Executive Order
Revised Policy on Administrative Executive Order compliance with activities relevant activities Approved Annual
Micronutrient Orders and/or agreement the law and regularly Budget
Supplementation and/or a line item monitors the Local Nutrition
2. 2008-029: budget in the implementation Action Plan
Implementing Health Approved Annual including having Minutes of meeting
Reforms for Rapid Budget which relevant discussions Accomplishment/
Reduction of supports either during C/MNC documentation
Maternal and DOH-AO 2010-0010 meetings and report
Neonatal Mortality or 2008-0029 adjustments
2h DepED Orders: The LGU is aware The LGU has a The LGU has The LGU allocates The LGU has Resolutions
1. 59-2 S. 2017 of provisions in resolution, activities to budget for sustained Ordinances
Weekly Folic Acid either of the DepED ordinance, promote year-round implementation of Executive Order
Supplementation for Issuances Executive Order compliance with activities relevant activities Approved Annual
Female Adolescents and/or agreement the law and regularly Budget
2. 39 S. 2017 and/or a line item monitors the Local Nutrition
Operational budget in the implementation Action Plan
Guidelines for Approved Annual including having Minutes of meeting
School-based Feeding Budget which relevant discussions DepED Reports
Program 3. 13 S. supports either of during C/MNC
2017 Policy and the issuances meetings and
Guidelines on Healthy adjustments
Food Choices in
Schools 4. 10-1 S.
2016 Policy
Guidelines for
Comprehensive
WASH in Schools
DepED Memo No.
223 S. 2016
Strengthening
Implementation of
Gulayan sa Paaralan
Project
2i NNC Governing The LGU is aware The LGU procured LGU uses height LGU uses verified LGU uses verified Resolutions
Board Resolutions of either NNC GB any type of height and length height and length height and length Ordinances
Nos. 1) 3 S.2012: Resolution No. 3 and length measuring tools of measuring tools of measuring tools of Executive Order
Approving the S.2018 or No. 3. measuring tools wooden/ wooden/ wooden/ Approved Annual
Guidelines on the S.2012 non-wood material non-wood material non-wood material Budget
Fabrication, as prescribed in the as prescribed in the as prescribed in the Local Nutrition
Verification, and guidelines guidelines and guidelines and Action Plan
Maintenance of available in at least available in all Minutes of meeting
Wooden Height 50% of the barangays Accomplishment/
Boards 2) 3 S.2018: barangays documentation
Approving the report
Guidelines on the
Selection of
Non-Wood Height
and Length
Measuring Tool
2j Salt Iodization The LGU is aware The LGU Relevant activities Relevant activities Sustained Resolutions
Advisory Board of the law and implements a are implemented at are implemented implementation of Ordinances
Resolution No.1 activities to one-time activity in least once a year year-round activities across Executive Order
series of 2018: implement the law support of the NSIP resulting to years with Approved Annual
Adopting the Strategic Plan increased increased Budget
Strategic Plan of the awareness of awareness and Local Nutrition
National Salt people actual use of Action Plan
Iodization Program iodized salt in Minutes of meeting
2018-2022 households and Accomplishment/
establishments documentation
report
2k NNC Governing The LGU is aware The LGU has a Nutrition Nutrition is in the The LGU monitors Resolutions
Board Resolution of the provisions on resolution, perspective is ELA, LDP and the implementation Ordinances
No.1 series of 2017: either NNC GB ordinance, evident in the ELA activities are of nutrition Executive Order
Approving and Resolution or DILG Executive Order and local budgeted activities funded by Approved Annual
Adopting the MC and/or agreement development plan responsive to the the LGU, through Budget
Philippine Plan of and/or a line and nutrition local nutrition regular C/MNC Local Nutrition
Action for Nutrition budget item in the activities are committee’s meetings, program Action Plan
2017-2022 Approved Annual funded through the assessment of the reviews with Minutes of meeting
Budget of agencies various offices situation activities Accomplishment/
DILG MC 2018-42 and nutrition office throughout the documentation
Adoption and which supports year by majority of report
Implementation of NNC GB res.1 s the members
PPAN 2017-2022 2017. And/or DILG
MC 2018-42
2l NNC Governing The LGU is not The LGU aware of The LGU has The updated LNAP The updated LNAP Resolutions
Board Resolution aware of the the provisions of formulated/ has been approved, has been approved, Ordinances
No.3 series of 2014: provisions in the the resolution updated their LNAP budgeted and being budgeted, Executive Order
Approving and resolution organized for the guided by the implemented implemented with a Approved Annual
Adopting the C/MNC provisions of the C/MNC review Budget
Guidelines on Local NNC Guidelines conducted Local Nutrition
Nutrition Planning Action Plan
Minutes of meeting
Accomplishment/
documentation
report
2m NNC Governing The LGU is aware The LGU has a The LGU has The LGU has The LGU has Resolutions
Board Resolution No. of the provisions of resolution, implemented implemented more implemented more Ordinances
6 series of 2012: the resolution ordinance, activities in support than 1 activity in than 2 activities in Executive Order
Adoption of the 2012 Executive Order of NNC GB res.6 s support of NNC GB support of NNC GB Approved Annual
Nutritional Guidelines and/or agreement 2012 res.6 s 2012 with res.6 s 2012 with Budget
for Filipinos in support to NNC multi-stakeholder multi-stakeholder Local Nutrition
GB res.6 s 2012 participation participation Action Plan
with a Minutes of meeting
corresponding plan Accomplishment/
for implementation documentation
report
2n NNC Governing The LGU is not The LGU provided The LGU conducts OPT Plus maintains The LGU maintains Resolutions
Board Resolution aware of provisions orientation to OPT Plus and uses a master list of an inventory of Ordinances
No.2 series of 2012: of NNC GB res.2 s nutrition workers weight and height children who are weight and height Executive Order
Approving the 2012. involved in OPT plus measuring wasted, stunted measuring Local Nutrition
Revised equipment and overweight and equipment and Action Plan
Implementing prescribed in the prevalence of allocates budget Approved Annual
Guidelines on OPT Plus various nutrition for maintenance Budget
Operation Timbang Implementing problems and and/or OPT Plus Report
Plus (OPT Plus) Guidelines utilizes data for replacement Masterlist of
planning and Beneficiaries
targeting of Inventory of
programs measuring
equipment
2o NNC Governing The LGU does not The LGU designated The LGU has issued Nutrition Cluster Nutrition Cluster Resolutions
Board Resolution No. have a resolution, the lead or focal a resolution has been formed has been formed Ordinances
2 series of 2009: ordinance, point for organizing the and NIEm Plan with clarified Executive Order
Adopting the Executive Order Nutrition-in- nutrition cluster in formulation relational link with Local Nutrition
National Policy on and/or agreement Emergencies the area or its initiated/completed the local DRRMC Action Plan
Nutrition on NNC GB res.2 s equivalent body during emergencies, NIEM Plan
Management in 2009. NIEm Plan Minutes of meeting
Emergencies and formulated and Accomplishment
Disasters clear fund source report/
documentation
report
1 2 3 4 5 EVIDENCE
3. GOVERNANCE AND ORGANIZATIONAL STRUCTURE
3a Presence of Local The LNC is The LNC is The LNC is The LNC is The LNC is Local Nutrition
Nutrition Committee organized but organized but does organized with the organized with the organized with full Action Plan
(LNC)* membership is not include all Local Chief Local Chief representation as Resolutions
limited to 3-4 member agencies Executive as Executive as stated in level 3 and Executive Order
agencies only of the NNC chairperson and is chairperson and is supported by a Organizational
Governing Board composed of LGU composed of LGU resolution Chart
(pursuant to PPAN counterparts of the counterparts of the indicating the
IG S.1981 and EO NNC Governing NNC Governing functions of each
234 S.1987) with Board member Board member member
LGU counterparts agencies agencies and
1. Office of the non-government
LCE organizations/
2. Health private sector/
3. Interior and people’s
Local Government organization
4. Agriculture
5. Social Welfare
and Development
6. Education
7. Planning and
Development
Budget
3b Functionality of the The LNC has met The LNC has met The LNC met at The LNC met at The LNC conducted Resolutions
Local Nutrition only once. twice for the year. least three times least three times quarterly meetings Ordinances
Committee and formulated and which included the Executive Order
LNAP is available funded the LNAP, following agenda: Local Nutrition
but no joint with updating on 1. OPT Plus results Action Plan
discussion on various nutrition 2. Local nutrition Approved Budget
progress and results projects during LNC planning and Minutes of meeting
of various meetings budgeting Functionality
programs 4. Resource checklist
generation PIR Documentation
5. Program report
Implementation
Review
3c Presence of Nutrition The LGU has There is a NAO The LGU has a The LGU has an The LGU has an Resolution
Office and Personnel designated a designate from one fulltime designate established established Executive Order
Nutrition Action of LGU offices, NAO working under separate nutrition nutrition office Local Nutrition
Officer (NAO) assisted by at least one of the LGU office with full time with full time NAO, Action Plan
without any staff to one staff offices with at least designate NAO, one more than one Organizational
provide assistance two support staff technical support technical staff and Chart
staff and one one support staff Approved Annual
support staff with with modest to full Budget
modest resource resource
complement for complement for
nutrition programs nutrition programs
3d Decision-making and The LNC is The LNC is The LNC meetings The LNC meetings LNC decisions are Minutes of meeting
Leadership of the convened only convened when are used to decide are used to decide made jointly by
Local Nutrition once for important important decisions on decisions and monitor members and LNC
Committee key program regarding the regarding planned progress on serves as clearing
decisions nutrition program activities with duly planned activities house for all
and other concerns signed with duly signed nutrition-related
on an adhoc basis documentation documentation matters including
emerging concerns

1 2 3 4 5 EVIDENCE
4. LOCAL NUTRITION COMMITTEE MANAGEMENT FUNCTIONS
4a Planning Local Nutrition LNAP exists in the LNAP is formulated LNAP is formulated A LNAP is Comprehensive
Action Plan is LGU and is by the members of by the members of formulated by the Development Plan
formulated but not formulated by the the LNC en banc the LNC en banc members of the Local Nutrition
signed nutrition action and updated at and updated once a LNC en banc and Action Plan
officer only least once within year updated twice a Minutes Meeting
the past three (3) year Accomplishment
years Report
Resolutions
Executive Order
4b LNC Mobilization Only 1-2 members Only 3-4 members All members of the All members of the All members of the Resolutions
of the LNC perform of the LNC LNC performs LNC performs LNC performs Executive Order
nutrition and performs nutrition nutrition and nutrition and nutrition and MOA with
nutrition-related and nutrition-related nutrition-related nutrition-related stakeholders
functions including nutrition-related functions and functions with functions with Documentation
attendance to LNC functions contributes support from the support from the report
activities resources to local peoples’ local peoples’ Minutes of the
activities organization who organization who Meeting
are non-LNC are non-LNC
members members and other
external partners
such as socio-civic
organizations,
international
organizations,
academic
institution
4c Advocacy for The LNC does not The LNC conducts The LNC regularly The LNC regularly The LNC regularly Local Nutrition
Nutrition Program conduct advocacy advocacy activities conducts advocacy conducts advocacy conducts advocacy Action Plan
and Nutrition activities for for nutrition and activities for activities for activities for Accomplishment
Workers nutrition and local local nutrition nutrition and local nutrition and local nutrition and local Report
nutrition workers workers to local nutrition workers nutrition workers nutrition workers Project/ Activity
decision makers to local decision to local and to local and Documentation
and legislators, but makers and national decision national decision Reports
on an ad hoc basis. legislators. makers and makers and
legislators./eij legislators and
external partners
4d Fund Source Not all LNAP The LNAP is funded The LNAP fund in The LNAP fund in The LNAP fund in Local Nutrition
activities are in the approved the approved the approved the approved Action Plan
funded annual LGU budget annual LGU budget annual LGU budget annual LGU budget Annual Investment
but limited to includes personnel includes personnel includes personnel Plan/ Approved
program budgets services, MOOE and services, MOOE and services, MOOE and Annual LGU Budget
program program with program with MOA with partners
additional support additional support Resolutions
in cash, kind or in cash, kind or
services from services from
community external partners
4e Interagency Progress of Monitoring and The LNC monitors The LNC monitors The LNC monitors Local Nutrition
Monitoring and implementation is evaluation of and evaluates the and evaluates the and evaluates the Action Plan
Evaluation only conducted at nutrition programs nutrition programs nutrition programs nutrition programs Monitoring/
midterm of the is conducted at least once a year at least once a year at least once a feedback report
PPAN period biannually and provides year, provides Documentation
feedback to the feedback and Report
city/ municipality or follows through the Minutes of Meeting
barangay recommendation in
monitored the succeeding
monitoring

