Interventions and Support: (Celina)

*The DOH, in coordination with the NNC, the DA, the LGUs and other NGAs
concerned, are responsible for the implementation of this Act.
National Nutrition Council
Department of Agriculture
Local Government Units

o What types of nutritional support or education does the program

provide?
o Are there any supplemental feeding or financial aid components? If so,
what are they?

A. Prenatal Care Services (First 270 Days)

Prenatal care during the first 270 days focuses on ensuring the health of the mother
and baby. The services provided at both facility and community levels include:

1. Pregnancy Tracking & ANC Enrollment

○ Tracking pregnancies and enrolling expectant mothers in antenatal
care (ANC) services.
2. Regular Follow-ups & Referrals
○ Ensuring the recommended minimum number of ANC visits and
referring high-risk pregnancies as necessary.
3. Maternal Immunizations
○ Administering vaccines, including tetanus and diphtheria toxoid, and
others as appropriate.
4. Birth & Emergency Planning
○ Empowering women to prepare birth and emergency plans, and
providing breastfeeding and rooming-in counseling.
5. Maternal Nutrition & Child Feeding Counseling
○ Providing guidance on maternal nutrition and feeding practices for
infants and young children.
6. Management of Nutritionally At-risk Pregnant Women
○ Early identification and management of at-risk women, including the
provision of supplementary food and dietary support.
7. Micronutrient Supplementation
○ Providing essential micronutrients such as iron, folic acid, calcium, and
iodine.
8. Promotion of Fortified Foods
○ Encouraging the consumption of iodized salt and other
micronutrient-fortified foods.
9. Parasitism Risk Assessment & Treatment
 ○ Assessing risks for parasitic infections and administering
anti-helminthic medicines as needed.
10. Oral Health Services
○ Offering oral health assessments and related services.
11. Hygiene & Sanitation Counseling
○ Counseling on proper hand-washing, environmental sanitation, and
personal hygiene practices.
12. Responsible Parenthood & Family Health Services
○ Providing counseling and support for responsible parenthood and
family health.
13. Health & Lifestyle Counseling
○ Promoting smoking cessation, healthy eating, and adopting a healthy
lifestyle.
14. PhilHealth Enrollment & Linkages
○ Facilitating enrollment in PhilHealth and linking to health and nutrition
workers.
15. Social Welfare Support
○ Providing social welfare support, including dietary supplementation,
especially for at-risk pregnant women from the poorest families.
16. Maternity Protection
○ Ensuring maternity protection during pregnancy.
17. Parental Interaction & Early Childhood Development Counseling
○ Supporting and counseling parents and caregivers on responsive care
and early stimulation for childhood development.
18. Psychosocial Support
○ Providing counseling and psychosocial support, with a focus on
high-risk pregnant women and adolescents from the poorest families.
19. Additional Services
○ Offering other services based on local, national, and international
guidelines and evidence.

B. Health and Nutrition Services for Women About to Give Birth and
Immediate Postpartum Period

Health and nutrition services at both facility and community levels for women about
to give birth and in the immediate postpartum period shall include, but are not
limited to, the following key interventions:

1. Birth and Breastfeeding Plans

● Adherence to the couple's birth, breastfeeding, and rooming-in plans.

2. Mother-Friendly Practices

● Provision of mother-friendly practices during labor and delivery, following:

 ○ Mother and Baby-Friendly Health Facility Initiative (MBFHFI)
○ Republic Act No. 10028 (Expanded Breastfeeding Promotion Act of
2009)
○ Executive Order No. 51 (Milk Code)
○ Other related Department of Health (DOH) administrative issuances on
maternal and newborn care.

3. Monitoring Labor and Well-being

● Monitoring the progress of labor and the health of both mother and fetus.
● Providing interventions for any health issues that may arise during labor.

4. High-Risk Newborn Identification

● Identifying high-risk newborns (e.g., premature, small for gestational age

[SGA], or low birth weight infants).
● Providing preventive interventions to reduce complications.

5. PhilHealth Maternal Care Coverage

● Ensuring coverage and utilization of PhilHealth benefit packages for

maternal care.

6. Nutrition Counseling and Food Provision

● Nutrition counseling and provision of nutritious meals for women, especially

those who gave birth to preterm, SGA, or low birth weight infants, until
discharge.

7. Lactation Management Services

● Providing lactation management services to support breastfeeding

initiation and exclusive breastfeeding for six months, especially for caesarean
deliveries, continuing until discharge.

8. Hygiene Counseling

● Counseling on proper hand-washing, environmental sanitation, and

personal hygiene.

