Percentage of Malnourished children over the course of 4 years
 |
| Percentage of Underweight Children |
Percentage of Wasted Children
Nutritional status and the baseline data
If the weight-for-age of a child is low compared to a
reference population of well nourished and healthy children, the child is
classified as underweight. It is estimated that the deaths of 3.7 million
children aged less than five are associated with the underweight status of the
children themselves or their mothers (source: Comparative Quantification of
Health Risks, 2004). Of the three growth standards, more children in Mirangan
are underweight, which is mostly attributed to undernourishment – the child’s
food intake does not include enough calories (energy) to meet minimum
physiological needs. Thirty percent among 244 children were underweight and 12%
were severely underweight in year 2011.
Stunting reflects shortness-for-age, which is an indicator of
chronic malnutrition and calculated by comparing the height-for-age of a child
with a reference population of well nourished and healthy children. This type
of malnutrition is irreversible once the child reaches the age of 2 years old. Chronically malnourished children can lead to delayed motor
development, impaired cognitive function and poor school performance. In 2011,
24% among children were stunted and 7% were severely stunted.
Wasting reflects
a recent and severe process that has led to substantial weight loss, usually
associated with starvation and/or disease. It is is calculated by
comparing weight-for-height of a child with a reference population of
well-nourished and healthy children. This form of malnutrition immediately
carries the increased risk of morbidity and mortality. These children have a
higher risk of dying from common diseases such as diarrhea and pneumonia than
normally nourished children. In Barangay Mirangan, 17% were wasted and 11% were
severely wasted.
Overall, 47% among children aged 5 years old
and below were malnourished in 2011. Malnutrition is frequently part of a
vicious cycle that includes poverty and disease. These three factors are
interlinked in such a way that each contributes to the presence and permanence
of the others (WHO). Malnutrition in children is the consequence of a range of
factors, that are often related to poor food quality, insufficient food intake,
and severe and repeated infectious diseases, or frequently some combinations of
the three. These conditions, in turn, are closely linked to the overall
standard of living and whether a population can meet its basic needs, such as
access to food, housing and health care. Therefore, in order to effectively
break this vicious cycle, strategies must be designed using this
multi-factorial approach.
The Team Mauswagong Mirangan
2015 formulated
solutions in collaboration with the community and local agencies in order to
address the problem on poor nutritional status among children under 5 years.
The formulation of Sustansyang Tatak
Mirangan was rooted in four (4) major approaches namely: Community
Engagement and Collaboration, Education and Promotion, Growth Monitoring, and
Food Security.
Given the multi-factorial problem of
malnutrition, a series of consultations and collaboration of the community was
done and presented to the key persons in the barangay. A set of action plans was formulated using strategies
that are appropriate for the community.
Formulation of Sustansyang Tatak Mirangan 4-Year Health Plan
Sustansyang Tatak Mirangan 4 – Year Health Plan (March – April 2012): Evaluated and approved by the Municipal Health Officer
Sustansyang Tatak Mirangan 4 – Year Health Plan (March – April 2012): Evaluated and approved by the Provincial Nutrition Action Officer
Sustansyang Tatak Mirangan 4 – Year Health Plan (March – April 2012): Women’s Association officers identified as one of the project’s key persons
To address the lack of access to information, culturally-appropriate
and socially-acceptable communication materials were developed and placed in
strategic areas. Other forms of media were also used, such as broadcasting key
messages on nutrition at a local radio station.
Radio guesting at Radyo Suhnan 98.7 FM with station manager, Mr. Jerry Kimos, on the importance of good nutrition.
Promotional Tools (October 2012 – February 2015): Communication materials being put up in strategic areas i.e. Sari-Sari Stores; Advocacy posters for nutrition
Health education series were also conducted to
target population, namely to mothers and to schoolchildren. The different forms
of education such as lectures, cooking demonstrations and role plays were used
in order to effectively relay the information
Mother’s Class (2012-2014): Conducted with topics on Proper Nutrition and breastfeeding for the mothers and primary caregivers of Barangay Mirangan
Buntis Congress (Aug. 21, 2014): Discussion of nutrition in pregnancy, as well as games such as Pinoy Henyo were played by participants
Nutri-Show Part 4 (January 2015): Mrs. Mary Grace Detablan (left) conducted the cooking demonstration of: “Tortang Kangkong (Swamp Cabbage Patties) (middle).” Free samples were distributed to the attendees (right).
A certificate and cash prize was awarded to the president of the association, Mrs. Rosie Guevara
Application of Learnings (December 16, 2014): “Barangay Susta-Gulaman” served as the Mirangan Women’s Association entry during the Cooking Contest in celebration of the 58th Araw ng Siay on December 16, 2014 in its theme: “Kinaiyahan Panggaon, Sama sa Pagpangga sa Kaugalingon.” The entry won 1st place in the Dessert Category.