1 2 3 4 5 EVIDENCE
5. NUTRITION INTERVENTION/ SERVICES
5a Infant and Young Child Feeding
Community-based health and nutrition support strengthening
1. Training on No nutrition Less than 70% of At least 70% of At least 85% of 100% of nutrition Local Nutrition
breastfeeding, counselor was nutrition workers nutrition workers nutrition workers workers trained on Action Plan
complementary trained on trained on trained on trained on breastfeeding, Accomplishment
feeding, relief breastfeeding, breastfeeding, breastfeeding, breastfeeding, complementary report
feeding, etc. complementary complementary complementary complementary feeding, relief Training report
feeding, relief feeding, relief feeding, relief feeding, relief feeding, etc. with Capacity map
feeding etc. feeding, etc. feeding, etc. feeding, etc. refresher as needed
2. Pool of trained Pool of trained Pool of trained Pool of trained Pool of trained Pool of trained Training report
mother -support nutrition counselor nutrition counselor nutrition counselor nutrition counselor nutrition counselor Capacity map
groups and established in less established in less established in at established in at established in all
counsellors for than 50% of than 70% of least 70% of least 85% of barangays and
lactating barangays barangays barangays barangays provided with
management, refresher course as
kangaroo mother necessary
care, growth
monitoring and
promotion,
complementary
feeding, early child
development and
acute malnutrition
for every barangay
established
Establishment of breastfeeding places in non-health establishments
3. Lactation stations The LGU does not The LGU has The LGU has The LGU has The LGU has (By ocular
established in have a lactation lactation stations in lactation station in lactation stations in lactation stations in inspection)
government facilities station in any of 1 or 2 of the the government several government any of the Documentation
such as major the areas government facility and public facilities and public government report
airports, sea ports, facilities places but not places, managed by facilities and public
public utility maintained personnel places, maintained,
passenger terminals, managed by
local government personnel and
offices and public accessible to the
places such as town public
plazas, public
markets, small shops
and multi-purpose
centers
Enforcement of Milk Code
4. 4th, 5th and 6th The LGU did not The LGU The LGU The LGU The LGU Resolution
class municipalities, establish a established a established and established and established and
independent monitoring and monitoring and implemented an implemented an implemented an Monitoring Report
chartered and reporting reporting integrated integrated integrated
component cities mechanisms of EO mechanisms of EO monitoring and monitoring and monitoring and
with established 51, RA 10028 and 51, RA 10028 and reporting reporting reporting
integrated other related other related mechanisms of EO mechanisms of EO mechanisms of EO
monitoring and issuances on IYCF issuances on IYCF 51, RA 10028 and 51, RA 10028 and 51, RA 10028 and
reporting other related other related other related
mechanisms of EO issuances on IYCF in issuances on IYCF in issuances on IYCF in
51, RA 10028 and 60% - 79% of the 80% - 99% of the 100% of the
other related barangays barangays barangays
issuances on IYCF in
every barangay
council for the
protection of
children
5b Philippine Integrated Management of Acute Malnutrition
Provision of services for SAM
5. Support to families The LGU provides The LGU provides The LGU provides The LGU provides The LGU provides Accomplishment/
with severely acute one-time support in intermittent periodic support in periodic support in periodic support in Documentation
malnourished cash or kind to support in cash or cash or kind to cash or kind for cash or kind for reports
children accessing families with kind to families families with medical needs of medical and other Masterlist of
Inpatient Therapeutic severely acute with severely acute severely acute severely acute needs of severely children with SAM
Care (ITC) and malnourished malnourished malnourished malnourished acute malnourished
Outpatient children accessing children accessing children accessing children accessing children accessing
Therapeutic Care ITC or OTC in any ITC or OTC in any ITC or OTC in any ITC or OTC in any ITC or OTC in any
(OTC) in hospitals and of the facilities of the facilities of the facilities of the facilities of the facilities
field health facilities
Building capacity of local implementers
6. Hospital and field The LGU have only The LGU have only The LGU have more The LGU have at The LGU have at Capacity map
health and nutrition one or hospital two hospital and/or than two hospital least 10% buffer of least 10% buffer of Training report
staff trained on the and/or field health field health and and field health and commodities and commodities and Documentation
appropriate and nutrition staff nutrition staff nutrition staff supplies and supplies and report
competencies to trained on the trained on the trained on the hospital and more hospital and more
identify, treat and management of management of management of than two field than two field
manage all forms of malnutrition and malnutrition and malnutrition and health and nutrition health and nutrition
malnutrition and delivery of nutrition delivery of nutrition delivery of nutrition staff trained on the staff including a
deliver quality services under services under services under management of physician trained
services both under routine health routine health routine health malnutrition and on the
routine health program and during program and during program and during delivery of nutrition management of
program and during emergencies emergencies emergencies services under malnutrition and
emergencies routine health delivery of nutrition
program and during services under
emergencies routine health
program and during
emergencies
7. Functional The LGU maintains The LGU has a The LGU has a The LGU has a The LGU has a Masterlist of
two-way referral a master list of two-way referral functional two-way functional two-way functional two-way children with SAM
system adopted children with system but caters referral system and referral system in referral system in Referral forms
severe acute to less than 50% of caters to at least at least 80% of more than 80% of
malnutrition but barangays with 50% of barangays barangays with barangays with
does not have a severe acute with severe acute severe acute severe acute
two-way referral malnutrition cases malnutrition cases malnutrition cases malnutrition cases
system
5c National Dietary Supplementation Program
Dietary supplementation of pregnant and lactating women
8. Nutritionally-at- The LGU does not The LGU has a The LGU has a The LGU has a The LGU has a NDSP Reports
risk pregnant women have a dietary dietary dietary dietary dietary
enrolled/ covered in supplementation supplementation supplementation supplementation supplementation
the dietary program for program for program for program for program for
supplementation pregnant and pregnant and pregnant and pregnant and pregnant and
program lactating women lactating women lactating women lactating women lactating women
but covers less than and covers at least and covers at least and covers more
80% of the target 80% of the target 80% of the target than 80% of the
for 90 days for 90 days target for 90 days
9. Health and The LGU provided The LGU provided The LGU provided The LGU provided The LGU provided Local Nutrition Action Plan
nutrition workers training on the training on the training on the training on the training on the Training report
capacitated on the management of management of management of management of management of Capacity map
management of dietary dietary dietary dietary dietary
dietary supplementation of supplementation of supplementation of supplementation of supplementation of
supplementation of pregnant women to pregnant women to pregnant women to pregnant women to pregnant women to
pregnant women less than 50% of less than 50% of at least 80% of at least 80% of more than 80% of
target health and target health and target health and target health and target health and
nutrition workers nutrition workers nutrition workers nutrition workers nutrition workers
but less than 80% and at least 80% and more than 80%
completed the completed the completed the
training training training
Dietary supplementation of infants and young children 6-23 months
10. Infants and young The LGU has a The LGU has a The LGU has a The LGU has a The LGU has a Local Nutrition
children 6-23 months dietary dietary dietary dietary dietary Action Plan
old enrolled in the supplementation supplementation supplementation supplementation supplementation Accomplishment/
dietary program for infants program for infants program for infants program for infants program for infants documentation
supplementation and young children and young children and young children and young children and young children report
program regardless 6-23 months old 6-23 months old 6-23 months old 6-23 months old 6-23 months old Masterlist of
of nutritional status but covers less than but covers less than and covers at least and covers at least and covers more children 6-23
50% of the target 80% of the target 80% of the target 80% of the target than 80% of the months
for less than 132 for 132 days target for 132 days
days
11. Health and The LGU provided The LGU provided The LGU provided The LGU provided The LGU provided Local Nutrition
nutrition workers training on the training on the training on the training on the training on the Action Plan
capacitated on the management of management of management of management of management of Training report
management of dietary dietary dietary dietary dietary Capacity map
dietary supplementation of supplementation of supplementation of supplementation of supplementation of
supplementation of infants and young infants and young infants and young infants and young infants and young
infants and young children 6-23 children 6-23 children 6-23 children 6-23 children 6-23
children 6-23 months months old to less months old to less months old to at months old to at months old to more
old including linkages than 80% of target than 80% of target least 80% of target least 80% of target than 80% of target
with services of other health and nutrition health and nutrition health and nutrition health and nutrition health and nutrition
programs e.g. workers workers workers but less workers and at workers and more
promotion of infant than 80% least 80% than 80%
and young child completed the completed the completed the
feeding, training training training
micronutrient
supplementation
Dietary supplementation of children in child development centers and supervised neighborhood play
12. Children in child The LGU is aware The LGU is aware The LGU provides The LGU provides The LGU provides Supplementary
development centers of the dietary of the dietary assistance in cash, assistance for the assistance for the feeding program
and supervised supplementation supplementation kind or services for dietary dietary report
neighborhood play program for program for the dietary supplementation supplementation Documentation
provided with dietary children in child children in child supplementation program for program for report
supplementation development development program for children in child children in child Minutes of LNC
centers and centers and children in child development development meeting
supervised supervised development centers and centers and Local Nutrition
neighborhood play neighborhood play centers and supervised supervised Action Plan
but does not and assists in supervised neighborhood play neighborhood play,
provide any form of disseminating neighborhood play and utilizes data in utilizes data in
assistance information about formulating program
the program programs for formulation and
preschool children monitors progress
of implementation
during Local
Nutrition
Committee meetings
Dietary supplementation of wasted school children
13. Support to the The LGU is aware The LGU is aware The LGU provides The LGU provides The LGU provides School-based
School-based Feeding of the of the support in cash, support to the support to the feeding program
Program (SBFP) School-based School-based kind or services to School-based School-based report
targeting children Feeding Program Feeding Program the School-based Feeding Program Feeding Program Documentation
from Kinder to Grade (SBFP) targeting (SBFP) targeting Feeding Program (SBFP) and utilizes (SBFP), utilizes data report
VI who are wasted children from children from (SBFP) data for for programs Minutes of LNC
Kinder to Grade VI Kinder to Grade VI formulation of formulation and meeting
who are wasted but who are wasted programs for monitors progress Local Nutrition
does not provide and provides school age children of program during Action Plan
any support assistance in Local Nutrition
disseminating Committee
information about meetings
the program
5d National Nutrition Promotion Program for Behavior Change*
5e Micronutrient Supplementation
14. Pregnant women Pregnant women Pregnant women Pregnant women Pregnant women Pregnant women FHSIS Report
provided with were provided with were provided with were provided with were provided with were provided with Master list of
iron-folic acid iron-folic acid iron-folic acid iron-folic acid iron-folic acid iron-folic acid pregnant women
covering less than covering less than covering at least covering more than covering more than receiving iron-folic
50% of the target 80% of the target 80% of the 80% of the target 90% of the target acid
target
15. Pregnant and Pregnant and Pregnant and Pregnant and Pregnant and Pregnant and FHSIS Report
lactating women in lactating women in lactating women in lactating women in lactating women in lactating women in Master list of
areas endemic to areas endemic to areas endemic to areas endemic to areas endemic to areas endemic to pregnant and
iodine deficiency iodine deficiency iodine deficiency iodine deficiency iodine deficiency iodine deficiency lactating women
provided with iodized were provided with were provided with were provided with were provided with were provided with receiving iodized oil
oil capsules* iodized oil capsules iodized oil capsules iodized oil capsules iodized oil capsules iodized oil capsules capsules
but covers less than but covers less than but covers at least and covers more and covers more
50% of the target 80% of the target than 80% of the than 80% of the than 90% of the
target target target
16. Vitamin A Vitamin A capsules Vitamin A capsules Vitamin A capsules Vitamin A capsules Vitamin A capsules FHSIS Report
capsules provided to were provided to were provided to were provided to were provided to were provided to Master list of
children 6 mos -5 children 6 mos -5 children 6 mos -5 children 6 mos -5 children 6 mos -5 children 6 mos -5 children 6 mos. to 5
years old years old but years old but years old twice in years old twice in years old twice in years receiving
averaging less than average coverage is the previous year the previous year the previous year vitamin A
60% for the two at least 60% of the and covers at least and covers 91% to and covers 100% of
supplementation target for the 90% of the target 99% of the target the target
periods supplementation
period
17. Micronutrient Micronutrient Micronutrient Micronutrient Micronutrient Micronutrient FHSIS Report

