WEEK 6

NUTRITION PROGRAM

I. PROGRAM STRATEGIES:
• Target the nutritionally at-risk and vulnerable. Priority is given to areas with high prevalence of
under-nutrition and micronutrient deficiencies among under five children.
• Promote Infant and young child feeding practices in various settings to reduce the prevalence of
underweight and stunted under-five children.
• Integrate and strengthen nutrition services in the maternal continuum of care.
• Promote universal access to the standard child survival package of interventions.
II. PROGRAM SITUATION
The Annual Operation Timbang by the Local Government Unit and the DepED annual nutrition
assessment of the school children. The statistics were categorized according to the three major
forms of malnutrition:
1. Protein Energy Malnutrition
Protein Energy Malnutrition (PEM) is one of the leading nutrition concerns in the country as
exhibited by poor physical growth. It is manifested by having low weight for age (underweight),
low weight for height (wasting/thinnes) and short height for age (stunting) resulting from
inadequate intake of energy or protein rich foods, failure to appropriately breastfeed or late
introduction of complementary foods to infants.

2. Micronutrient Deficiencies
Micronutrient deficiencies can cause inter-generational consequences. The level of health care
and nutrition that women receive before and during pregnancy, at childbirth and immediately
post-partum has significant bearing on the survival, growth and development of their fetus and
newborn. Undernourished babies tend to grow into undernourished adolescents. When
undernourished adolescents become pregnant, they in turn, may give birth to low-birth weight
infants with greater risk of multiple micronutrient deficiencies.

3. Overweight/Obesity.
Individuals with body mass exceeding 25 are considered overweight/obese.
Classification BMI (in imperial) BMI (in imperial)
Underweight < 18.50 < 3.79 < 3.79
Normal range 18.50 to 24.99 3.79 to 5.12
Overweight 25.00 to 29.99 5.13 to 6.14
Obese class I 30.00 to 34.99 6.15 to 7.16
Obese class II 35.00 to 39.99 7.17 to 8.18
Obese class III > 8.18 > 40.00
ORAL HEALTH PROGRAM

STRATEGIES AND ACTION POINTS:

1. Formulate policy and regulations to ensure the full implementation of OHP
a. Establishment of effective networking system (Deped, DSWD, LGU, PDA, Fit for School,
Academe and others)
b. Development of policies, standards, guidelines and clinical protocols
• Fluoride Use
• Toothbrushing
• Other Preventive Measures

2. Ensure financial access to essential public and personal oral health services
a. Develop an outpatient benefit package for oral health under the NHIP of the government
a. Develop financing schemes for oral health applicable to other levels of care (Fee for service,
Cooperatives, Network with HMOS)
b. Restoration of oral health budget-line item in the GAA of DOH Central Office

2. Provide relevant, timely and accurate information management system for oral Health.
a. Improve existing information system/data collection (reporting and recording dental services
and accomplishments)
• setting of essential indicators
• development of IT system on recording and reporting oral health service accomplishments
and indices
• integrate oral health in every family health information tools, recording books/manuals
b. Conduct Regular Epidemiological Dental Surveys – every 5 years

4. Ensure access and delivery of quality oral health care services.

a. Upgrading of facilities, equipment, instruments, supplies
b. Develop packages of essential care/services for different groups (children, mothers and
marginalized groups)
• revival of the sealant program for school children
• tooth brushing program for pre-school children
• outreach programs for marginalized groups
c. Design and implement grant assistance mechanism for high performing LGUs
• Awards and incentives
• Sub-allotment of funds for priority programs/activities
d. Regular conduct of consultation meetings, technical updates and program implementation
reviews with stakeholders

5. Build up highly motivated health professionals and trained auxiliaries to manage and provide
quality oral health care
a. Provision of adequate dental personnel
b. Capacity enhancement programs for dental personnel and non-dental person
ESSENTIAL HEALTH PACKAGES FOR THE ADOLESCENT and OLDER PERSONS
A. HEALTH PACKAGES FOR THE ADOLESCENT
In April 2000, DOH issued the Administrative Order 34- A s 2000, the Adolescent and Youth Health
(AYH) Policy, creating the Adolescent Youth Health Sub-program under the Children’s Health Cluster
of Family Health Office. In 2006, the department created the Technical Committee for Adolescent and
Youth Health Program, composed of both government and non-government organizations dedicated
to uplifting the welfare of adolescents and tasked to revitalize the program. Due to an increasing
health risky behaviour among our Filipino adolescents,

DOH embarked on revising the policy and to focus on the emerging issues of the adolescents which
are the 10 – 19 years old.

