Mellpi Pro Form BNC

WELCOME
LOCAL GOVERNMENT NUTRITIO

MONITORING AND EVALUATIO
COME
MENT NUTRITION
ND 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
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 3
Action Plan Action Plan contribution to the other stakeholders’
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: BARANGAY PROFILE SHEET
Barangay Municipality/ City/

Province
TOTAL POPULATION NO. OF HOUSEHOLDS NO. OF SITIOS/ PUROKS
Population 0-59 mos 60-71 mos 72-120 mos Pregnant Lactating

No. of households with Estimated
access to safe water Actual
No. of households with 2019 Nutritional Status of Preschool Children

sanitary toilets Normal
Underweight
No. of Day Care Centers 0 Severely Underweight
Overweight
No. of public elementary
schools Normal
Wasted
No. of public secondary Severely Wasted
schools Overweight
Obese
No. of Barangay Health
Stations Normal
Stunted
No. of retail outlets/ Severely Stunted
sari-sari stores Tall
No. of bakeries Normal

Nutritionally at-risk
No. of public markets Overweight
Obese
No. of transport
terminals 2019 Nutritional Status of School Children
Normal
Percent of lactating mothers Wasted
exclusively breastfeeding Severely Wasted
until the 5th month Overweight
Obese
INTERVENTIONS WITH ACTION LINES FROM NGA/ NEW STANDARDS

Intervention Type NGA Responsible/ Available/ Date Volume/ Remarks
LGU Dept Responsible Received Y/N received No. of Pax
I. Philippine Integrated
Managements of Acute Training DOH/ C/MHO
Malnutrition
II. National Dietary

Suppplementation Program
1. Pregnant Women Training NNC
2. Children 6-23 months Training NNC
III. Micronutrient Supplementation
1. Iron-Folic Acid
Supplementation for Commodity DOH/ C/MHO
Pregnant Women
2. Vitamin A
children 6-11 months
3. Vitamin A
children 6-11 months
4. Micronutrient Powder
for children 6-23 months Commodity DOH/ C/MHO
5. Weekly Iron-Folic Acid

Supplementation for
female adolescents in Commodity DOH/ C/MHO
public schools
5. Weekly Iron-Folic Acid

Supplementation for
female adolescents in Commodity DOH/ C/MHO
outside the public school
system
IV. Mandatory Food Fortification

1. Retail outlets selling Equipment (WYD) LGU
adequately iodized salt
V. Nutrition-in-Emergencies
1. NiEM Plan integrated in
the Barangay Disaster Risk Training NNC
Reduction Management Plan
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 mission A vision mission The vision mission The vision mission The vision mission Barangay Nutrition
knowledge of vision statement for statement for statement for statement for statement for Action Plan
mission statement nutrition was nutrition was nutrition program nutrition program nutrition program Minutes of Meeting
formulated but not formulated and exists and exists and exists and Documentation of
reflected in the reflected in the disseminated to disseminated to disseminated to dissemination
Barangay Nutrition Barangay Nutrition BNC members BNC members and BNC members,
Action Plan Action Plan other stakeholders stakeholders and to
the rest of the
community
1b Presence of Nutrition-related Nutrition-related Nutrition-related Nutrition-related Nutrition outcomes Barangay
nutrition-related PAP is integrated in PAP are integrated PAP are integrated objectives are included in the Development Plan
concerns in the one of the sectoral in more than one of in the sectoral included in at least overall success
Barangay plans in the the sectoral plans plans of health, three of the indicators of the
Development Plan Barangay in the social welfare, sectoral plans Barangay
Development Plan Barangay education and Development Plan
Development Plan agriculture
1c Presence of At least one More than one More than two More than two More than two Annual Investment
nutrition-related nutrition-related nutrition-related nutrition-related nutrition-related nutrition-related Program
concerns in the PAP integrated in PAP integrated in PAP integrated in PAP integrated in PAP integrated in
Annual Investment the Annual the Annual the Annual the Annual the Annual
Program Investment Investment Investment ProgramInvestment Investment Program
Program Program under MOOE Program under under MOOE,
MOOE and Special Special Purpose
Purpose Appropriations
Appropriations (SPA) and external
(SPA) funds
MELLPI Pro Form B 27 of 36


1 2 3 4 5 EVIDENCE
2a Adoption, Barangay Nutrition The barangay passed a The barangay The PAPs in the The PAPs in the Resolutions
implementation and Action Plan formulated resolution adopting the passed a resolution Barangay Nutrition Barangay Nutrition Barangay Nutrition
monitoring of Barangay Nutrition adopting the Action Plan are Action Plan are Action Plan
Barangay Nutrition Action Plan Barangay Nutrition implemented and implemented and Approved Annual
Action Plan Action Plans and accomplishments are accomplishments are Budget
allocating funds reported during BNC reported during BNC PPAN
thereof meetings once a year meetings at least twice Accomplishment
a year Report
Minutes of meeting
2b Adoption of newly The barangay The law was discussed in The Barangay The barangay posted a The barangay Copy of the law
passed national/ maintains a printed/ one of the Barangay Nutrition copy of the resolution implemented activities Minutes of meetings
sectoral policies electronic copy of RA Nutrition Committee Committee passed in the barangay hall to disseminate Resolution
11148 meetings within one a resolution/ provisions of the law to Documentation of
Republic Act 11148 year after it was enacted ordinance adopting the general public posting and/or
Kalusugan at RA 11148 dissemination
Nutrisyon ng activities
Mag-Nanay Act of
2019
2c Republic Act 11037 The barangay The law was discussed in The Barangay The barangay posted a The barangay Copy of the law
Masustansyang maintains a printed/ one of the Barangay Nutrition copy of the resolution implemented activities Minutes of meetings
Pagkain Para sa electronic copy of RA Nutrition Committee Committee passed in the barangay hall to disseminate Resolution
Batang Pilipino 11037 meetings within one a resolution/ provisions of the law to Documentation of