powder provided to powder provided to powder provided to powder provided to powder provided to powder provided to Master list of
young children 6-23 young children 6-23 young children 6-23 young children 6-23 young children 6-23 young children 6-23 children 6-23
months old months old but months old but months old and months old and months old and months receiving
covers less than covers less than covers at least 80% covers more than covers at more MNP
50% of the target 80% of the target of the target 80% of the target than 80% of the
with at least 80% target with more
compliance than 80%
compliance
18. Weekly provision Iron-folic acid Iron-folic acid Iron-folic acid Iron-folic acid Iron-folic acid School-based
of iron-folic acid tablets provided to tablets provided tablets provided tablets provided tablets provided Weekly Iron Folic
tablets to adolescent less than 80% weekly to less than weekly to 100% of weekly to 100% of weekly to 100% of Acid
female learners in adolescent female 100% of adolescent adolescent female adolescent female adolescent female Supplementation
public schools learners in public female learners in learners in public learners in public learners in public Report
through Weekly Iron schools public schools schools for two schools for two schools for two LNC minutes of
Folic Acid (WIFA) cycles cycles and cycles, information meeting
Supplementation information on the on the benefits of
Program benefits of WIFA WIFA disseminated
disseminated among parents and
among parents Local Nutrition
Committee
provided updates
during LNC
meetings
19. Weekly Iron Folic Iron-folic acid Iron-folic acid Iron-folic acid Iron-folic acid Iron-folic acid FHSIS Report
Acid (WIFA) provided tablets not tablets provided tablets provided tablets provided tablets provided Master list of
to adolescent provided to less weekly to less than weekly to at least weekly to more weekly to 100% of adolescents
females in Grade 7 to than 50% of 80% of adolescent 80% of adolescent than 80% of adolescent females receiving WIFA
10 from private adolescent females females through females through adolescent females through Barangay
schools, through Barangay Barangay Health Barangay Health through Barangay Health Stations for
out-of-school Health Stations Stations Stations for two Health Stations for two cycles
adolescent females cycles two cycles for two
and women aged cycles
10-49 years not
covered by WIFA in
public schools
5f Mandatory Food Fortification
20. Retail outlets Less than 50% of Less than 75% of At least 75% of the More than 75% of Consistently above Local Nutrition
selling iodized salt retail outlets not retail outlets selling retail outlets selling retail stores selling 90% of retail stores Action Plan
selling iodized salt iodized salt iodized salt adequately iodized selling adequately Master list of retail
salt iodized salt outlets selling
iodized salt
21. Bakery owners Less than 50% of Less than 75% of At least 75% of the More than 75% of Consistently above Local Nutrition
using vitamin A the bakery owners the bakery owners bakery owners are bakery owners are 90% of bakery Action Plan
fortified flour are using vitamin A are using vitamin A using vitamin A using vitamin A owners are using Master list of
fortified flour in fortified flour in fortified flour in fortified flour in vitamin A fortified bakeries using
baked products baked products baked products/eij baked products flour in baked fortified flour
products
22. Establishments Less than 50% of Less than 75% of At least 75% of More than 75% of Consistently above Local Nutrition
selling vitamin A selling vitamin A vitamin A fortified establishments establishments 90% of the Action Plan
fortified cooking oil fortified cooking oil cooking oil selling vitamin A selling vitamin A establishments Master list of
fortified cooking oil fortified cooking oil selling vitamin A markets selling
fortified cooking oil vitamin A fortified
cooking oil
5g Nutrition in Emergencies Program
23. NiEm Plan NiEm Plan NiEm Plan was NiEm Plan was NiEm Plan was NiEm Plan was Local Nutrition
integration in the developed but not developed and developed and developed, developed, Action Plan
DRRM-H plan and integrated in the integrated to the integrated to the integrated to the integrated to the Local DRRM Plan
Local DRRM Plan Local Nutrition Local Nutrition Local Nutrition Local Nutrition Local Nutrition Comprehensive
Action Plan Action Plan but not Action Plan, Action Plan, Action Plan, Development Plan
integrated to the DRRM-H plan and DRRM-H plan and DRRM-H plan and
DRRM-H plan and Local DRRM Plan Local DRRM Plan Local DRRM Plan,
Local DRRM Plan and implemented implemented and
reviewed
24. Staff trained and Personnel provided Less than 80% of At least 80% of Personnel trained Personnel trained Local Nutrition
capacitated on NiEm with NiEM target number of target number of on NiEm and on NiEm and Action Plan
and information materials but not personnel trained personnel trained information information Training report
management trained on NiEm on NiEm and on NiEm and management management Capacity Map
and information information information deployed and deployed and
management management management covered at least covered at more
80% of target 80% of target
25. Key supplies Key supplies Key supplies Key supplies Key supplies Key supplies NIEM Plan
stockpiled, available but not stockpiled or stockpiled or stockpiled or stockpiled or Inventory of
pre-positioned and pre-positioned pre-positioned but pre-positioned and pre-positioned and pre-positioned and nutrition supplies
mobilized per NIEM when needed less than the 10% within the required within the required within the required and commodities
Strategic Plan buffer stock of the 10% buffer stock of 10% buffer stock of 10% buffer stock of
2017-2022 when total quantity of the total quantity the total quantity the total quantity
needed commodities of commodities of commodities of commodities
a. Tents available at the available at the available at the available at the
b. Vitamin A RHU (Vitamin A, RHU (Vitamin A, RHU (Vitamin A, RHU (Vitamin A,
(100,000) and Micronutrient Micronutrient Micronutrient Micronutrient
200,000 IU) Powder, Iron-Folic Powder, Iron-Folic Powder, Iron-Folic Powder, Iron-Folic
c. Micronutrient Acid) Acid) Acid). Nutrition Acid). Nutrition
Powders assessment tools assessment tools,
d. Iron-Folic Acid and equipment also equipment and
e. Nutrition IEC available breastfeeding kit
materials also available
f. MUAC Tapes
g. Weighing scales
h. CGS reference
tables
i. Height boards
j. Ready-to-Use
Therapeutic Food
k. Ready-to-Use
Supplementary Food
l. Antibiotics,
deworming tablets
Breastfeeding kits
(bag, feeding cup
with cover, food
container with spoon
and fork, 1L glass
tumbler with cover,
IEC materials, birth
registration form
5h Overweight and Obesity Management and Prevention Program
26. Activities on the LGU conducted LGU conducted LGU conducted LGU conducted LGU conducted Local Nutrition
promotion of healthy only one activity on more than one more than one more than one more than one Action Plan
lifestyle (physical the promotion of activity on the activity on the activity on the activity on the Approved Annual
activity and healthy healthy lifestyle promotion of promotion of promotion of promotion of budget
eating) included in and not included in healthy lifestyle healthy lifestyle healthy lifestyle healthy lifestyle Accomplishment
the LGU budget the approved LGU and not included in included in the including including report/
budget the approved LGU approved LGU monitoring and monitoring and documentation
budget budget with allocation in with allocation in report
the approved LGU the approved LGU
budget budget and budget
from external
partners
27. IEC materials on IEC materials on LGU developed/ LGU developed/ LGU developed/ LGU developed/ Local Nutrition
healthy lifestyle healthy lifestyle distributed IEC distributed IEC distributed IEC distributed IEC Action Plan
developed and/or available at the materials on materials on materials on materials on Accomplishment
distributed LGU but not healthy lifestyle to healthy lifestyle to healthy lifestyle to healthy lifestyle to report
distributed to less than 80% of at least 80% of the more than 80% of 100% of the target Inventory of IEC
target population the target target the target materials
IEC materials
5i Nutrition-Sensitive Programs
NS Programs to increase income and improve economic access to food
28. Households with LGU does not LGU provides less LGU provides at LGU provides more LGU provides 100% Local Nutrition
nutritionally provide households than 80% of least 80% of than 80% of of households with Action Plan
vulnerable or with nutritionally households with households with households with nutritionally Accomplishment/
affected provided vulnerable or nutritionally nutritionally nutritionally vulnerable or Documentation
with livelihood affected with vulnerable or vulnerable or vulnerable or affected with report
opportunities livelihood affected with affected with affected with livelihood Master list of
opportunities livelihood livelihood livelihood opportunities beneficiaries
opportunities opportunities opportunities
NS Programs to improve physical access to food
29. Gulayan sa Less than 80% of At least 80% of 100% of schools 100% of the 100% of the Local Nutrition
Paaralan established the schools schools maintain a established a schools maintain a schools maintain a Action Plan
and maintained in maintain a Gulayan Gulayan sa Gulayan sa Gulayan sa Gulayan sa GPP reports
schools sa Paaralan Paaralan Paaralan with Paaralan with Paaralan during
produce used for produced used for school days and
the School-based School-based during summer with
feeding Program feeding Program produced used for
School-based
feeding Program
30. Households with LGU provide inputs LGU provide inputs LGU provide inputs LGU provide inputs LGU provide inputs Local Nutrition
nutritionally for home gardening for home gardening for home gardening for home gardening including seeds Action Plan
vulnerable or to less than 80% of to at least 80% of to more than 80% to 100% of contributing to any Accomplishment/
affected provided households with households with of households with households with two of the documentation
with inputs for home nutritionally nutritionally nutritionally nutritionally nutrients: reports
gardening vulnerable or vulnerable or vulnerable or vulnerable or carbohydrates, Master list of
affected affected affected affected protein and vitamin beneficiaries
A or iron to 100%
of households with
nutritionally
vulnerable or
affected
NS Programs to improve access to safe drinking water and sanitary toilet facilities
31. Households with LGU ensures that LGU ensures that LGU ensures that at LGU ensures that LGU ensures that Local Nutrition
nutritionally less than 50% of less than 75% of least 75% more than 75% of 100% of Action Plan
vulnerable or the households households households households households Accomplishment
affected provided with nutritionally especially those especially those especially those especially those report
with access to safe vulnerable or with nutritionally with nutritionally with nutritionally with nutritionally OPT Plus Family
drinking water affected are vulnerable or vulnerable or vulnerable or vulnerable or Profile
provided with affected are affected are affected are affected are
access to safe provided with provided with provided with provided with
drinking water access to safe access to safe access to safe access to safe
drinking water drinking water drinking water drinking water
32. Households with LGU ensures that LGU ensures that LGU ensures that at LGU ensures more LGU ensures that Local Nutrition
nutritionally less than 50% of less than 75% of least 75% of than 75% 100% of Action Plan
vulnerable or households households households households households Accomplishment
affected provided especially those especially those especially those especially those especially those report
with access to with nutritionally with nutritionally with nutritionally with nutritionally with nutritionally OPT Plus Family
sanitary toilet vulnerable or vulnerable or vulnerable or vulnerable or vulnerable or Profile
facilities affected provided affected provided affected provided affected provided affected provided Master list of
with access to with access to with access to with access to with access to household with
sanitary toilet sanitary toilet sanitary toilet sanitary toilet sanitary toilet access to sanitary
facilities facilities facilities facilities facilities toilets
33. Schools provided Schools implement Schools implement Schools Schools Schools DepED WinS
with access to safe less than 5 of the at least the 5 implementing the implementing the implementing the Reports
water, adequate crucial indicators crucial indicators WinS was given a WinS was given a WinS was given a
toilets, handwashing for the for the one-star rating two-star rating three-star rating
facilities through the implementation of implementation of based on the based on the based on the
WASH in Schools the WinS program the WinS program DepED WinS Three DepED WinS Three DepED WinS Three
(WinS) program/eij 1. Safe drinking Star Approach Star Approach Star Approach
water
2. At least one set
of gender
segregated toilets
3. Group
handwashing
facility with soap
4. Group
handwashing
activities
5. Access to
sanitary pads within
the school
NS Programs to prevent teen-age pregnancy
34. Adolescent LGU does not LGU implements LGU implements LGU implements LGU implements
Health Development implement the the Adolescent the Adolescent the Adolescent the Adolescent
Program Adolescent Health Health Health Health Health
implemented Development Development Development Development Development
Program Program but covers Program and covers Program and covers Program and covers
less than 80% of at least 80% of the more than 80% of 100% of the targets
the targets only targets the targets
5j Local Initiatives (e.g. The LGU does not The LGU The LGU The LGU The LGU Local Nutrition
Research, have a local implements at least implements more implements and implements, Action Plan
Development of initiative one (1) local than one local monitors more monitors and Project/ Activity
learning sites) initiative initiative than one local sustains more than Documentation
initiative one local initiative Reports
35. Local initiative 1

