Uplifting and Normalizing Malnourished Children of Lamut, Ifugao through Macro and Micro Nutrient Supplementation and Advocacy Analysis

+ Presence of a national program on malnutrition; where the municipal programs are anchored—Vitamin A supplementation, Asin Law, Operation Timbang, Macro and Micro nutrient supplementation programs (Vitamin A, Iron and Iodine supplementation);

+ Local Government Unit with a Municipal Nutrition Action Program (MNAP);

+ Convergence Mechanism among MSWO, MHO, and MAO on nutrition;

+ Barangay LGUs serve as the local converging institution in all barangays;

+ Twelve  Barangays LGUs covered by the MNAP;

+ Municipal Local Health Board supporting the program;

+ The BNS can be mobilized for the project;

+ Presence of local NGOs—LAGSADECO and LAWO participating in local development efforts;

+ PEF through CORDNET.

- The MNAP has limited coverage and funding;

- MNAP was seen primarily as a  “dole out” project;

- Lack of experience in project implementation (first time of LAWO to implement a project, specifically a nutrition project)

+ Development funds from PEF through the CORDNET (P255,420);

+ Regular budgets of the convergence team;

+ LGU committed P75,000 in counterpart funds.

- Limited LGU IRA (P18 million per year), that could limit Convergence Team’s mobility (e.g., lack of transportation especially in areas with rugged terrain), resulting in limited service delivery and minimal municipal counterpart funds

+ Existing systems and procedures in the delivery of services (e.g., feeding program);

+ Systems and procedures in the assessment and monitoring of children’s nutritional status (e.g., using Body Mass Index [BMI], physician’s evaluation procedures, etc.)

- There are no formal community organizations or people’s organizations in the barangays, except for some areas where LAGSADECO operate.

+ LGU core set of personnel (one doctor, one nurse, midwives, one BNS per barangay, one BHW per barangay, social welfare officer/ and staff, agriculturists) that already work for the project;

+ LAWO officers and staff;

+ LAWO’s president is a nutritionist by profession and knows nutrition well;

+ Mothers that can be mobilized for the project—assisting in the food preparation and feeding of the children during feeding sessions;

+ Some concerned community residents/ mothers;

+ Majority of the target/ affected families are cooperative—they have a high degree of acceptance of the project and express support for the project.

- The lack of health professionals (e.g., there is only one  doctor, one  nurse and four  midwives covering all eighteen barangays;

- LAWO lacks permanent personnel--its officers are also the executive officers and staff;

- Lack of knowledge among the parents on various foods and their nutritional values;

- Thus, they only eat what they have been  accustomed to eat;

- This leads to very few families planting vegetables in their backyard because majority do not know how to cook them, or worse, they do not know they are edible;

- There were 139 children they needed to rehabilitate;

- Pregnant women and lactating mothers who do not know much about nutrition;

- Lack of commitment of some BNS personnel due to very low financial incentives;

- Laziness of some mothers.

+ Counterparting is a very important part of the local culture, as part of the community spirit (i.e., napateg in Ilocano, meaning intense or deep-seated)

- Dole-out mentality of the people—they will not participate if there are no tangible benefits that they can derive;

- Social stigma attached to having a malnourished child—parents have a hard time accepting this reality due to pride;

- Some negative cultural practices:

- The father should eat first because he is the one working, thus he should have the biggest portion of the meal.  Usually, half of the family’s meal goes to the father alone.

- They prioritize buying or growing betel nuts over food because these  satiate their hunger.

- Some cultural traditions and beliefs are perceived to be making the poor people poorer, e.g., practices of Cañao and dowry

+ The beneficiaries have an available plot that they can use for backyard gardening.

- Geographically, Lamut is far from the oceans which is a source of iodine micronutrients;

- Their backyards are not maximized for food production due to the lack of knowledge about  other vegetables that they can eat

+ MAO has technology on bio-intensive backyard gardening;

+ Availability of Micronutrient supplements—Vitamin A, Iodine, Iron and Vitameal;

+ Simple and affordable recipes are available and can be taught to the mothers.

- The communities lack appropriate technology on nutrition

• Presence of a national program on malnutrition where the municipal programs are anchored—Vitamin A supplementation, Asin Law, Operation Timbang, Macro and Micro nutrient supplementation programs (Vitamin A, Iron and Iodine supplementation);
• Local Government Unit with a Municipal Nutrition Action Program (MNAP);
• Convergence Mechanism among MSWO, MHO, and MAO on nutrition;
• Twelve Barangays LGUs covered by the MNAP;
• Municipal Local Health Board supporting the program;
• Presence of local NGOs—LAGSADECO and LAWO participating in local development efforts;
• PEF through CORDNET.

• Institutional Development and Partnership Expansion
  • Broadening of Stakeholder Capital base that would result in an  increase in physical and financial capital;
  • Strengthening of the Convergence Team;
  • Institutionalization of the Program at the Municipal and Barangay Levels.