Program Components
1. Nutrition
2. National Safe Motherhood
3. Family Planning
4. Oral Health
5. National Immunization Program
6. Dangerous Drugs Abuse Prevention and Treatment
7. Harmful Use of Alcohol
8. Tobacco Control
9. Mental Health
10. Violence & Injury Prevention
11. Women and Children Protection
12. HIV/STI

HEALTH PACKAGES FOR THE ADOLESCENT

1. Violence: Sixteen percent of women age 15-19 have experienced physical violence at least once
in their life and 4.4% are survivors of sexual violence. Seventeen percent of Young Adult Fertility
and Sexuality Survey in 2013 (YAFSS) adolescent respondents have experienced violence in the
past year, and 23 % have been aggressors of violence between the aged 15 – 24 years old. Almost
half (47.7%) of 13-15 year old schoolchildren in the 2013 Global Scholl Health Survey (GSHS) have
experienced bullying and 4.8% of YAFSS adolescents have been harassed using technology.

2. Alcohol, Tobacco, and Illegal Substances: In the 2013 National Nutrition Survey (NNS), 6.8% of
adolescents are current smokers and 5.7% are former smokers. Fifteen percent (15.6%) of YAFSS
(2013) respondents are current smokers and 2.6% have ever used drugs. In YAFSS, 8.1% of
adolescents 15-19 years old have ever passed out drunk. The 2015 Global Youth Tobacco Survey
(GYTS), together with Global School Based Health Survey (GSHS) and YAFS describe other risk
behaviors. In 2015, GSHS found that 18.2% of schoolchildren 13-15 years old have experienced
being really drunk at least one drinking alcohol once one or more days during the past 30 days.
According GSHS, 11.0% have smoked cigarettes in the past month. In 2015, GYTS analyzed that a
total of 16.0% of the respondents currently use any tobacco product (smoked tobacco and/or
smokeless tobacco) and 28.1% of students are ever tobacco users.

3. Malnutrition: It is a double burden with 12.4% of adolescents wasted and 8.3% overweight or
obese. The latter is somewhat expected given that 42.2% consume soft drinks one or more times
per day while only 13.9% were physically active for a total of at least 60 minutes daily on five or
 more days during the past week. On the other hand, one in three (37.2%) pregnant adolescents
are nutritionally at risk (based on weight for- height classification.

4. Sexual and Reproductive Health: While General Fertility (GF) has significantly decreased since
1970, Age Specific Fertility Rates (ASFR) of adolescents has changed little. The 2017 National
Demographic and Health Survey (NDHS) places adolescent ASFR at 47 live births per 1,000 women
15-19 years old, up from 57 in the 2013 NDHS. According to YAFSS 4, data shows that in the
Philippines, an increasing proportion of adolescents and young people have early sexual
encounters. In 2013, 1 in 3 young people report having premarital sex. The prevalence of early
sexual encounters has increased over the last 20 years. Males are more likely to report having
premarital sex than females. In 2013, 36% of males reported having early sexual encounters
compared to 29% of females. The highest levels of early sexual encounters are reported in NCR
(41%) & Central Luzon (31%) regions. Also, many young people marry young, and it is important
that they have good information before they are married so that they can make healthy, informed
decisions.

5. HIV and AIDS: In April 2017, there were 629 new HIV antibody sero-positive individuals reported
to the HIV/ AIDS & ART Registry of the Philippines (HARP). More than half were from the 25-34
year age group while 30% were youth aged 15-24 years. 33 adolescents aged 10-19 years were
reported. All were infected through sexual contact were 8 male-female sex, 19 male-male sex, 6
sex with both males & females). From January 1984 to April 2017, 1,606 of the reported cases were
19 years old and below. Seven percent (111 out of 1,606) were children (less than 10 y/o) and
among them, 108 were infected through mother-to-child transmission, 1 through blood
transfusion and 2 had no specified mode of transmission. Ninety three percent (1,495 out 1,606)
were adolescents. Among these, 1,359 were male. Most of the adolescents were infected through
sexual contact 185 male-female sex, 843 male-male sex, 367 sex with both males & females), 85
were infected through sharing of infected needles, 8 through mother-to-child transmission, and 7
had no specified mode of transmission.

ESSENTIAL HEALTH PACKAGES OLDER PERSONS

In support of the RA 9257 (The Expanded Senior Citizens Act of 2003) and the RA 9994 (Expanded Senior
Citizen Act of 2010), the Department of Health issued Administrative Orders for health implementors to
undertake and promote the health and wellness of senior citizens as well as to alleviate the conditions of
older persons who are encountering degenerative diseases.

With the goal of Health and Wellness Program for Senior Citizen of promoting quality of life among older
persons and contribute to the nation building, the HWPSC intends to provide the following:
1. focused service delivery packages and integrated continuum of quality care,
2. patient-centered and environment standard to ensure safety and accessibility for senior citizens,
3. equitable health financing,
4. capacitated health providers in the implementation of health programs for senior citizens,
5. data base management, and
6. strengthened coordination and collaboration with other stakeholders involved in the
implementation of programs for senior citizens.