MELLPI PRO FORM B 1a: BARANGAY NUTRITION MONITORING
Barangay Municipality/ City/ Province
PERFORMANCE LEVEL DOCUMENT REMARKS/

ELEMENTS RATING
1 2 3 4 5 SOURCE EVIDENCE
1a Presence and A vision statement A vision statement A vision statement A vision statement A vision statement Barangay Nutrition
knowledge of vision for nutrition was for nutrition was for nutrition for nutrition for nutrition Action Plan
Barangay Nutrition Barangay Nutrition stakeholders aware of their aware of their and
vision contribution to the
vision
1b Presence and A mission statement A mission statement A mission statement A mission statement A mission statement Barangay Nutrition
knowledge of mission for nutrition was for nutrition was for nutrition for nutrition for nutrition Action Plan
Barangay Nutrition Barangay Nutrition stakeholders aware of their aware of their and
mission contribution to the
mission
MELLPI Pro Form B 25 of 36

ELEMENTS RATING
1c Presence of nutrition The Comprehensive The Comprehensive The Comprehensive The Comprehensive Comprehensive
The Comprehensive
concerns in the Development Plan Development Plan Development Plan Development Plan Development Plan Development Plan
Cmprehensive includes includes includes includes includes
Development Plan one one at least one more than one more than one Approved Annual
nutrition-specific nutrition-specific nutrition-specific nutrition-specific nutrition-specific Budget
program only program with program program program
budget in the and at least one and at least one and more than one
approved annual nutrition-sensitive nutrition-sensitive nutrition-sensitive
budget program with program with program with
budget in the budget in the budget in the
approved annual approved annual approved annual
budget budget budget


1 2 3 4 5 EVIDENCE
2a Adoption, The barangay is aware The barangay has a The barangay The BNC monitors The BNC discuss the Resolutions
implementation and that a Barangay resolution, allocated budget for implementation of the result of monitoring and Ordinances
monitoring of barangayNutrition Action ordinance and/or implementation of Barangay Nutrition identify action lines Executive Order
nutrition plan Plan was agreement the Barangay Action Plan to improve Approved Annual
formulated adopting the Barangay Nutrition Action implementation of the Budget
Nutrition Action Plan Plan plan Local Nutrition
Action Plan
Quarterly
Accomplishment
Report
Minutes of meeting
2b Adoption, The barangay is aware The barangay has a The barangay The barangay The barangay Resolutions
implementation and of the provisions of EO resolution, ordinance, implemented implemented activities implemented activities Ordinances
monitoring of 51 Executive Order and/or activities to to promote and to promote and monitor Executive Order
national/ regional agreement and/or a line promote and monitor compliance compliance to the local
nutrition policies budget item in the monitor compliance to the local ordinance, ordinance, resolution or Approved Annual
Executive Order 51: Approved Annual Budget to the local resolution or Executive Order and Budget
National Code of on EO 51 or related ordinance, Executive Order maintains record of
Marketing Breastmilk concern resolution or and maintains record facilities compliant to Local Nutrition
Substitutes, Breastmilk Executive Order of facilities compliant EO 51 and follows Action Plan
Supplements and Other to EO 51 through non-compliant
Related Products facilities

1 2 3 4 5 EVIDENCE
2c Republic Act 10028: The barangay is aware The barangay has a The barangay Budgeted activities The barangay has Resolutions
Expanded of the provisions of RA resolution, ordinance, implemented are fully initiated compliance Ordinances
Breastfeeding 10028 and/or DILG MC Executive Order and/or activities to implemented through establishment/ Executive Order
Promotion Act of 2011-54 agreement and/or a line promote and pursuant to the maintenance of Approved Annual
2009 budget item in the monitor compliance laws lactation stations at the Budget
Approved Annual Budget to the law implementation public facilities within Local Nutrition
DILG Memorandum on RA 10028 or related the barangay Action Plan
Circular 2011-54 concern Accomplishment/
Implementation and documentation
Monitoring of the report
National Masterlist of
Breastfeeding Policy establishments/
offices with
lactation stations
2d Republic Act 8172: An The barangay is aware The barangay has a The barangay The barangay The BNC discusses Resolutions
Act for Salt Iodization of the provisions of resolution, implemented monitors the activities the result of monitoring Ordinances
Nationwide (ASIN RA 8172 ordinance, activities to and compliance and identify with action Executive Order
Law) Executive Order promote to the law lines to improve Approved Annual
and/or agreement compliance to the compliance to the law Budget
and/or a line item law Local Nutrition
budget in the Action Plan
Approved Annual Minutes of meeting
Budget which Accomplishment/
supports R.A. 8172 documentation
report
Masterlist of
establishments
complaint to RA 8172
2e Republic Act 8976: The barangay is aware The barangay has a The barangay The barangay The BNC discusses Resolutions
Philippine Food of the provisions of resolution, implemented monitors the activities the result of monitoring Ordinances
Fortification Act RA 8976 ordinance, activities to and compliance and identify with action Executive Order
Executive Order promote to the law lines to improve Approved Annual
and/or agreement compliance to the compliance to the law Budget

1 2 3 4 5 EVIDENCE
and/or a line item law Local Nutrition
report
Masterlist of
establishments
complaint to RA 8976
2f Republic Act 11148 The barangay is aware The barangay has a The barangay The barangay The BNC discusses Resolutions
First 1000 Days Law of the provisions of resolution, implemented monitors the activities the result of monitoring Ordinances
RA 11148 ordinance, activities to and identify with action Executive Order
Executive Order promote lines to improve Approved Annual
and/or agreement compliance to the implementation of Budget
and/or a line item law activities Local Nutrition
report
ECCD F1K Reports
2g DOH Administrative The barangay is aware The barangay has a The barangay The report on the The BNC discusses the Resolutions
Orders: of provisions in resolution, implemented implementation of outcomes in the report Ordinances
1. 2010-0010: either of the DOH ordinance, activities to activities related to and identify action lines Executive Order
Revised Policy on Administrative Executive Order promote the DOH AO is to assist the Barangay Approved Annual
Micronutrient Orders and/or agreement compliance to the shared to the Health Station in Budget
Supplementation and/or a line item DOH AO barangay by the improving Local Nutrition
2. 2008-029: budget in the Midwife implementation of the Action Plan
Implementing Health Approved Annual DOH AO Minutes of meeting
Reforms for Rapid Budget which Accomplishment/
Reduction of supports either documentation
Maternal and DOH-AO 2010-0010 report
Neonatal Mortality or 2008-0029 Related reports from
Barangay Health
Station

1 2 3 4 5 EVIDENCE
2h DepED Orders: The barangay is aware The barangay has a The barangay The report on the The BNC discusses the Resolutions
1. 59-2 S. 2017 of provisions in the resolution, implemented implementation of outcomes in the report Ordinances
Weekly Folic Acid DepED Orders ordinance, activities to activities related to and identify action lines Executive Order
Supplementation for Executive Order promote the Deped Order is to assist the school Approved Annual
Female Adolescents and/or agreement compliance to the shared to the in improving Budget
2. 39 S. 2017 and/or a line item DepED Order Barangay by the BNC implementation of the Local Nutrition
Operational budget in the member from the DepED Order Action Plan
Guidelines for Approved Annual school Minutes of meeting
School-based Feeding Budget which Accomplishment/
Program 3. 13 S. supports either documentation
2017 Policy and DOH-AO 2010-0010 report
Guidelines on Healthy or 2008-0029 Related reports from
Food Choices in school
Schools 4. 10-1 S.
2016 Policy
Guidelines for
Comprehensive
WASH in Schools
DepED Memo No.
223 S. 2016
Strengthening
Implementation of
Gulayan sa Paaralan
Project
2i NNC Governing The barangay is aware The barangay procured The barangay uses The barangay uses The barangay uses Approved Annual
Board Resolutions of either NNC GB any type of height height and length verified height and verified height and Budget
Nos. 1) 3 S.2012: Resolution No. 3 and length measuring tools of length measuring tools length measuring tools Local Nutrition
Approving the S.2018 or No. 3. measuring tools wooden/ non-wood of wooden/ of wooden/ non-wood Action Plan
Guidelines on the S.2012 material as non-wood material as material as prescribed in OPT Plus Report
Fabrication, prescribed in the prescribed in the the guidelines and
Verification, and guidelines guidelines allocates budget for
Maintenance of maintenance/
Wooden Height replacement of height
Boards 2) 3 S.2018: and length measuirng
Approving the tools
Guidelines on the
Selection of