1 2 3 4 5 EVIDENCE
year after it was enacted ordinance adopting the general public posting and/or
RA 11037 dissemination
activities
2d Adoption, The barangay The barangay has a The barangay The barangay The barangay conducted Copy of the law
implementation and maintains a printed/ resolution/ ordinance/ conducted activities conducted activities activities to promote Resolution/ Ordinance
monitoring of electronic copy of EO Executive Order and/or to promote to monitor and monitor compliance Barangay Nutrition
national/ sectoral 51 a line item in the compliance to EO compliance to EO 51 to EO 51 and follow Action Plan
nutrition policies Approved Annual Budget 51 through activities for Approved Annual
on EO 51 - related individuals/ facilities Budget
Executive Order 51: concerns with EO 51 violation Documentation of
National Code of promotion,
Marketing Breastmilk monitoring and
Substitutes, Breastmilk follow through
Supplements and Other activities conducted
Related Products for EO 51
2e Republic Act 10028: The barangay The barangay has a The barangay The barangay The barangay conducted Copy of the law
Expanded maintains a printed/ resolution/ ordinance conducted activities conducted activities to activities to monitor Resolution/ Ordinance
Breastfeeding electronic copy of RA and/or a line budget to promote monitor compliance compliance to RA 10028 Barangay Nutrition
Promotion Act of 10028 and/or DILG MC item in the Approved compliance to the to RA 10028 and maintains an Action Plan
2009 2011-54 Annual Budget on RA law updated masterlist of Approved Annual
10028 - related concerns establishments/ offices Budget
DILG Memorandum with lactation stations Documentation of
Circular 2011-54 promotion and
Implementation and monitoring
Monitoring of the Masterlist of
National establishments/
Breastfeeding Policy offices with
lactation stations

1 2 3 4 5 EVIDENCE
2f Republic Act 8172: An The barangay The barangay has a The barangay The barangay The barangay conducted Copy of the law
Act for Salt Iodization maintains a printed/ resolution/ ordinance conducted activities conducted activities to activities to monitor Resolution/ Ordinance
Nationwide (ASIN electronic copy of RA and/or a line item in the to promote monitor compliance compliance to RA 8172 Barangay Nutrition
Law) 8172 Approved Annual Budget compliance to the to RA 8172 and maintains an Action Plan
on RA 8172 - related law updated masterlist of Documentation of
concerns retail stores selling promotion and
iodized salt monitoring
Masterlist of
retail stores selling
iodized salt
2g Republic Act 8976: The barangay The barangay has a The barangay The barangay The barangay conducted Copy of the law
Philippine Food maintains a printed/ resolution/ ordinance conducted activities conducted activities to activities to monitor Resolution/ Ordinance
Fortification Act electronic copy of RA and/or a line item in the to promote monitor compliance compliance to RA 8976 Barangay Nutrition
8976 Approved Annual Budget compliance to the to RA 8976 and maintains an Action Plan
on RA 8976 - related law updated masterlist of Approved Annual Budg
concerns retail stores selling Documentation of
fortified foods promotion and
monitoring
Masterlist of
retail stores selling
fortified foods
2h NNC Governing The barangay The activities in the The activities in the The BNC monitors The BNC discuss the Resolutions
Board Resolution maintains a printed/ Barangay Nutrition Barangay Nutrition implementation of the result of monitoring and Ordinances
No.1 series of 2017: electronic copy of NNC Action Plan are Action Plan aligned activities aligned with identify action lines Barangay Nutrition
Approving and GB Resolution No. 1 S. aligned with the with the priorities the PPAN priorities in to improve Action Plan
Adopting the 2017 and/or DILG MC priorities of the of the PPAN the Barangay Nutrition implementation of the Approved Annual
Philippine Plan of 2018-42 PPAN 2017-2022 2017-2022 are Action Plan activities aligned with Budget
Action for Nutrition allocated with PPAN priorities Minutes of meeting
2017-2022 budget based on the Minutes of meeting
approved annual Accomplishment/
DILG MC 2018-42 budget Documentation
Adoption and reports
Implementation of
PPAN 2017-2022

1 2 3 4 5 EVIDENCE
2i NNC Governing The barangay The barangay procured The barangay uses The barangay uses The barangay uses Approved Annual
Board Resolutions maintains a printed/ any type of height height and length verified height and verified height and Budget
Nos. 1) 3 S.2012: electronic copy of NNC and length measuring tools of length measuring tools length measuring tools Local Nutrition
Approving the NNC GB Resolution measuring tools wooden/ non-wood of wooden/ of wooden/ non-wood Action Plan
Guidelines on the No. 3 S. 2012 and No. material as non-wood material as material as prescribed in OPT Plus Report
Fabrication, 3 S. 2018 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
Non-Wood Height
and Length
Measuring Tool
2j NNC Governing The LNC maintains a The barangay The barangay The barangay The barangay conducts OPT Plus
Board Resolution printed/ electronic conducts OPT Plus conducts OPT Plus conducts OPT Plus as OPT Plus, utilizes the Implementing
No.2 S.2012: copy of NNC NNC GB but not in accordance to as provided in the provided in the E-OPT tool and Guidelines
Approving the Resolution No. 3 the guidelines on the ff: guidelines: guidelines and uses disseminates results Barangay Nutrition
Revised S.2012 1. Use of proper 1. Use of proper E-OPT during the BNC meetings Action Plan
Implementing measurement tools measurement tools Consolidated OPT
Guidelines on 2. At least 80% coverage 2. At least 80% Plus Report
OPT Plus 3. Timely submission coverage Masterlist of
3. Timely submission malnourished children
Minutes of meeting
2k NNC Governing The barangay The barangay has a The barangay The barangay The barangay conducted Resolutions
Board Resolution No. maintains a printed/ resolution, ordinance, implemented at conducted more than more than two activities Ordinances
6 series of 2012: electronic copy of NNC Executive Order least one activity one activity to to promote the NGF Executive Order
Adoption of the 2012 NNC GB Resolution in support to the with promote the NGF Approved Annual
Nutritional Guidelines No. 6 S. 2012 resolution multi-stakeholder Budget
for Filipinos participation to Barangay Nutrition
promote the NGF Action Plan
Minutes of meeting
Accomplishment/
documentation
report
2l NNC Governing The barangay The barangay designated The barangay has Barangay Nutrition Barangay Nutrition Resolutions
Board Resolution No. maintains a printed/ the lead or focal point issued a resolution Cluster has been Cluster has been Ordinances
2 series of 2009: electronic copy of NNC for Nutrition-in- organizing the formed and planning formed and integrated Executive Order
Adopting the NNC GB Resolution Emergencies nutrition cluster in has been initiated/ with the BDRRMC with Barangay Nutrition