• The MNAP has limited coverage and funding;
• MNAP was seen as a “dole out” project;
• First time of LAWO to implement a project, specifically a nutrition project;

• Development funds from PEF through the CORDNET (P255,420);
• Regular budget for the convergence team ;
• LGU committed P75,000 in counterpart funds

• Leveraging of Funds:
• LGU funds with PEF/CORDNET Funding and other sources of financial and physical capital;
• Capital Mobilization activities;
• Institutionalization of the Program through annual budget allocation at the Municipal and Barangay Levels.

• Limited LGU IRA (P18 million per year), that could limit Convergence Team’s mobility (e.g., lack of transportation especially in areas with rugged terrain) resulting in limited service delivery and minimal municipal counterpart funds.

• The BNS can be mobilized for the project.
• Existing systems and procedures in the delivery of services (e.g., feeding program)
• Systems and procedures in the assessment and monitoring of children’s nutritional status (e.g., using Body Mass Index [BMI], physician’s evaluation procedures, etc.);
• Barangay LGUs serve as the local converging institution in all barangays.

• “Business Not Usual” approach through:
  • Adoption of participatory approaches;
  • Emphasizing the important role of Barangay LGU on nutrition;

• There are no formal community organizations or people’s organizations in the barangays, except for some areas where LAGSADECO operate.

• LGU core set of personnel (one doctor, one nurse, midwives, one BNS per barangay, one BHW per barangay, social welfare officer/ and staff, agriculturists) that already work for the project;
• LAWO officers and staff;
• LAWO’s president is a nutritionist by profession who knows nutrition well;
• Mothers and some concerned community residents/ mothers that can be mobilized for the project—assisting in the food preparation and feeding children during feeding sessions;.
• Majority of the targeted/ affected families are cooperative—they have a high degree of acceptance of the project and expressed support to the project.

• Pooling and Developing Human Resources:
• Tapping External Experts;
• Mobilizing Mothers and other community members/ Community Volunteers;
• Team Approach to attacking the problem of Malnutrition through the Convergence Team;
• Increased knowledge and developed skills through Training and IEC Activities.

• The lack of health professionals (e.g., there is only one  doctor, one nurse and four  midwives covering all eighteen barangays;
• LAWO lacks permanent personnel--Its officers are also the executive officers and staff;
• Lack of knowledge among the parents on various foods and their nutritional values;
• Thus, they only eat what they have been  accustomed to eat;
• This leads to very few families planting vegetables in their backyard because majority do not know how to cook them, or worse, they do not know that they are edible;
• There were 139 children they needed to rehabilitate;
• Pregnant women and lactating mothers who do not know much about nutrition;
• Lack of commitment of some BNS personnel due to very low financial incentives;
• Laziness of some mothers.

• Counterparting is a very important part of the local culture, as part of the community spirit (i.e., napateg in Ilocano)

• Banking on strong cultural capital/asset and acculturation on food preparation

• Dole-out mentality of the people—they will not participate if there are no tangible benefits that they can get;
• Social stigma attached to having a malnourished child—parents have a hard time accepting this reality due to pride.

• The beneficiaries have an available plot that they can use for backyard gardening.

• Sustainable use of available land for backyard vegetable gardening.

• Geographically, Lamut is far from the oceans which is a source of iodine micronutrients
• Their backyards are not maximized for food production due to lack of knowledge on other vegetables that they can eat.

• MAO has technology on bio-intensive backyard gardening;
• Availability of Micronutrient supplements—Vitamin A, Iodine, Iron and Vitameal;
• Simple and affordable recipes are available and can be taught to the mothers.

• Customizing technologies
• Developing technologies

• The communities lack appropriate technology on nutrition

• Twelve out of the eighteen  barangays are now funding community health projects;
• The Sangguniang Bayan through the Municipal Health Board has passed  legislation to support the project;
• Increase in the number of partners for health and nutrition projects.  These include:
  • IFEDECO (Ifugao Federation of Development Cooperatives);
  • Medical/ Drug Companies; 
  • Armed Forces of the Philippines; 
  • Feed the Children-Philippines; 
  • LAGSADECO.

• P3,000 – 6,000 annual appropriation from the Barangay LGU for health projects;
• P50,000 annual appropriation by the Municipal Health Board;
• Imputed counterpart of parents (labor, contributions for feeding program);

• At the LGU Level: Improved systems and procedures in the delivery of services and in terms of informal procedures on capital mobilization;
• At the community level: BNS, BHWs and parents/families have improved systems in feeding, monitoring and evaluation.

• The BNS and BHWs gained additional knowledge in macro and micro nutrient supplementation, maternal and childcare, since they also benefited from the training they conducted for the mothers.
• 505 mothers have become more knowledgeable about nutrition and maternal and child care;
• 129 children are more healthy, thus preventing them from catching common illnesses, and school children can be expected to have better academic performance;
• Mothers can now experiment on various menus to suit the family’s budget and their taste preferences.

• Improved commitment of BHW and BNS personnel;
• “Dole-out” mentality of the target families was reduced because of their participation in the project;
• Changed their eating habits because they were exposed to other foods that hey they were not  accustomed to eat, thus widening their food choices, as well as adopting healthier food preparation practices.

• The use of their backyards is maximized by planting vegetables that they can consume and become a source of additional income.

• Introduction of alternative menus/recipes for poor families as a replacement for the Vita Meal.