1 2 3 4 5 EVIDENCE
Non-Wood Height
and Length
Measuring Tool
2j NNC Governing The barangay is aware The activities in the The activities in the The BNC monitors The BNC discuss the Resolutions
Board Resolution of the provisions on Barangay Nutrition Barangay Nutrition implementation of the result of monitoring and Ordinances
No.1 series of 2017: either NNC GB Action Plan are Action Plan aligned activities aligned with identify action lines Executive Order
Approving and Resolution or DILG aligned with the with the priorities the PPAN priorities in to improve Approved Annual
Adopting the MC priorities of the of the PPAN the Barangay Nutrition implementation of the Budget
Philippine Plan of PPAN 2017-2022 2017-2022 are Action Plan activities aligned with Local Nutrition
Action for Nutrition allocated with PPAN priorities Action Plan
2017-2022 budget based on the Minutes of meeting
approved annual Accomplishment/
DILG MC 2018-42 budget documentation
Adoption and report
Implementation of
PPAN 2017-2022
2k NNC Governing The barangay is aware The barangay has a The barangay The BNC monitors The BNC discuss the Resolutions
Board Resolution No. of the provisions of resolution, implemented at implementation of the result of monitoring and Ordinances
6 series of 2012: the resolution ordinance, least one activity activities identify action lines Executive Order
Adoption of the 2012 Executive Order with to improve Approved Annual
Nutritional Guidelines and/or agreement multi-stakeholder implementation of the Budget
for Filipinos in support to NNC participation to activities Local Nutrition
GB Res.6 S.2012 support the NNC GB Action Plan
Resolution Minutes of meeting
Accomplishment/
documentation
report
2l NNC Governing The barangay is aware The members of the OPT The barangay The BNC maintains the The barangay utilizes the Resolutions
Board Resolution of the provisions of Plus Team attended the conducts OPT Plus complete OPT Plus E-OPT and maintains the Local Nutrition
No.2 S.2012: the resolution orientation on OPT Plus and uses weight and reports and uses them complete OPT Plus Action Plan
Approving the height measuring in nutrition situation reports and uses them in Approved Annual
Revised equipment assessment and nutrition situation Budget
Implementing prescribed in the planning assessment and planning OPT Plus Report
Guidelines on OPT Plus IG Masterlist of
OPT Plus malnourished children

1 2 3 4 5 EVIDENCE
2m NNC Governing The barangay is aware The barangay designated The barangay has Barangay Nutrition Barangay Nutrition Resolutions
Board Resolution No. of NNC GB Res. 2 S. the lead or focal point issued a resolution Cluster has been Cluster has been Ordinances
2 series of 2009: 2009 for Nutrition-in- organizing the formed and planning formed and integrated Executive Order
Adopting the Emergencies nutrition cluster in has been initiated/ with the BDRRMC with Local Nutrition
National Policy on the area or its completed allocated budget Action Plan
Nutrition equivalent body NIEM Plan
Management in Minutes of meeting
Emergencies and Accomplishment
Disasters report/
documentation
report

ELEMENTS RATING
3d Decision-making and The BNC is The BNC is The BNC meetings The BNC meetings The BNC meetings Minutes of meeting
Leadership of the convened only convened for are used for key are used for key are used for key
Barangay Nutrition once for key key decisions decisions regarding decisions and decisions,
Committee program decisions regarding the planned activities monitoring of monitoring of
nutrition program with duly signed progress on progress on
and other concerns documentation planned activities planned activities
on an adhoc basis with duly signed and follow through
documentation actions with duly
signed
documentation


ELEMENTS RATING
3a Presence of Barangay The BNC is The BNC is The BNC is The BNC is The BNC is Barangay Nutrition
Nutrition Committee organized but organized but does organized with the organized with the organized with full Action Plan
(BNC) membership is not include all Barangay Captain as Local Chief representation as Resolutions
limited to 3-4 member agencies chairperson and is Executive as stated in level 3 and Executive Order
members only of the NNC composed of Bgy chairperson and is supported by a Organizational
Governing Board counterparts of the composed of LGU resolution Chart
(pursuant to PPAN NNC Governing counterparts of the indicating the
IG S.1981 and EO Board member NNC Governing functions of each
234 S.1987) with agencies Board member member
Bgy counterparts agencies and
1. Barangay non-government
Captain (Chair) organizations/
2. Kagawad on private sector/
Health people’s
3. Rural Health organization
Midwife (RHM)

ELEMENTS RATING
4. Agriculture
Technician (AT)

ELEMENTS RATING
5. School
Principal/
Teacher
6. Day Care Worker
7. Barangay
Secretary
3b Functionality of the The BNC has met The BNC has met The BNC met at The BNC met at The BNC conducted Resolutions
Barangay Nutrition only once. twice for the year. least three times least three times quarterly meetings Ordinances
Committee and jointly which included the Executive Order
LNAP is available formulated and following agenda: Barangay Nutrition
but no joint funded the 1. OPT Plus results Action Plan
discussion on Barangay Nutrition 2. BNAP Approved Budget
progress and results Action Plan formulation Minutes of meeting
of various 3. Nutrition Month
programs Celebration
4. Resource
generation
3c Presence of Nutrition The barangay has The barangay The barangay The barangay The barangay Resolution
Office and Personnel designated a designated a BNS designated a BNS designated a BNS designated a BNS Executive Order
Barangay Nutrition and allocated with monthly with monthly with monthly Barangay Nutrition
Scholar budget for monthly honorarium, budget honorarium, budget honorarium, budget Action Plan
honorarium for supplies and for supplies and for supplies, Organizational
designated a designated a designated a BNS Chart
BNS desk BNS corner/ office corner/ office and Approved Annual
is assisted by Budget
Barangay Health
Workers or other
bgy personnel in

ELEMENTS RATING
the conduct of OPT
Plus or other activities


ELEMENTS RATING
4a Planning Barangay Nutrition BNAP exists in the BNAP is formulated BNAP is formulated BNAP is Comprehensive
Action Plan is barangay and is by the members of by the members of formulated by the Development Plan
formulated but not formulated by the the BNC en banc the BNC en banc members of the Barangay Nutrition
signed Barangay Nutrition and updated at and updated once a BNC and updated Action Plan
Scholar only least once within year once a year and Minutes Meeting
the past three (3) reviewed for Accomplishment
years assessment and Report
formulation of Resolutions
plan for the next Executive Order
year
4b BNC Mobilization Only 1-2 members Only 3-4 members All members of the All members of the All members of the Resolutions
of the BNC perform of the BNC BNC performs BNC performs BNC performs Executive Order
nutrition and performs nutrition nutrition and nutrition and nutrition and MOA with
nutrition-related and nutrition-related nutrition-related nutrition-related stakeholders

ELEMENTS RATING
functions including nutrition-related functions and functions with functions with Documentation
attendance to BNC functions contributes support from the support from the report

ELEMENTS RATING
activities resources to local peoples’ local peoples’ Minutes of the
activities organization organization who Meeting
and other
external partners
such as socio-civic
organizations,
international
organizations,
academic
institution
4c Advocacy for The LNC does not The LNC conducts The LNC regularly The LNC regularly The LNC regularly Barangay Nutrition
Nutrition Program conduct advocacy advocacy activities conducts advocacy conducts advocacy conducts advocacy Action Plan
and Nutrition activities for for nutrition and activities for activities for activities for Accomplishment
Workers nutrition and local local nutrition nutrition and local nutrition and local nutrition and local Report
nutrition workers workers to local nutrition workers nutrition workers nutrition workers Project/ Activity
decision makers to local decision to local and to local and Documentation
and legislators, but makers and national decision national decision Reports
on an ad hoc basis. legislators. makers and makers and
legislators./eij legislators and
external partners
4d Fund Source Not all BNAP The BNAP is funded The BNAP fund in The BNAP fund in The BNAP fund in Barangay Nutrition
activities are in the approved the approved the approved the approved Action Plan
funded annual budget annual LGU budget annual LGU budget annual LGU budget Annual Investment
but limited to includes personnel includes personnel includes personnel Plan/ Approved
program budgets services, MOOE and services, MOOE and services, MOOE and Annual LGU Budget
program program with program with MOA with partners
additional support additional support Resolutions
either through fund either through fund
support, in kind or support, in kind or
services from services from

ELEMENTS RATING
community external partners
4e Interagency Progress of BNAP Progress of BNAP The BNC monitors The BNC monitors The BNC monitors Barangay Nutrition
Monitoring and implementation is implementation is implementation of implementation of implementation of Action Plan
Evaluation only conducted by monitored by the the nutrition the nutrition the nutrition Monitoring/
the BNS BNC but not program at least program at least program at least feedback report
on an annual basis once a year once a year and once a year and Documentation
discusses the discusses the Report
results during BNC results during BNC Minutes of Meeting
meetings to identify meetings and
action lines follows through
identified action
lines in the
succeding meeting


1 2 3 4 5 EVIDENCE
5a Infant and Young Child Feeding
Community-based health and nutrition support strengthening
1. Functional Breastfeeding Breastfeeding Breastfeeding Breastfeeding Breastfeeding Written agreement on 0
breastfeeding support group support group support group support group support group estbalishment of 0
support group established in the conducts meetings conducted conducted conducted Breastfeeding Support 0
barangay with as planned activities such as activities and breastfeeding Group 0
written agreement peer counseling, referred lactating support activities, Directory of members
of its sharing of mothers with referred lactating Referral documents
establishment and experience and breastfeeding mothers with Documentation Report
directory of assistance in challenges to breastfeeding
members breastfeeding for Midwife or Rural challenges to
pregnant and Health Physician Midwife or Rural
lactating mothers Health Physician and
provided assistance
on complementary
feeding

1 2 3 4 5 EVIDENCE
Establishment of breastfeeding places in barangay facilities
2. Lactation stations The barangay does The barangay has The barangay has The barangay has The barangay has (By ocular
established in not have a only one lactation one lactation more than one more than one inspection)
barangay facilities lactation station in station area but station and lactation station, lactation station, Documentation
such as Barangay any of the areas not maintained maintained by the maintained by maintained by report
Health Stations, barangay/ school the barangay/ the barangay/ Lactation station logbook
multi-purpose hall school and marked school, marked of users
and in public by signages by signages and
schools maintains a logbook
of users
Promotion of compliance to the Milk Code
3. Activities The barangay have The Barangay The Barangay The BNC monitors The BNC monitors Milk code materials
conducted to Milk Code materials Nutrition Committee Health Station compliance to the compliance to the IYCF classes topic guide
promote compliance posted in the and Barangay includes a Milk Code in BNAP Milk Code in BNAP Barangay Nutrition Action
to Executive Order Barangay Health Health Station discussion on Milk implementation implementation Plan
51, Milk Code Station personnel are Code in its Infant and maintains and maintains Masterlist of compliant
aware of the and Young Child records of records of and non-compliant
provisions of the Feeding classes facilities compliant compliant facilities facilites
EO 51 including for pregnant and with EO 51 and follows through
the violations lactating mothers non-compliant ones
5b Philippine Integrated Management of Acute Malnutrition