1 2 3 4 5 EVIDENCE
National Policy on No. 2 S. 2009 the area or its completed allocated budget Action Plan
Nutrition equivalent body NIEM Plan
Management in Minutes of meeting
Emergencies and
Disasters


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 the Action Plan
(BNC) membership is not include all Barangay Captain Barangay Captain Barangay Captain Resolutions
limited to 1 to 2 nutrition-related as chairperson and as chairperson, as chairperson, Executive Order
sectors only sectors as is composed of all composed of composed of Organizational
applicable in the nutrition-related nutrition-related nutrition-related Chart
barangay sectors in level 2 as sectors in level 2 as sectors in level 2 as
(pursuant to PPAN applicable in the applicable in the applicable in the
IG S.1981 and EO barangay barangay and is barangay and
234 S.1987) supported by a external partners,
1. Barangay Captain resolution is supported
2. Kagawad on indicating the by a resolution
Health functions of each indicating the
3. Rural Health member functions of each
Midwife member and
4. Child reorganized as
Development necessary
Worker

ELEMENTS RATING
5. School Principal/
Teacher
6. Agriculture
Technician
7. Barangay
Secretary
3b 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
the conduct of OPT
Plus or other activities
3c Decision-making and The BNC is The BNC is The BNC The BNC The BNC are Minutes of meeting
Leadership of the convened only convened more are convened at are convened at convened at least Barangay Nutrition
Barangay Nutrition once for the than once to least twice to: least three times to four times to Action Plan
Committee conduct of one disseminate 1. Disseminate accomplish accomplish Accomplishment
nutrition-related nutrition-related nutrition-related activities in level activites in level 4 Report
activity information information three and discuss and discuss
2. Formulate the implementation of progress of
Barangay Nutrition activities implementation of
Action Plan the Barangay
Nutrition Action
Plan


ELEMENTS RATING
4a Nutrition Assessment Updated Operation Only updated and Updated OPT Plus OPT Plus and Nutrition situation Consolidated OPT
Timbang Plus consolidated OPT reports in Level 2 school weighing prepared and used Plus reports
reports available Plus reports are and school reports in Level 3 in the formulation School weighing
but not available weighing reports used to prepare of the Barangay reports
consolidated available nutrition situation Nutrition Action Nutrition Situation
report Plan Barangay Nutrition
Action Plan
4b Planning Barangay Nutrition BNAP is formulated BNAP formulated BNAP formulated Three year BNAP is Barangay Nutrition
Action Plan is and adopted and adopted in Level 3 is integrated in the Action Plan
formulated but not through a through a reviewed and Barangay Resolutions
adopted through a resolution with resolution with updated at least Development Plan Minutes of Meeting
resolution allocation of funds allocation of fund once a year Barangay
adopts a three year Development Plan
format

ELEMENTS RATING
4c Resource Generation Only one activity in The budget for the The PAPs in the The budget for At least 90% of the Barangay Nutrition
and Mobilization the BNAP is funded BNAP is limited to BNAP are BNAP in the budget for BNAP in Action Plan
in the approved sectoral budgets in integrated in the approved annual the approved Annual Investment
barangay budget the approved Annual Investment barangay budget barangay budget Program
barangay budget Program includes personnel are released and Approved Annual
services, MOOE utilized LGU Budget
and program Summary of
Income and
Expenditures
4c Service Delivery Less than 50% of More than 50% of At least 80% of the More than 80% of 100% of the Barangay Nutrition
the vulnerable the vulnerable vulnerable the vulnerable vulnerable Action Plan
population are population are population are population are population are Masterlist of
targeted in delivery targeted in delivery targeted in delivery targeted in delivery targeted in delivery malnourished
of of of barangay-funded of barangay-funded of barangay-funded children
barangay-funded barangay-funded nutrition programs nutrition programs nutrition programs Masterlist of
nutrition programs nutrition programs beneficiaries
4d Monitoring and Monitoring Interagency Interagency Interagency Results of Barangay Nutrition

Evaluation conducted by BNS monitoring monitoring monitoring interagency Action Plan
only conducted but not conducted and conducted and monitoring Monitoring report
documented documented at documented at disseminated during Documentation
least once a year least twice a year BNC meeting/s and report
used in BNAP Minutes of meeting
formulation
4e Capacity Only one member Only two members Barangay Captain, Three BNC More than the Barangay Nutrition
Development of the Barangay of the Barangay Kagawad on Health members in Level 3three BNC Action Plan
Nutrition Nutrition and one BNC trained in NPM andmembers in Level 3 Barangay
Barangay Nutrition Committee trained Committee trained member trained on attended least onetrained in NPM and Development
Committee members on Nutrition on NPM NPM nutrition-related attended at least on Plan
Program trainings/ forums nutrition-related Training Cetificates
Management within the year training/ forum Documentation
within the year
Less than 100% of 100% of BNSs 100% of BNSs 100% of BNSs 100% of BNSs Barangay Nutrition
BNSs trained in trained in Basic trained in Basic trained in Basic trained in Basic Action Plan
Basic Course for Course for BNSs Course for BNSs Course for BNSs Course for BNSs Barangay
BNSs and at least one and at least one and at least one Development
trained in Nutrition trained in NPM and trained in NPM and Plan
Program less than 50% of BNSmore than 50% of Training Cetificates
Management one BNS attended at Documentation
nutrition-related least one
training/ forum nutrition-related
training/ forum