9. Family Planning Counseling

● Counseling on and providing access to modern methods of family planning

and reproductive health care services, as outlined in Republic Act No. 10354
(The Responsible Parenthood and Reproductive Health Act of 2012).

10. Rooming-In and Breastfeeding Initiation

 ● Ensuring non-separation of mother and newborn and promoting rooming-in
for early breastfeeding initiation.

11. Women and Child-Friendly Spaces

● Assuring women and child-friendly spaces during calamities, disasters, or

other emergencies.

12. Support for Fathers and Caregivers

● Providing support to fathers and caregivers to encourage their commitment

to proper health and nutrition care for mother and child.
● Offering necessary counseling and positive parenting support interventions.

13. Responsive Care and Early Childhood Development

● Counseling and support for parents and caregivers on responsive

parent-child interaction and early stimulation for early childhood
development.

14. Additional Guidelines

● Other services as determined by international and national guidelines and

locally generated evidence.

C. Postpartum and Lactating Women: Health and Nutrition Services

Health and nutrition services for postpartum and lactating women at both facility
and community levels shall include, but are not limited to, the following:

1. Follow-up Visits
○ Encourage women to return to health facilities where they gave birth
for postnatal care.
2. Home Visits for Remote Areas
○ Provide home visits, especially for women in geographically isolated
and disadvantaged areas (GIDA).
3. Lactation Support and Counseling
○ Offer continuous lactation support from birth up to two years and
beyond, including for women returning to work, in the informal sector,
or experiencing breastfeeding challenges.
4. Nutrition Assessment and Counseling
○ Conduct assessments and provide counseling to meet the nutritional
demands of lactation, both in health facilities and workplaces.
5. Malnutrition Management
○ Identify and manage malnutrition, particularly for chronically
energy-deficient (CED) and nutritionally-at-risk postpartum and
 lactating women, including adolescent mothers, through dietary
supplementation and ready-to-use supplementary foods (RUSF).
6. Community-based Mother Support Groups
○ Organize support groups and peer counselors for breastfeeding in
cooperation with health and nutrition workers.
7. Lactation Breaks in Workplaces
○ Ensure women have access to lactation breaks in workplaces,
including micro, small, and medium enterprises.
8. Lactation Stations in Workplaces
○ Make lactation stations available in government and private sectors,
informal economy workplaces, public places, and public
transportation, as per Republic Act No. 10028 (Expanded
Breastfeeding Promotion Act of 2009).
9. Workplace Breastfeeding Support Groups
○ Form breastfeeding support groups in workplaces with the help of
trained occupational health workers and HR managers.
10. Micronutrient Supplementation
○ Provide essential micronutrients, such as iron, folic acid, Vitamin A,
and others as necessary.
11. Promotion of Fortified Foods
○ Promote the use of iodized salt and foods fortified with essential
micronutrients.
12. Oral Health Services
○ Ensure access to oral health services for postpartum and lactating
women.
13. Family Planning and Reproductive Health Services
○ Offer counseling and access to modern family planning methods and
reproductive health care, in accordance with Republic Act No. 10354
(Responsible Parenthood and Reproductive Health Act of 2012).
14. Social Welfare Support
○ Provide social welfare assistance to enhance access to health and
nutrition services, including dietary supplements and nutritious food
products for CED and nutritionally-at-risk women in the poorest
families.
15. Women- and Child-friendly Spaces in Emergencies
○ Ensure the availability of safe spaces for mothers to breastfeed during
calamities, disasters, or emergencies.
16. Support for Fathers and Caregivers
○ Offer counseling and interventions to encourage fathers and
caregivers to support the health and nutrition needs of both mother
and child.
17. Early Childhood Development Support
 ○ Provide counseling to parents and caregivers on parent-child
interaction, responsive care, and early stimulation for early childhood
development.
18. Additional Services
○ Any other services as recommended by international and national
guidelines and locally generated evidence.