Provision of services for SAM
4. Support to families The barangay The barangay The barangay The barangay The barangay Accomplishment/ 0
with severely acute provides one-time provides provides periodic provides periodic provides periodic Documentation 0
malnourished support thru fund intermittent support thru fund support thru fund support thru fund reports 0
children assistance or in support thru fund assistance or in assistance or in assistance or in kind Masterlist of
kind to families assistance or in kind to families kind for medical for medical and other children with SAM
with severely acute kind to families with severely acute needs of severely needs of severely
malnourished with severely acute malnourished acute malnourished acute malnourished
children malnourished children children children
children

1 2 3 4 5 EVIDENCE
5. Referral of The barangay The barangay The barangay The barangay The barangay Masterlist of
severely acute maintains a maintains a maintains a maintains a through the BNS children with SAM
malnourished master list of master list of master list of master list of continuously Referral forms
children to Barangay children with children with children with children with monitors progress of
Health Stations severe acute severe acute severe acute severe acute the severely acute
and/or Rural Health malnutrition but malnutrition and malnutrition, refer malnutrition, malnourished child
Units does not refer the refer the children the children to the refer the children until he/ she
children to the BHS to the BHS or RHU BHS or RHU and to the BHS or RHU, improves and/or
or RHU but does not follows through follows rehabilitated
follow through next step after through next step
next steps after referral after referral and
referral monitors
compliance to the
treatment protocol
5c National Dietary Supplementation Program

Dietary supplementation of pregnant women
6. Nutritionally-at- The barangay does The barangay The barangay The barangay The barangay Barangay Nutrition Action 0
risk pregnant women not implement/ implements/ implements/ implements/ implements/ Plan 0
enrolled/ covered in coordinate the coordinates the coordinates the coordinates the coordinates the Accomplishment/ 0
the dietary dietary dietary dietary dietary dietary Documentation reports 0
supplementation supplementation supplementation supplementation supplementation supplementation NDSP Reports 0
program program for program for program for program for program for
pregnant women pregnant women pregnant women pregnant women pregnant women
but for less than for the target 90 for the target 90 for the target 90
the target 90 days days but covers days but covers days but covers
less than 80% of at least 80% of the more than 80% of the
target population target population target population
Dietary supplementation of infants and young children 6-23 months
7. Infants and young The barangay does The barangay The barangay has The barangay has The barangay has Barangay Nutrition Action
children 6-23 months not implement/ implements/ a dietary a dietary a dietary Plan
old enrolled in the coordinate the coordinates the supplementation supplementation supplementation Accomplishment/
dietary dietary dietary program for program for program for documentation

1 2 3 4 5 EVIDENCE
supplementation supplementation supplementation infants and young infants and young infants and young report
program regardless program for program for children 6-23 children 6-23 children 6-23 Masterlist of
of nutritional status infants and young infants and young months old for the months old for the months old for the children 6-23
children 6-23 children 6-23 target 132 days target 132 days target 132 days months
months old months old but for but covers less and covers at least and covers more
less than the than 80% of the 80% of the target than 80% of the
target 132 days target population population target population
Dietary supplementation of children in child development centers and supervised neighborhood play
8. Children in child The barangay does The barangay The progress of The barangay The barangay Supplementary feeding
development centers not coordinate coordinates with implementation is provides utilizes the data program report
and supervised with the Day Care the Day Care shared by the Day assistance shared but the Day Documentation report
neighborhood play Center in the Center on the Care Worker and identified to the Care Workers in the Minutes of BNC meeting
provided with dietary implementation of progress of discussed by the dietary assessment and Barangay Nutrition Action
supplementation the of the dietary implementation of BNC to identify supplementation formulation of Plan
supplementation the dietary areas where BNC program for activities in the
program for supplementation can assist children in child BNAP for preschool
children in child program for development age children
development children in child centers and
centers and development supervised
supervised centers and neighborhood play
neighborhood play supervised based on progress
neighborhood play of implementation
shared by the Day
Care Worker
Dietary supplementation of wasted school children
9. Support to the The barangay does The barangay The progress of The barangay The barangay School-based feeding
School-based Feeding not coordinate coordinates with implementation is provides utilizes the data program report
Program (SBFP) with the school in the school in the shared by the assistance as shared but the Day Documentation report
targeting children the implementation of school and identified to the Care Workers in the Minutes of BNC meeting
from Kinder to Grade implementation of the School-based discussed by the the School-based assessment and Barangay Nutrition Action
VI who are wasted the School-based Feeding Program BNC to identify Feeding Program formulation of Plan

1 2 3 4 5 EVIDENCE
Feeding Program (SBFP) targeting areas where BNC (SBFP) activities in the
(SBFP) targeting children from can provide BNAP for school age
children from Kinder to Grade VI assistance children
Kinder to Grade VI who are wasted
who are wasted
5d Micronutrient Supplementation
10. Pregnant women Pregnant women Pregnant women Pregnant women Pregnant women Pregnant women FHSIS Report 0
provided with were provided with were provided with were provided with were provided with were provided with Master list of 0
iron-folic acid iron-folic acid iron-folic acid as iron-folic acid as iron-folic acid as iron-folic acid as pregnant women 0
but less than the prescribed but prescribed and prescribed and prescribed and receiving iron-folic 0
prescribed 180 covers less than covers at least covers more than covers more than acid 0
tablets 80% of the target 80% of the target 80% of the target 90% of the target 0
11. Vitamin A Vitamin A capsules Vitamin A capsules Vitamin A capsules Vitamin A capsules Vitamin A capsules FHSIS Report
capsules provided to were provided to were provided to were provided to were provided to were provided to Master list of
children 6 mos -5 children 6 mos -5 children 6 mos -5 children 6 mos -5 children 6 mos -5 children 6 mos -5 children 6 mos. to 5
years old years old only years old twice in years old twice in years old twice in years old twice in years receiving
once in the the previous year the previous year the previous year the previous year vitamin A
previous year but covers less and covers at least and covers 91% to and covers 100% of
than 90% of the 90% of the target 99% of the target the target
target
12. Micronutrient Micronutrient Micronutrient Micronutrient Micronutrient Micronutrient FHSIS Report

powder provided to powder provided powder provided powder provided powder provided powder provided to Master list of
young children 6-23 to young children to young children to young children to young children young children 6-23 children 6-23
months old 6-23 months old 6-23 months old 6-23 months old 6-23 months old months old and months receiving
but covers less but covers less and covers at least and covers more covers at more than MNP
than 70% of the than 80% of the 80% of the target than 80% of the 80% of the target
target target target with at least with more than 80%
80% compliance compliance

1 2 3 4 5 EVIDENCE
13. Weekly provision Iron-folic acid Iron-folic acid Iron-folic acid Iron-folic acid Iron-folic acid School-based
of iron-folic acid tablets provided to tablets provided tablets provided tablets provided tablets provided Weekly Iron Folic
tablets to adolescent less than 80% weekly to less than weekly to 100% of weekly to 100% of weekly to 100% of Acid
female learners in adolescent female 100% of adolescent adolescent female adolescent female adolescent female Supplementation
public schools learners in public female learners in learners in public learners in public learners in public Report
through Weekly Iron schools public schools schools for two schools for two schools for two BNC minutes of
Folic Acid (WIFA) cycles cycles and cycles, information meeting
Supplementation information on the on the benefits of
Program benefits of WIFA WIFA disseminated
disseminated among school
among school children and parents
children
14. Weekly Iron Folic Iron-folic acid Iron-folic acid Iron-folic acid Iron-folic acid Iron-folic acid FHSIS Report
Acid (WIFA) provided tablets not tablets provided tablets provided tablets provided tablets provided Master list of
to adolescent provided to less weekly to less than weekly to at least weekly to more weekly to more than adolescents
females in Grade 7 to than 70% of 80% of adolescent 80% of adolescent than 80% of 90% of adolescent receiving WIFA
10 from private adolescent females through females through adolescent females females through
schools, females through Barangay Health Barangay Health through Barangay Barangay Health
out-of-school Barangay Health Stations Stations for two Health Stations for Stations for two
adolescent females Stations cycles two cycles for two cycles
and women aged cycles
10-49 years not
covered by WIFA in
public schools
5e Mandatory Food Fortification
15. Retail outlets Less than 50% of Less than 75% of At least 75% of the More than 75% of Consistently above Barangay Nutrition Action 0
selling iodized salt retail outlets not retail outlets selling retail outlets selling retail stores selling 90% of retail stores Plan 0
selling iodized salt iodized salt iodized salt adequately iodized selling adequately Master list of retail 0
salt iodized salt outlets selling 0
iodized salt

1 2 3 4 5 EVIDENCE
16. Bakery owners Less than 50% of Less than 75% of At least 75% of the More than 75% of Consistently above Barangay Nutrition Action
using vitamin A the bakery owners the bakery owners bakery owners are bakery owners are 90% of bakery Action Plan
fortified flour are using vitamin A are using vitamin A using vitamin A using vitamin A owners are using Master list of
fortified flour in fortified flour in fortified flour in fortified flour in vitamin A fortified bakeries using
baked products baked products baked products/eij baked products flour in baked fortified flour
products
17. Establishments Less than 50% of Less than 75% of At least 75% of More than 75% of Consistently above Barangay Nutrition Action
selling vitamin A selling vitamin A vitamin A fortified establishments establishments 90% of the Action Plan
fortified cooking oil fortified cooking oil cooking oil selling vitamin A selling vitamin A establishments Master list of
fortified cooking oil fortified cooking oil selling vitamin A markets selling
fortified cooking oil vitamin A fortified
cooking oil
5f Nutrition in Emergencies Program
18. NiEm Plan NiEm activities NiEm activities NiEm activities NiEm activities NiEm activities Barangay Nutrition Action 0
integration in the identified but not identified and identified and identified and identified and Plan 0
DRRM-H plan and integrated in the integrated to the integrated to the integrated to the integrated to the Barangay DRRMC 0
Local DRRM Plan Barangay Nutrition Barangay Nutrition Barangay Nutrition Barangay Nutrition Barangay Nutrition
Action Plan Action Plan but not Action Plan and Action Plan and Action Plan and
integrated to the Barangay DRRMC Barangay DRRMC Barangay DRRMC
Barangay DRRMC and implemented and implemented
and reviewed
19. Key supplies Key supplies Key supplies Key supplies Key supplies Key supplies NIEM Plan
stockpiled, available but not stockpiled or stockpiled or stockpiled or stockpiled or Inventory of
pre-positioned and pre-positioned pre-positioned but pre-positioned and pre-positioned and pre-positioned and nutrition supplies
mobilized per NIEM when needed less than the 10% within the required within the required within the required and commodities
Strategic Plan buffer stock of the 10% buffer stock of 10% buffer stock of 10% buffer stock of
2017-2022 when total quantity of the total quantity the total quantity the total quantity
needed commodities of commodities of commodities of commodities
a. Tents available at the available at the available at the available at the
b. Vitamin A RHU (Vitamin A, RHU (Vitamin A, RHU (Vitamin A, RHU (Vitamin A,
(100,000) and Micronutrient Micronutrient Micronutrient Micronutrient