ELEMENTS RATING


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 oriented on Infant conducted conducted conducted activities Breastfeeding Support 0
barangay with and Young Child activities such as activities in Level 3 and maintains a list Group 0
written agreement Feeding and Milk peer counseling, and maintains a list of lactating mothers Directory of members
of its Code and provided sharing of of lactating and status of Documentation of activities
establishment and guidance in the experience and mothers and status breastfeeding and/or Masterlist of lactating
directory of conduct of peer assistance in of breastfeeding complementary mothers with breastfeeding
members counselling and breastfeeding and and/or feeding and conducts and complementary
referral complementary complementary follow through feeding status
feeding for feeding including activities until the
pregnant and information on lactating mother
lactating mothers those with have transitioned
breastfeeding or from exclusive
complementary breastfeeding to
feeding challenges continued
breastfeeding with
complementary
feeding

1 2 3 4 5 EVIDENCE
Establishment of breastfeeding places in barangay facilities
2. Lactation stations The barangay has The barangay has The barangay has The barangay has The barangay has (By ocular
established in one lactation one lactation one lactation one lactation more than one inspection)
barangay facilities station but not station with station with station with lactation station with Documentation
such as Barangay maintained adequate facilities adequate facilities adequate facilities, adequate facilities, report
Health Stations, (basic provisions in and accessible to is accessible to accessible to the Lactation station logbook
multi-purpose hall RA 10028, signages) the public the public and public and maintains of users
and in public maintains a a logbook of users
schools logbook of users
Promotion of compliance to the Milk Code
3. Activities The barangay have The Barangay The Barangay The Barangay Members of the Milk code materials
conducted to Milk Code materials Health Station is Health Station issued a Barangay Nutrition Ocular inspection of the
promote compliance posted in the compliant to the includes a resolution in Committee conduct Barangay Health Station
to Executive Order Barangay Health Milk Code discussion on Milk support of the Milk inspection in the IYCF classes learning
51, Milk Code Station Code in its Infant Code including Barangay Health materials
and Young Child regular inspection Stations at least Resolution
Feeding classes of Barangay Health twice a year to Documentation Report
for pregnant and Station/s ensure compliance of
lactating mothers health workers and
clients in the public
health facility
5b Philippine Integrated Management of Acute Malnutrition

#REF!
Provision of services for Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM)

1 2 3 4 5 EVIDENCE
4. Referral of The LGU only Barangay conducts Barangay conducts Barangay conducts Barangay conducts Masterlist of no refferal forms
severely and maintains a active case finding active case finding active case finding active case finding children with SAM
moderately acute master list of of SAM and MAM of SAM and MAM of SAM and MAM of SAM and MAM Referral forms
malnourished children with cases cases and refers cases, refers cases cases, refers cases
children to Barangay severe and cases to the to the appropriate to the appropriate
Health Stations moderate acute appropriate facility facility for PIMAM facility for PIMAM
and/or Rural Health malnutrition for PIMAM and monitors and monitors
Units the progress of the the progress of the
SAM and MAM casesSAM and MAM cases
enrolled but not enrolled and reports
reported monthly monthly
5c National Dietary Supplementation Program

0
Dietary supplementation of pregnant women
5. Nutritionally-at- The barangay The barangay The barangay The barangay The barangay Barangay Nutrition Action no at risk pregnant 1
risk pregnant women monitors the implements/ implements/ implements/ implements/ Plan mother 0
enrolled/ covered in nutritional status of coordinates the coordinates the coordinates the coordinates the Accomplishment/ 0
the dietary all pregnant women dietary dietary dietary dietary Documentation reports 1
supplementation supplementation supplementation supplementation supplementation NDSP Reports 0
program program and covers program and covers program and covers program and covers
less than 90% of at least 90% of the more than 90% of 100% of the target
the target pregnant target pregnant the target pregnant pregnant women for
women for women for 90 days women for 90 days 90 days but covers
90 days days but covers less days but covers at more than 80% of the
than 80% of target least 80% of the target population
population target population
Dietary supplementation of infants and young children 6-23 months
6. Infants and young The barangay The barangay The barangay The barangay The barangay Barangay Nutrition Action
children 6-23 months monitors the implements/ implements/ implements/ implements/ Plan
old enrolled in the nutritional status of coordinates the coordinates the coordinates the coordinates the Accomplishment/
dietary all infants and dietary dietary dietary dietary documentation