Performance of Gulay Fairy
Health Education on Go, Grow and Glow Foods (March 2012): Learn and play method was used wherein students were divided into teams to classify the cutout fruits and vegetables into go, grow and glow foods with a post-activity synthesis
Nutrition Month 2014 Culminating Activity (July 22, 2014): Creative performances were presented, awarding of prizes for the winners of the contests, a tiangge showcase per classroom and a salo-salo during lunch time
Promotion of Healthy Eating and Physical Activity (July 2014): Discussion of the “10 Nutritional Guidelines for Filipinos” from the National Nutrition Council (NNC) per grade level.
Poster-Making Contest (July 11, 2014): 9 participants from grades 4-6 created posters in accordance to the Nutrition Month 2014 theme: “Kalamidad Paghandaan: Gutom at Malnutrisyon Agapan”.
Quiz Bee (July 17, 2014): 31 participants from grades 4-6 wherein knowledge on nutrition topics were tested
Children’s Hour (March 2013): Educational games, lessons on nutrition and song and dance incorporating key nutrition messages done for students 5 times a week for a duration of 1 month of their summer break.
The
utilization of a behavior change strategy, Trials of Improved Practice (TIPs)
Methodology, was used in order to involve the mothers and caregivers in
improving their feeding practices. This was done by means of home visits and
counseling. Establishment of a breastfeeding station in the barangay’s local
health station was also accomplished in order for the health workers to teach
proper breastfeeding techniques and provide counseling to mothers. This area
also provided mothers with privacy and comfort while breastfeeding their child.
Trials of Improved Practices (TIPs) Methodology on teaching mothers appropriate feeding practices for children. House to house assessment, counseling and evaluation done by BHWs and BNS on target households with 85% coverage (46 of 54 target households)
Establishment of Breastfeeding Station (January – February 2015): A breastfeeding station was created to provide privacy for mothers during breastfeeding as well as to provide an avenue for health workers to conduct counseling on breastfeeding. The room has a bed, a chair, a handwashing station and IECs on breastfeeding. Promotion of Healthy Eating and Physical Activity (July 2014): Discussion of the “10 Nutritional Guidelines for Filipinos” from the National Nutrition Council (NNC) per grade level.
Growth
monitoring and updating of database is key to determine whether the strategies
being implemented are effective in decreasing the malnutrition rate of the
community. A nutrition data board was introduced, wherein children under 5
years old were classified according to their nutritional status and their
geographical location per hamlet. This way, children can be monitored
accordingly by the barangay health
worker in her assigned area. The improvement of the Barangay Nutrition and
provision of growth monitoring materials was also done for proper growth
monitoring.
The BNS gives consultation to mothers on appropriate complementary feeding practices.
The Improvement of the Barangay Nutrition Station (BNS) (Dec. 2014 – February 2015): The BHWs utilize the weight stand and height board for proper growth monitoring
Barangay Health Worker (BHW) 3 –day Training Seminar (Dec. 2014): Lecture and Demonstration on proper anthropometric measurements, growth monitoring, record keeping and case referral done with the trainees
Database of Anthropometric Measurements (Dec. 2014 – February 2015): House-to-House height and weight measurement of children under 5 years of age conducted twice a year by the BNS and the BHWs.
Growth Monitoring Scheme – Nutrition Data Board (January – February 2015): Ms. Divine Lustria from MNAO approved the use of nutrition data board, which shows the color-coded symbols corresponding to a child’s nutritional status per hamlet. Nutrition Data Board posted at Barangay Nutrition Station. BHWs and BNS mapped per hamlet color-coded symbols corresponding to a child’s nutritional status
To ensure food
security, an existing barangay ordinance on 1 backyard garden per household was
strengthened by conducting house-to-house monitoring as well as health
education on backyard gardening and vermicomposting. A community garden, Gulayan sa Paaralan was also created in
collaboration with the identified key persons in the community.
Gulayan sa Paaralan Community Garden
Backyard Gardening Monitoring
Planting seedlings for Gulayan sa Paaralan
Some of the harvested vegetables from Gulayan sa Paaralan
Lecture on Backyard Gardening
Lecture and demonstration of vermicomposting
Mirangan Bakery
Over
the course of 4 years, given the result of the combined strategic planning and
efforts by all sectors involved, it is therefore rational to conclude that the
interventions engaged in the achievement of the goal for this problem were all
effective. The problem on poor nutritional status in Barangay Mirangan have
been addressed adequately through the full involvement of the community to
reach the goal of providing good nutrition for children.
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