1 2 3 4 5 EVIDENCE
200,000 IU) Powder, Iron-Folic Powder, Iron-Folic Powder, Iron-Folic Powder, Iron-Folic
c. Micronutrient Acid) Acid) Acid). Nutrition Acid). Nutrition
Powders assessment tools assessment tools,
d. Iron-Folic Acid and equipment equipment and
e. Nutrition IEC also available breastfeeding kit
materials also available
f. MUAC Tapes
g. Weighing scales
h. CGS reference
tables
i. Height boards
j. Ready-to-Use
Therapeutic Food
k. Ready-to-Use
Supplementary Food
l. Antibiotics,
deworming tablets
Breastfeeding kits
(bag, feeding cup
with cover, food
container with spoon
and fork, 1L glass
tumbler with cover,
IEC materials, birth
registration form
5g Overweight and Obesity Management and Prevention Program
20. Activities on the Barangay Barangay Barangay Barangay Barangay Barangay Nutrition Action 0
promotion of healthy conducted only conducted only conducted conducted conducted Plan 0
lifestyle (physical one activity on the one activity on the activities as activities as activities as Approved Annual budget
activity and healthy promotion of promotion of planned for the planned including planned including Accomplishment/
eating) included in healthy lifestyle healthy lifestyle promotion of progress progress documentation report
the LGU budget and not included in and included in the healthy lifestyle as monitoring for the monitoring for the
the approved approved budget planned with promotion of promotion of

1 2 3 4 5 EVIDENCE
budget multistakeholder healthy lifestyle as healthy lifestyle as
participation and planned with planned with
approved budget multistakeholder multistakeholder
participation and participation and
approved budget approved budget
and external funding
5h Nutrition-Sensitive Programs
NS Programs to increase income and improve economic access to food
21. Households with Barangay does not Barangay provides Barangay provides Barangay provides Barangay provides Barangay Nutrition Action 0
nutritionally provide households less than 80% of at least 80% of more than 80% of more than 90% of Plan 0
vulnerable or with nutritionally households with households with households with households with Accomplishment/ 0
affected provided vulnerable or nutritionally nutritionally nutritionally nutritionally documentation report 0
with livelihood affected with vulnerable or vulnerable or vulnerable or vulnerable or Master list of beneficiaries 0
opportunities livelihood affected with affected with affected with affected with 0
opportunities livelihood livelihood livelihood livelihood 0
opportunities opportunities opportunities opportunities 0
NS Programs to improve physical access to food
22. Gulayan sa Less than 80% of At least 80% of 100% of schools 100% of the 100% of the Barangay Nutrition Action
Paaralan established the schools schools maintain a established a schools maintain a schools maintain a Plan
and maintained in maintain a Gulayan Gulayan sa Gulayan sa Gulayan sa Gulayan sa GPP reports
schools sa Paaralan Paaralan Paaralan Paaralan with Paaralan during
produced used for school days and
School-based during summer with
feeding Program produced used for
School-based
feeding Program
23. Households with Barangay Barangay Barangay Barangay Barangay distributes Barangay Nutrition Action
nutritionally distributes inputs distriubutes inputs distributes inputs distributes inputs inputs including seeds Plan
vulnerable or for home gardening for home gardening for home gardening for home gardening contributing to any Accomplishment/
affected provided to less than 80% of to at least 80% of to more than 80% to 100% of two of the nutrients: documentation reports
with inputs for home households with households with of households with households with carbohydrates, Master list of beneficiaries

1 2 3 4 5 EVIDENCE
gardening nutritionally nutritionally nutritionally nutritionally protein and vitamin A
vulnerable or vulnerable or vulnerable or vulnerable or or iron to 100% of
affected affected affected affected households with
nutritionally
vulnerable or
affected
NS Programs to improve access to safe drinking water and sanitary toilet facilities
24. Households with Barangay ensures Barangay ensures Barangay ensures Barangay ensures Barangay ensures Barangay Nutrition Action
nutritionally that less than 50% that less than 75% that at least 75% that more than 75% that 100% of Plan
vulnerable or of the households of households households of households households especially Accomplishment/
affected provided with nutritionally especially those especially those especially those those with documentation reports
with access to safe vulnerable or with nutritionally with nutritionally with nutritionally nutritionally OPT Plus Family Profile
drinking water affected are vulnerable or vulnerable or vulnerable or vulnerable or
provided with affected are affected are affected are affected are provided
access to safe provided with provided with provided with with access to safe
drinking water access to safe access to safe access to safe drinking water
drinking water drinking water drinking water
25. Households with Barangay ensures Barangay ensures Barangay ensures Barangay ensures Barangay ensures Barangay Nutrition Action
nutritionally that less than 50% that less than 75% that at least 75% of more than 75% that 100% of Plan
vulnerable or of households of households households households households especially Accomplishment/
affected provided especially those especially those especially those especially those those with documentation reports
with access to with nutritionally with nutritionally with nutritionally with nutritionally nutritionally OPT Plus Family Profile
sanitary toilet vulnerable or vulnerable or vulnerable or vulnerable or vulnerable or Master list of household
facilities affected provided affected provided affected provided affected provided affected provided with access to sanitary
with access to with access to with access to with access to with access to toilets
sanitary toilet sanitary toilet sanitary toilet sanitary toilet sanitary toilet
facilities facilities facilities facilities facilities
26. Schools provided Schools implement Schools implement Schools Schools Schools DepED WinS
with access to safe less than 5 of the at least the 5 implementing the implementing the implementing the Reports
water, adequate crucial indicators crucial indicators WinS was given a WinS was given a WinS was given a
toilets, handwashing for the for the one-star rating two-star rating three-star rating

1 2 3 4 5 EVIDENCE
facilities through the implementation of implementation of based on the based on the based on the
WASH in Schools the WinS program the WinS program DepED WinS Three DepED WinS Three DepED WinS Three
(WinS) program/eij 1. Safe drinking Star Approach Star Approach Star Approach
water
2. At least one set
of gender
segregated toilets
3. Group
handwashing
facility with soap
4. Group
handwashing
activities
5. Access to
sanitary pads within
the school
NS Programs to prevent teen-age pregnancy
27. Adolescent Barangay does not Barangay Barangay Barangay Barangay

Health Development implement the implements the implements the implements the implements the
Program Adolescent Health Adolescent Health Adolescent Health Adolescent Health Adolescent Health
implemented Development Development Development Development Development
Program Program but covers Program and covers Program and covers Program and covers
less than 80% of at least 80% of more than 80% of more than 90% of
the targets only the targets the targets the targets
5i Barangay Innovations
35. Local initiative 1 The barangay does The barangay The barangay The barangay The barangay Barangay Nutrition Action 0
not have a local implements at implements more implements and implements, Plan 0
initiative least one activity than one activity monitors more monitors and Project/ Activity 0
for the local for the local than one acitivity sustains more than Documentation Reports 0
initiative initiative one activity

MELLPI Pro FORM B 1b: SUMMARY OF BARANGAY NUTRITION MONITORING
DIMENSION 1: VISION AND MISSION
ELEMENTS PERFORMANCE LEVEL CURRENT RATING
1a. Presence and knowledge

#DIV/0! #DIV/0!
of vision statement
1b. Presence and knowledge

#DIV/0! #DIV/0!
of mission statement
1c. Presence of Executive Legislative

Agenda (ELA) and/or Annual
#DIV/0! #DIV/0!
Investment Plan (AIP) on
Nutrition
PERFORMANCE RATING #DIV/0!
DIMENSION 2: NUTRITION LAWS AND POLICIES
2a. Adoption, implementation and monitoring of local

#DIV/0! #DIV/0!
nutrition plan
2b. Executive Order 51: National

Code of Marketing Breastmilk
#DIV/0! #DIV/0!
Substitutes, Breastmilk Supplements
and Other Related Products (Milk Code)
2c. Republic Act 10028: Expanded Breastfeeding

#DIV/0! #DIV/0!
Promotion Act of 2009
2d. Republic Act 8172: An Act for Salt

#DIV/0! #DIV/0!
Iodization Nationwide (ASIN LAW)
2e. Republic Act 8976: Philippine Food Fortification Act

#DIV/0! #DIV/0!
2f. Republic Act 11148 First 1000 Days Law

#DIV/0! #DIV/0!
2g. DOH Administrative Order 2010-0010: Revised Policy on

Micronutrient Supplementation
DOH Administrative Order 2008-0029: Implementing Health #DIV/0! #DIV/0!

Reforms for Rapid Reduction of Maternal and Neonatal Mortality
2h. DepED Orders:

1. 59-2 S. 2017 Weekly Folic Acid Supplementation for Female
Adolescents
2. 39 S. 2017 Operational Guidelines for School-based Feeding
Program
3. 13 S. 2017 Policy and Guidelines on Healthy Food Choices in
#DIV/0! #DIV/0!
Schools
4. 10-1 S. 2016 Policy Guidelines for Comprehensive WASH in
Schools MELLPI Pro Form B 26 of 36
DepED Memo No. 223 S. 2016 Strengthening Implementation of
Gulayan sa Paaralan Project
2h. DepED Orders:
1. 59-2 S. 2017 Weekly Folic Acid Supplementation for Female
Adolescents
2. 39 S. 2017 Operational Guidelines for School-based Feeding
Program
3. 13 S. 2017 Policy and Guidelines on Healthy Food Choices in #DIV/0! #DIV/0!
Schools
4. 10-1 S. 2016 Policy Guidelines for Comprehensive WASH in
Schools
DepED Memo No. 223 S. 2016 Strengthening Implementation of

Gulayan sa Paaralan Project
2i. NNC Governing Board Resolutions Nos. 1) 3

S.2012: Approving the Guidelines on the Fabrication, Verification,
and Maintenance of Wooden Height Boards #DIV/0! #DIV/0!
2) 3 S.2018: Approving the Guidelines on the Selection of Non-

Wood Height and Length Measuring Tool

2j. NNC Governing Board Resolution No.1 series of 2017:
Approving and Adopting the Philippine Plan of Action for
Nutrition 2017-2022
DILG MC 2018-42 Adoption and Implementation of PPAN 2017- #DIV/0! #DIV/0!
2022
2k. NNC Governing Board Resolution No.6 series of 2012: #DIV/0! #DIV/0!
Adoption of the 2012 Nutritional Guidelines for Filipinos
2l. NNC Governing Board Resolution No.2 series of 2012:

Approving the Revised Implementing Guidelines on Operation #DIV/0! #DIV/0!
Timbang Plus (OPT Plus)
2m. NNC Governing Board Resolution No. 2 series of 2009:

Adopting the National Policy on Nutrition Management in #DIV/0! #DIV/0!
Emergencies and Disasters
DIMENSION 3: GOVERNANCE AND ORGANIZATIONAL STRUCTURE
3a. Presence of Local Nutrition

#DIV/0! #DIV/0!
Committee (LNC)
3b. Functionality of the Local Nutrition

#DIV/0! #DIV/0!
Committee
3c. Presence of Nutrition Office

#DIV/0! #DIV/0!
and Personnel
3d. Decision-making and Leadership

#DIV/0! #DIV/0!
of the Local Nutrition Committee
DIMENSION 4: LOCAL NUTRITION COMMITTEE MANAGEMENT FUNCTIONS
4a. Planning #DIV/0! #DIV/0!
4b. LNC Mobilization #DIV/0! #DIV/0!
4c. Advocacy for Nutrition Program

#DIV/0! #DIV/0!
and Nutrition Workers
4d. Fund Source #DIV/0! #DIV/0!
4e. Interagency Monitoring and Evaluation #DIV/0! #DIV/0!
DIMENSION 5: NUTRITION INTERVENTIONS/SERVICES
5a. Infant and Young Child Feeding #DIV/0! #DIV/0!
5b. Philippine Integrated Management of Acute Malnutrition

#DIV/0! #DIV/0!