1 2 3 4 5 EVIDENCE
supplementation young children 6-23 supplementation supplementation supplementation supplementation report
program months program and covers program and covers program and covers program and covers Masterlist of
less than 90% of all at least 90% of all more than 90% of more than 90% of children 6-23
infants and young infants and young all infants and all infants and months
children 6-23 children 6-23 young children 6-23 young children 6-23
months for 90 - 120 months for 90 - 120 months for 90 - 120 months for 90 - 120
days days but covers less days but covers less days but covers less
than 80% of target than 80% of target than 80% of target
Dietary supplementation of children in child development centers and supervised neighborhood play
7. Children in child Child Development CDW shares BNC uses the data BNC implements BNC assesses the Minutes of meeting
development centers Worker (CDW) consolidated data on the nutritional the PAPs and effectiveness and Nutrition Situation
and supervised provides updates to the Barangay status of children in monitors the efficiency of the PAPs Local Nutrition Action Plan
neighborhood play on the Nutrition child development progress in formulated to Supplementary Feeding
provided with dietary Supplementary Committee and centers and improving the complement the Report
supplementation Feeding in Day Care used for the supervised nutritional status of supplementary Plan Implementation
Centers and preparation of the neighborhood play children in child feeding program in Report
Supervised nutrition situation for the development child development
Neighborhood Play in the area identification of centers and centers and
during the Barangay PAPs for supervised supervised 0
Nutrition preschool-age neighborhood play neighborhood play
Committee children in the local and provides
meeting/s nutrition action recommendations to
plan to improve
complement the implementation of
supplementary PAPs to achieve
feeding program better nutrition
outcomes
Dietary supplementation of wasted school children
8. Support to the Barangay Nutrition BNC member from The progress of The barangay The barangay School-based feeding
School-based Feeding Committee DepED shares implementation is provides utilizes the data program report
Program (SBFP) member from consolidated data shared by the assistance as shared but the Day Documentation report
targeting children DepED provides to the Barangay school and identified to the Care Workers in the Minutes of BNC meeting
from Kinder to Grade updates on the Nutrition discussed by the the School-based assessment and Barangay Nutrition Action
VI who are wasted School-based Committee and BNC to identify Feeding Program formulation of Plan

1 2 3 4 5 EVIDENCE
Feeding Program used for the areas where BNC (SBFP) activities in the
during the Barangay preparation of the can provide BNAP for school age
Nutrition nutrition situation assistance children
Committee meeting in the area
5d National Nutrition Promotion Program for Behavior Change
9. Nutrition Nutrition Nutrition Nutrition Nutrition Nutrition Barangay Nutrition Action

promotion activities promotion promotion promotion promotion promotion Plan
for behavior change activities targeting activities including activities including activities including activities including Documentation reports
conducted for mothers/ those integrated in those integrated in those integrated in those integrated in IEC materials
mothers/ caregivers caregivers other sectoral other sectoral other sectoral other sectoral Sectoral accomplishments
conducted activities targeting activities targeting activities targeting activities targeting
mothers/ mothers/ mothers/ mothers/
caregivers caregivers caregivers caregivers
conducted conducted and IEC conducted and IEC conducted and IEC
materials on materials on materials on
nutrition for nutrition for nutrition for
mothers/ mothers/ mothers/
caregivers available caregivers caregivers distributed
distributed and complemented
with other activities
promoting good
nutrition
10. Nutrition Activities in Activities in Activities for Activities for Activities for Barangay Nutrition Action
promotion for celebration of the celebration of nutrition month, nutrition month, nutrition month, Plan
behavior change National Nutrition National Nutrition breastfeeding breastfeeding breastfeeding Documentation reports
activities for the Month conducted Month, National awarenes month awarenes month awarenes month IEC materials
public conducted Breastfeeding and national food and national food and national food
Awareness month fortification day fortification day fortification day
and National Food conducted and conducted and conducted and
Fortification Day said campaigns reinforced in reinforced in
conducted reinforced in other other nutrition other nutrition
nutrition activities activities for the activities for the
for the year year, and printed/ year, and printed/
0
electronic IEC electronic IEC
materials on the materials on the
Nutritional Nutritional
Guidelines for Guidelines for
Filipinos (NGF) Filipinos (NGF)
available at the available and utilized
nutrition office/ during activities
barangay health

0

1 2 3 4 5 EVIDENCE
station for room
use
5e Micronutrient Supplementation
11. Pregnant women Iron-folic acid was Pregnant women Pregnant women Pregnant women Pregnant women FHSIS Report 0
provided with prescribed to were provided with were provided with were provided with were provided with Masterlist of pregnant 0
iron-folic acid pregnant women iron-folic acid iron-folic acid iron-folic acid iron-folic acid mothers who received 0
but not provided covering less than covering at least covering more than covering 100% of the iron-folic acid 0
90% of the target 90% of the target 90% of the target target for 180 days 0
for 180 days for 180 days 0
12. Vitamin A Vitamin A was One dose of One dose of One dose of One dose of vitamin FHSIS Report
provided to children prescribed to vitamin A provided vitamin A provided vitamin A provided A provided to 100% Masterlist of children 6-11
6-11 months old children 6-11 to less than 90% of to at least 90% of to more than 90% of children 6-11 months who received
months but not children 6-11 children 6-11 of children 6-11 months old Vitamin A
provided months old months old months old
13. Vitamin A Vitamin A was Two doses of Two doses of Two doses of Two doses of vitamin FHSIS Report
capsules provided to prescribed to vitamin A provided vitamin A provided vitamin A provided A provided 100% of Masterlist of children 12-59
children 12-59 children 12-59 to less than 90% of to at least 90% of more than 90% of children 12-59 months who received
months old months old but not children 12-59 children 12-59 children 12-59 months old Vitamin A
provided months old months old months old
14. Micronutrient Micronutrient Micronutrient Micronutrient Micronutrient Micronutrient FHSIS Report

powder provided to powder was powder provided to powder provided to powder provided to powder provided to Masterlist of children 6-23
young children 6-23 prescribed to young young children 6-23 young children 6-23 young children 6-23 young children 6-23 months who received MNP
months old children 6-23 months old but months old and months old and months old and
months old but not covers less than covers at least 90% covers more than covers 100% of the
provided 90% of the target of the target 90% of the target target

1 2 3 4 5 EVIDENCE
15. Weekly provision Iron-folic acid Iron-folic acid Iron-folic acid Iron-folic acid Iron-folic acid School-based Weekly Iron
of iron-folic acid tablets prescribed tablets provided tablets provided tablets provided tablets provided Folic Acid Supplementation
tablets to adolescent to adolescent weekly to less than weekly to 100% of weekly to 100% of weekly to 100% of Report
female learners in female learners in 100% of adolescent adolescent female adolescent female adolescent female Minutes of meeting
public schools public schools but female learners in learners in public learners in public learners in public
through Weekly Iron not provided public schools schools for two schools for two schools for two
Folic Acid (WIFA) cycles cycles and cycles, information
Supplementation information on the on the benefits of
Program benefits of WIFA WIFA disseminated
disseminated among parents and
among parents BNC member from
school provided
updates during
meeting/s
16. Weekly Iron Folic Iron-folic acid Iron-folic acid Iron-folic acid Iron-folic acid Iron-folic acid FHSIS Report
Acid (WIFA) provided tablets prescribed tablets provided tablets provided tablets provided tablets provided Masterlist of adolescents
to adolescent to adolescent weekly to less than weekly to at least weekly to more weekly to 100% of who received WIFA from
females in Grade 7 to females outside the 90% of adolescent 90% of adolescent than 90% of adolescent females Barangay Health Station
10 from private public school females through females through adolescent females through Barangay
schools, system but not Barangay Health Barangay Health through Barangay Health Stations
out-of-school provided Stations Stations Health Stations
adolescent females
and women aged
10-49 years not
covered by WIFA in
public schools
5f Mandatory Food Fortification
17. Retail outlets The LGU monitors Less than 90% of At least 90% of the At least 90% of the More than 90% of Barangay Nutrition Action 0
selling iodized salt retail outlets selling retail outlets selling retail outlets selling retail stores selling retail stores selling Plan 0
table salt iodized salt iodized salt adequately iodized adequately iodized Master list of retail 0
salt salt outlets selling 0
iodized salt

1 2 3 4 5 EVIDENCE
18. Bakery owners The LGU monitors Less than 90% of At least 90% of the More than 90% of 100% of bakery Barangay Nutrition Action
using vitamin A the type of flour the bakery owners bakery owners are bakery owners are owners are using Action Plan
fortified flour the bakeries use are using vitamin A using vitamin A using vitamin A vitamin A fortified Master list of
fortified flour in fortified flour in fortified flour in flour in baked bakeries using
baked products baked products baked products products fortified flour
19. Retail stores The LGU monitors Less than 90% of At least 90% of More than 90% of 100% of the retail Barangay Nutrition Action
selling retail stores selling the retail stores the retail stores the retail stores stores selling vitamin Action Plan
vitamin A fortified cooking oil selling vitamin A selling vitamin A selling vitamin A A fortified cooking oil Master list of
cooking oil fortified cooking oil fortified cooking oil fortified cooking oil markets selling
vitamin A fortified
cooking oil
5g Nutrition in Emergencies Program
20. 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
5h Overweight and Obesity Management and Prevention Program
21. Activities Information Information Information Information In addition to the Documentation report 0
promoting healthy dissemination on dissemination and dissemination, dissemination, parameters in Level IEC materials
diets and active Pinggang Pinoy and other activities distribution of IEC distribution of IEC 4, the LGU Resolution
lifestyle for active lifestyle for conducted to materials and other materials and formulated policies in Ocular inspection of safe,
preschool children preschool children promote Pinggang activities to conduct of other support of promotion open spaces and play
conducted conducted Pinoy and active promote Pinggang activities to of healthy diets and areas for children
lifestyle Pinoy and active promote Pinggang active lifestyle and 0
lifestyle Pinoy and active maintains safe and
inplemented and lifestyle open spaces and play
covered at least implemented and areas for children
50% of preschool covered more than
children 50% of preschool
children

1 2 3 4 5 EVIDENCE
22. Activities Information Information Information In addition to the In addition to the Documentation report
promoting proper dissemination on dissemination and dissemination, parameters in Level parameters in Level IEC materials
diet and healthy Pinggan Pinoy and other activities distribution of IEC 3, promotion of 4, the LGU maintains Resolution
lifestyle for the healthy lifestyle conducted to materials and other proper diet and safe open Ocular inspection of safe
general public for the general promote Pinggang activities healthy lifestyle is indoor/outdoor spaces for indoor/outdoor
0
conducted public conducted Pinoy and active conducted to supported by a physical activities physical activities
lifestyle promote Pinggang policy
Pinoy and active
lifestyle
5h Nutrition-Sensitive Programs
0.00
NS Programs to increase income and improve economic access to food
23. Eligible Less than 30% of Less than 50% of At least 50% of More than 50% of More than 50% of Barangay Nutrition Action
households with eligible households eligible households eligible households eligible households eligible households Plan
nutritionally with nutritionally with nutritionally with nutritionally with nutritionally with nutritionally Accomplishment/
vulnerable or vulnerable or vulnerable or vulnerable or vulnerable or vulnerable or documentation report
affected provided affected included in affected included in affected included in affected included in affected included in Master list of beneficiaries
with seed capital the provision of the provision of the provision of the provision of the provision of seed
assistance for seed capital/ seed capital/ seed capital/ seed capital/ capital/ material
livelihood material assistance material assistance material assistance material assistance assistance and
for livelihood for livelihood and and market-linkages
market-linkages market-linkages
24. Eligible Less than 30% of Less than 50% of At least 50% of More than 50% of More than 50% of Barangay Nutrition Action 1
households with eligible households eligible households eligible households eligible households households with Plan 0
nutritionally with nutritionally with nutritionally with nutritionally with nutritionally nutritionally Accomplishment/ 0
vulnerable or vulnerable or vulnerable or vulnerable or vulnerable or vulnerable or documentation report 0
affected provided affected included in affected included in affected included in affected included in affected included in Master list of beneficiaries 1
with livelihood the provision of the provision of the provision of the provision of the provision of 0
training livelihood training livelihood livelihood training livelihood training livelihood training 0
training and and and 0
industry-linkages industry-linkages industry-linkages
NS Programs to improve physical access to food
25. Gulayan sa Member of the BNC member from BNC uses the BNC implements BNC conducts data Minutes of meeting
Paaralan established Barangay Nutrition DepED shares data data in the PAPs in the monitoring of the Nutrition Situation
and maintained in Committee from to the local identification of barangay nutrition status of the Gulayan Local Nutrition Action Plan
school DepED provides nutrition PAPs in the action plan sa Paaralan and Documentation Report
updates on the committee and barangay nutrition complementing the determines possible
Gulayan sa used in the action plan to Gulayan sa assistance from the
Paaralan Project preparation of the complement the Paaralan Project BNC if necessary
during BNC nutrition situation Gulayan sa
meeting/s Paaralan Project