5c. National Dietary Supplementation Program #DIV/0! #DIV/0!
5d. Micronutrient Supplementation

#DIV/0! #DIV/0!
5e. Mandatory Food Fortification

#DIV/0! #DIV/0!

5f. Nutrition in Emergencies Program
#DIV/0! #DIV/0!
5g. Overweight and Obesity Management and Prevention #DIV/0! #DIV/0!

Program
5h. Nutrition-Sensitive Programs

#DIV/0! #DIV/0!
5i. Local initiatives 0.05
#DIV/0!
B-1c Diagram for Barangay Nutrition Monitoring
1. Vision and Mission
100.0
5. Nutrition Intervention/Services 50.0 2. Nutrition Laws and Policies

TARGET RATING
0.0 PERFORMANCE RATING
4. Local Nutrition Committee Management Functions 3. Governance and Organizational Structure
TARGET
DIMENSION RATING PERFORMANCE RATING
1. Vision and Mission 100.0 #DIV/0!
2. Nutrition Laws and Policies 100.0 #DIV/0!
3. Governance and Organizational Structure 100.0 #DIV/0!
4. Local Nutrition Committee Management Functions 100.0 #DIV/0!
5. Nutrition Intervention/Services 100.0 #DIV/0!
TOTAL RATING 100.0 #DIV/0!
REMARKS
TARGET
DIMENSION RATING PERFORMANCE RATING
1. Vision and Mission 100.0 #DIV/0!
2. Nutrition Laws and Policies 100.0 #DIV/0!

MELLPI Pro FORM B 2a: CHANGES IN THE NUTRITIONAL STATUS IN THE BARANGAY

ELEMENTS SOURCE RATING EVIDENCE
0 1 2 3 4
1 Prevalence of Increased No change in Decreased Sustained decrease Sustained decrease Barangay Nutrition Prevalence:
underweight 0-59 prevalence prevalence prevalence in prevalence for in prevalence for Action Plan Current year
months children compared to the compared to the compared to the the past two years the past three years Operation Timbang Previous year
previous year previous year previous year Report (previous Past two years
and Current year) Past three years
stunted 0-59 months prevalence prevalence prevalence in prevalence for in prevalence for Action Plan Current year
children compared to the compared to the compared to the the past two years the past three years Operation Timbang Previous year
previous year previous year previous year Report Past two years
Past three years

ELEMENTS RATING
3 Prevalence of wasted Increased No change in Decreased Sustained decrease Sustained decrease Barangay Nutrition Prevalence:
0-59 months children prevalence prevalence prevalence prevalence for the prevalence for the Action Plan Current year
compared to the compared to the compared to the past two years past three years Operation Timbang Previous year
previous year previous year previous year Report Past two years
Past three years
overweight and prevalence prevalence prevalence prevalence for the prevalence for the Action Plan Current year
obesity among compared to the compared to the compared to the past two years past three years Heath Office Previous year
children 0-59 months previous year previous year previous year Reports Past two years
children Past three years
5 Prevalence of wasted Increased No change in Decreased Sustained decrease Sustained decrease Barangay Nutrition Prevalence:
school-age children prevalence prevalence prevalence prevalence for the prevalence for the Action Plan Current year
compared to the compared to the compared to the past two years past three years School Weighing Previous year
previous year previous year previous year Reports Past two years
Past three years

ELEMENTS RATING
overweight and prevalence prevalence prevalence prevalence for the prevalence for the Action Plan Current year
obesity school-age compared to the compared to the compared to the past two years past three years School Weighing Previous year
children previous year previous year previous year Reports Past two years
Past three years
nutritionally at-risk prevalence prevalence prevalence prevalence for the prevalence for the Action Plan Current year
pregnant women compared to the compared to the compared to the past two years past three years Prenatal Records Previous year
previous year previous year previous year Heath Office Past two years
Reports Past three years
*LGU's with prevalence of underweight preschool children less than 5% will be given a rating of 4

MELLPI Pro FORM B 2b: SUMMARY OF CHANGES IN THE NUTRITIONAL STATUS IN THE BARANGAY
CHANGES IN THE NUTRITIONAL STATUS IN THE BARANGAY
1. Prevalence of underweight 0-59 months children #DIV/0! #DIV/0!
2. Prevalence of stunted 0-59 months children #DIV/0! #DIV/0!
3. Prevalence of wasted 0-59 months children #DIV/0! #DIV/0!
4. Prevalence of overweight and obesity among children 0-59 months children #DIV/0! #DIV/0!
5. Prevalence of wasted school-age children #DIV/0! #DIV/0!
6. Prevalence of overweight and obesity school-age children #DIV/0! #DIV/0!
7. Prevalence of nutritionally at-risk pregnant women #DIV/0! #DIV/0!
B-2c Diagram for Changes in Nutritional Status in the Barangay
1. Prevalence of underweight 0-59 months children
7. Prevalence of nutritionally at-risk pregnant women 100.0 2. Prevalence of stunted 0-59 months children
50.0
TARGET RATING
6. Prevalence of overweight and obesity school-age children 3. Prevalence of wasted 0-59 months children
5. Prevalence of wasted school-age children 4. Prevalence of overweight and obesity among children 0-59 months children
TARGET
ELEMENTS RATING PERFORMANCE RATING
1. Prevalence of underweight 0-59 months
children 100.0 #DIV/0!
2. Prevalence of stunted 0-59 months
3. Prevalence of wasted 0-59 months
4. Prevalence of overweight and obesity
among children 0-59 months children 100.0 #DIV/0!

5. Prevalence of wasted school-age children 100.0 #DIV/0!
6. Prevalence of overweight and obesity
school-age children 100.0 #DIV/0!
7. Prevalence of nutritionally at-risk
pregnant women 100.0 #DIV/0!
TOTAL RATING 100.0 #DIV/0!

REMARKS

ARANGAY

MELLPI PRO FORM B-3: DISCUSSION QUESTIONS FOR LEARNING AN
Barangay ___________________________________________ Municipality/ City/ Province
Date of Monitoring __________________________________________ Period Covered
Dimensions What are the issues and What are the good practices
problems and why done/initiated?
1 Vision and Mission
2 Nutrition Laws and Policies
3 Governance and Organizational

Structure
4 Local Nutrition Committee

Management Functions

Dimensions What are the issues and What are the good practices
problems and why done/initiated?
5 Nutrition Interventions/ Services
6 Changes in Nutritional Status in

the Local Government Unit

NS FOR LEARNING AND ACTION
____________________________________________________
____________________________________________________
What are the immediate actions What local initiatives have been
for improvement? done?

What are the immediate actions What local initiatives have been
for improvement? done?

MELLPI PRO FORM B-4: SUMMARY OF EVALUATION FINDINGS AND RECOMMENDATION & DIAGRAM FOR BARANGAY NUTRITION MONITO
B-1c Diagram for Barangay Nutrition Monitoring B-2c Diagram for Changes in Nutritional Status in the Bara
1. Prevalence
1. Vision and Mission
100.0 7. Prevalence of nutritionally at-risk pregnant women
5. Nutrition Intervention/Services 50.0 2. Nutrition Laws and Policies

TARGET RATING
6. Prevalence of overweight and obesity school-age children
4. Local Nutrition Committee Management Functions 3. Governance and Organizational Structure

5. Prevalence of wasted school-age childre
Major Findings (Use extra sheets if necessary)

Recommendations (Use extra sheets if necessary)
Name of Team Member Designation and Office

OR BARANGAY NUTRITION MONITORING AND CHANGES IN NUTRITIONAL STATUS
for Changes in Nutritional Status in the Barangay
1. Prevalence of underweight 0-59 months children
100.0
Prevalence of nutritionally at-risk pregnant women 2. Prevalence of stunted 0-59 months children
50.0
TARGET RATING
of overweight and obesity school-age children 3. Prevalence of wasted 0-59 months children
5. Prevalence of wasted school-age children 4. Prevalence of overweight and obesity among children 0-59 months children

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WELCOME

LOCAL GOVERNMENT NUTRITION

Date of Monitoring Period Covered

PERFORMANCE LEVEL REMARKS/

PERFORMANCE LEVEL REMARKS/

PERFORMANCE LEVEL REMARKS/

PERFORMANCE LEVEL REMARKS/

Enforcement of Milk Code

Building capacity of local implementers

Dietary supplementation of infants and young children 6-23 months

5d National Nutrition Promotion Program for Behavior Change*

17. Micronutrient Micronutrient Micronutrient Micronutrient Micronutrient Micronutrient FHSIS Report

5f Mandatory Food Fortification

5g Nutrition in Emergencies Program

NS Programs to improve physical access to food

NS Programs to prevent teen-age pregnancy

35. Local initiative 1

36. Local initiative 2

37. Local initiative 3

Barangay Municipality/ City/ Province

Date of Monitoring Period Covered

PERFORMANCE LEVEL DOCUMENT REMARKS/

MELLPI Pro Form B 25 of 36

MELLPI Pro Form B 26 of 36

Barangay Municipality/ City/ Province

Date of Monitoring Period Covered

PERFORMANCE LEVEL REMARKS/

MELLPI Pro Form B 3 of 36

MELLPI Pro Form B 4 of 36

MELLPI Pro Form B 5 of 36

MELLPI Pro Form B 6 of 36

MELLPI Pro Form B 7 of 36

MELLPI Pro Form B 8 of 36

MELLPI Pro Form B 9 of 36

Barangay Municipality/ City/ Province

Date of Monitoring Period Covered

PERFORMANCE LEVEL DOCUMENT REMARKS/

MELLPI Pro Form B 10 of 36

MELLPI Pro Form B 11 of 36

MELLPI Pro Form B 12 of 36

MELLPI Pro Form B 13 of 36

Barangay Municipality/ City/ Province

Date of Monitoring Period Covered

PERFORMANCE LEVEL DOCUMENT REMARKS/

MELLPI Pro Form B 12 of 36

MELLPI Pro Form B 13 of 36

MELLPI Pro Form B 14 of 36

MELLPI Pro Form B 15 of 36

Barangay Municipality/ City/ Province

Date of Monitoring Period Covered

PERFORMANCE LEVEL REMARKS/

MELLPI Pro Form B 15 of 36

Promotion of compliance to the Milk Code

5b Philippine Integrated Management of Acute Malnutrition

MELLPI Pro Form B 16 of 36

5c National Dietary Supplementation Program

Dietary supplementation of infants and young children 6-23 months

MELLPI Pro Form B 17 of 36

Dietary supplementation of wasted school children

MELLPI Pro Form B 18 of 36

12. Micronutrient Micronutrient Micronutrient Micronutrient Micronutrient Micronutrient FHSIS Report

MELLPI Pro Form B 19 of 36

MELLPI Pro Form B 20 of 36