1 2 3 4 5 EVIDENCE
26. Households with Barangay provides Barangay provides Barangay provides Barangay provides Barangay provides Barangay Nutrition Action
nutritionally technical assistance technical assistance technical assistance technical assistance technical assistance, Plan
vulnerable or to households in and inputs for and inputs for and inputs for inputs for the Documentation Report
affected provided establishing establishing a establishing a establishing a backyard vegetable Master list of beneficiaries
with inputs for backyard vegetable backyard vegetable backyard vegetable backyard vegetable garden and conducts Monitoring report

1 2 3 4 5 EVIDENCE
backyard vegetable gardens garden to less than garden to at least garden to more monitoring of the
gardening 80% of households 80% of households than 80% of status of the gardens
with nutritionally with nutritionally households with at least twice a year
vulnerable or vulnerable or nutritionally
affected affected vulnerable or
affected
NS Programs to improve access to safe drinking water and sanitary toilet facilities
27. Households have Barangay conducts Barangay ensures Barangay ensures Barangay ensures Barangay ensures Barangay Nutrition Action
access to safe data monitoring of that less than 90% that at least 90% of that more than 90% that more than 90% Plan
drinking water the number of of households households have of households of households Documentation report
households with have access to safe access to safe have access to safe have access to safe Monitoring report
access to safe drinking water drinking water drinking water drinking water OPT Plus Family Profile 0
drinking water Masterlist of households
with access to safe drinking
water
28. Households have Barangay conducts Barangay ensures Barangay ensures Barangay ensures Barangay ensures Barangay Nutrition Action
access to data monitoring of that less than 90% that at least 90% of that more than 90% that more than 90% Plan
sanitary toilet the number of of households households have of households of households Documentation report
facilities households with have access to have access to have access to have access to Monitoring report
access to sanitary sanitary toilet sanitary toilet sanitary toilet sanitary toilet OPT Plus Family Profile
toilet facilities facilities facilities facilities facilities Masterlist of households
with access to safe drinking
water
29. Schools provided Member of the Member of the BNC uses the data BNC conducts data BNC conducts Minutes of meeting
with access to safe Barangay Nutrition Barangay Nutrition in identification of monitoring of the data monitoring of Nutrition Situation
water, adequate Committee from Committee from PAPs in the access to safe WASH in Schools Barangay Nutrition Action
toilets, handwashing DepED provides DepED shares data Barangay Nutrition drinking water, and determines Plan

1 2 3 4 5 EVIDENCE
facilities through the updates on the to the BNC and Action Plan to access to possible assistance Monitoring Report
WASH in Schools WASH in Schools used in the complement the functional toilets from the BNC if
(WinS) program Program during preparation of the WASH in Schools and access to necessary
BNC meeting/s nutrition situation Program handwashing
facilities in relation
to the nutritional
status of school
children
NS Programs to prevent teen-age pregnancy
30. Reproductive Barangay conducts Barangay conducts Barangay conducts In addition to the In addition to the Barangay Nutrition Action
health programs for data monitoring of data monitoring on data monitoring, parameters in Level parameters in Level Plan
adolescents teenage teenage assists in provision 3, the barangay also 4, the barangay also Monitoring Report
implemented pregnancies pregnancies and of services for provides policy mobilized the Documentation Report
assists in the adolescents and support for the Sangunianng Resolution
provision of conducts Adolescent Health Kabataan in
services for information Development cooperation with the
adolescents (e.g. dissemination Program Barangay Health
counseling) activities on Station to lead the
reproductive health activities for the
among adolescents Adolescent Health
Development
Program

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-mission statement
1b. Presence of nutrition-related concerns in the barangay

#DIV/0! #DIV/0!
development plan of mission statement
1c. Presence of nutrition-related concerns in the Annual

Investment Program (AIP)
#DIV/0! #DIV/0!
PERFORMANCE RATING #DIV/0!
DIMENSION 2: NUTRITION LAWS AND POLICIES
2a. Adoption, implementation and monitoring of local

#DIV/0! #DIV/0!
nutrition plan
2b. RA 11148 Kalusugan at Nutrisyon ng Mag-Nanay Act of

#DIV/0! #DIV/0!
2018
2c. RA 11037 Masustansyang Pagkain para sa Batang Pilipino

#DIV/0! #DIV/0!
2d. EO 51 National Code of Marketing of Breastfeeding

#DIV/0! #DIV/0!
Substitutes, Breastmilk Supplements and related products
2e. RA 10028 Expanded Breastfeeding Promotion Act

#DIV/0! #DIV/0!
2f. RA 8172 An Act for Salt Iodization Nationwide

Err:508 Err:508
2g. RA 8976 Philippine Food Fortification Act

Err:508 Err:508
2h. NNC GB Resolution No. 1 S. 2017 Approving and Adopting

Err:508 Err:508
the Philippine Plan of Action 2017-2022
2i. NNC GB 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 GB Resolution No. 2 S. 2012 Approving the Revised
Implementing Guidelines on OPT Plus #DIV/0! #DIV/0!
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 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 Barangay Nutrition Committee

#DIV/0! #DIV/0!
3b. Presence of Nutrition Office and Personnel

Err:508 Err:508
3c. Decision-making and leadership of the Barangay Nutrition

#DIV/0! #DIV/0!
Committee
DIMENSION 4: LOCAL NUTRITION COMMITTEE MANAGEMENT FUNCTIONS
4a. Nutrition Assessment #DIV/0! #DIV/0!
4b. Planning #DIV/0! #DIV/0!
4c. Resource Generation and Mobilization #DIV/0! #DIV/0!
4d. Service Delivery #DIV/0! #DIV/0!
4e. Monitoring and Evaluation #DIV/0! #DIV/0!
4f. Capacity Building #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

#REF! #REF!
5c. National Dietary Supplementation Program 0.00 0.00
5d. National Nutrition Promotion Program for Behavior Change #DIV/0! #DIV/0!
5e. Micronutrient Supplementation

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

#DIV/0! #DIV/0!

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

Program
5i. Nutrition-Sensitive Programs

0.00 0.00
5i. Local initiatives 0.05 Err:508
#REF!
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 RATING
1 Prevalence of Increased No change in Decreased Sustained decrease Reduction/ Barangay Nutrition Prevalence:
underweight 0-59 prevalence prevalence prevalence in prevalence for maintenance of Action Plan Current year
months children compared to the compared to the compared to the the past two years prevalence of Operation Timbang Previous year
previous year previous year previous year malnutrition to Report (previous Past two years
lower than public and Current year)
health significance
(<5%) in the past
two years
stunted 0-59 months prevalence prevalence prevalence in prevalence for maintenance of Action Plan Current year
children compared to the compared to the compared to the the past two years prevalence of Operation Timbang Previous year
previous year previous year previous year malnutrition to Report Past two years
lower than public
health significance
(<10%) in the past
two years

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

ELEMENTS RATING
overweight and prevalence prevalence prevalence prevalence for the maintenance of Action Plan Current year
obesity school-age compared to the compared to the compared to the past two years prevalence of School Weighing Previous year
children previous year previous year previous year malnutrition to Reports Past two years
lower than public
health significance
(<5%) in the past
two years
7 Prevalence of No data indicative Data indicative of Barangay Nutrition Prevalence:

nutritionally at-risk of nutrition status nutritional status of Action Plan Current year
pregnant women of pregnant women pregnant women Prenatal Records Previous year
is available available and Heath Office Past two years
covers 100% of Reports
pregnant women

MELLPI Pro FORM B 2b: SUMMARY OF CHANGES IN THE NUTRITIONAL STATUS IN THE BARANGAY
Barangay Dungeg Municipality/ City/ Province
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
0.0 PERFORMANCE 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

MELLPI PRO FORM B-3: DISCUSSION QUESTIONS FOR LEARNING AND ACTION
Barangay ___________________________________________ Municipality/ City/ Province ____________________________________________________
Date of Monitoring __________________________________________ Period Covered ____________________________________________________
Dimensions What are the good practices What are the issues and What local initiatives have been What are the immediate actions
done/ inititated? problems and why? done? for improvement?
1 Vision and Mission
1
2 Nutrition Laws and Policies
3 Governance and Organizational

Dimensions What are the good practices What are the issues and What local initiatives have been What are the immediate actions
done/ inititated? problems and why? done? for improvement?
Structure
4 Local Nutrition Committee

Management Functions
5 Nutrition Interventions/ Services
6 Changes in Nutritional Status in

the Local Government Unit

MELLPI PRO FORM B-4: SUMMARY OF EVALUATION AND RECOMMENDATION
B-1c Diagram for Barangay Nutrition Monitoring B-2c Diagram for Changes in Nutritional Status in the Barangay
1. Prevalence of underweight 0-59 months children

1. Vision and Mission
100.0
100.0 7. Prevalence of nutritionally at-risk pregnant women 2. Prevalence of stunted 0-59 months children
50.0
5. Nutrition Intervention/Services 50.0 2. Nutrition Laws and Policies
TARGET RATING TARGET RATING
0.0 PERFORMANCE RATING 0.0 PERFORMANCE RATING
6. Prevalence of overweight and obesity school-age children 3. Prevalence of wasted 0-59 months children
4. Local Nutrition Committee Management Functions 3. Governance and Organizational Structure

5. Prevalence of wasted school-age children 4. Prevalence of overweight and obesity among children 0-59 months children

Major findings
Recommendations (Use extra sheets if necessary)

MELLPI PRO FORM B-4: SUMMARY OF EVALUATION FINDINGS AND RECOMMENDATION
Recommendations (Use extra sheets if necessary)
Name of Team Member Designation and Office Signature Date Signed

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WELCOME

LOCAL GOVERNMENT NUTRITIO

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/

TOTAL POPULATION NO. OF HOUSEHOLDS NO. OF SITIOS/ PUROKS

Population 0-59 mos 60-71 mos 72-120 mos Pregnant Lactating

No. of households with 2019 Nutritional Status of Preschool Children

No. of bakeries Normal

INTERVENTIONS WITH ACTION LINES FROM NGA/ NEW STANDARDS

II. National Dietary

1. Pregnant Women Training NNC

2. Children 6-23 months Training NNC

III. Micronutrient Supplementation

5. Weekly Iron-Folic Acid

5. Weekly Iron-Folic Acid

IV. Mandatory Food Fortification

Barangay Municipality/ City/ Province

Date of Monitoring Period Covered

PERFORMANCE LEVEL DOCUMENT REMARKS/

MELLPI Pro Form B 27 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

Barangay Municipality/ City/ Province

Date of Monitoring Period Covered

PERFORMANCE LEVEL DOCUMENT REMARKS/

MELLPI Pro Form B 9 of 36

MELLPI Pro Form B 10 of 36

Barangay Municipality/ City/ Province

Date of Monitoring Period Covered

PERFORMANCE LEVEL DOCUMENT REMARKS/

MELLPI Pro Form B 12 of 36

4d Monitoring and Monitoring Interagency Interagency Interagency Results of Barangay Nutrition

MELLPI Pro Form B 13 of 36

MELLPI Pro Form B 14 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