D. Birth and Newborn Period (First 28 Days)

Health and Nutrition Services at Facility and Community Levels:

1. Baby-Friendly Practices
○ Ensure compliance with MBFHFI and the Department of Health’s (DOH)
essential newborn care protocol in all birthing facilities.
2. Skin-to-Skin Contact
○ Provide early, continuous skin-to-skin contact for full-term babies
and kangaroo mother care for preterm and low birth weight babies,
following DOH guidelines.
3. Non-Separation of Mother and Newborn
○ Promote non-separation after birth to encourage early breastfeeding
initiation and exclusive breastfeeding.
4. Routine Newborn Care
○ Administer services like eye prophylaxis, Vitamin K supplementation,
and necessary immunizations.
5. Newborn Screenings
○ Conduct newborn screening and hearing screening in line with
established health protocols.
6. PhilHealth Benefit Packages
○ Utilize appropriate PhilHealth benefits, especially for preterm, low
birth weight, and small newborns.
7. Referral for Higher-Level Care
○ Facilitate early referral to advanced care facilities for managing
illnesses or complications.
8. Breastmilk Availability
○ Ensure that facilities with neonatal intensive care units (NICUs) have
human milk pasteurizers, especially for preterm and low birth weight
infants.
9. Child-Friendly Spaces During Emergencies
○ Create child-friendly spaces to support breastfeeding during
calamities, disasters, or emergencies.
10. Social Welfare Support
○ Provide welfare support to improve healthcare access for newborns
from the poorest families.
11. Birth and Death Registration
 ○ Ensure prompt registration of births, deaths, and fetal deaths, with a
focus on restoring lost or damaged records during disasters.
12. Parent-Caregiver Counseling
○ Offer counseling and support to parents/caregivers to foster healthy
infant interaction and responsive care for early childhood
development.
13. Support for Early Stimulation
○ Provide resources to assist parents/caregivers with early stimulation
and responsive care for infants.
14. Other Services
○ Implement additional services based on international and national
guidelines or new local evidence.

E. Health and Nutrition Services for the First Six Months of Infancy (180
Days)

Health and nutrition services provided to infants during the first six months focus on
comprehensive care and support for both mother and child. The services include the
following:

1. Exclusive Breastfeeding Support

○ Continuous support for mothers and infants to promote exclusive
breastfeeding.
○ Referrals to trained health workers for lactation management and
breast condition treatment.
2. Immunization and Health Assessment
○ Provision of appropriate and timely immunization services.
○ Integration of immunization with breastfeeding assessments, early
child development, growth monitoring, and Infant and Young Child
Feeding (IYCF) counseling.
3. Growth and Development Monitoring
○ Regular monitoring and promotion of growth and development in
infants under six months, with special attention to those with low birth
weight, stunted growth, or acute malnutrition.
4. Hygiene and Sanitation Counseling
○ Education for household members on hand-washing, environmental
sanitation, and personal hygiene.
5. Referral to Higher-Level Health Facilities
○ Early referral to advanced health facilities for managing common
childhood illnesses, including acute malnutrition.
6. Management of Malnutrition
○ Identification and management of moderate or severe acute
malnutrition in infants under six months.
 ○ Provision of lactation management services and addressing medical
conditions that contribute to malnutrition.
7. Parent/Caregiver-Infant Interaction Support
○ Counseling and support for parents and caregivers to promote
responsive care and early stimulation for early childhood development.
8. Social Welfare Support
○ Assistance to ensure access to health and nutrition services for
newborns from the poorest families.
9. Support for Fathers and Caregivers
○ Encouragement and counseling for fathers and caregivers to support
the mother and child in maintaining proper health and nutrition.
○ Provision of positive parenting support interventions.
10. Child-Friendly Spaces During Emergencies
● Assurance of women- and child-friendly spaces during emergencies, such as
calamities or disasters, where health and nutrition services for women and
children are provided.

F. Health and Nutrition Services for Infants (6 Months to 2 Years Old)

1. Introduction of Complementary Foods

● Timely introduction of safe, appropriate, and nutrient-dense complementary

foods.
● Continued and sustained breastfeeding.
● Use of home-prepared, nutrient-rich, locally available foods, prepared and
fed safely.

2. Nutrition Counselling

● Provide counselling on the preparation and feeding of complementary foods

to mothers and caregivers.

3. Dietary Supplementation

● Age-appropriate, nutrient-dense complementary foods as dietary

supplements.

4. Growth and Development Monitoring

● Regular monitoring and promotion of growth and development both at health

facilities and at home.

5. Routine Immunizations

● Ensure provision of vaccines based on the latest Department of Health (DOH)

guidelines.
6. Micronutrient Supplementation

● Provide necessary micronutrient supplements as deemed necessary for the

child’s growth.

7. Management of Childhood Illnesses

● Follow WHO and DOH guidelines to manage common childhood illnesses.

8. Malnutrition Management

● Manage moderate and severe acute malnutrition.

● Ensure referral to higher-level health facilities for cases with serious medical
complications.

9. Oral Health Services

● Provide oral health services, including fluoride varnish application to prevent

dental caries.

10. Anti-Helminthic Treatment

● Provide anti-helminthic tablets for children aged 1 to 2 years, as appropriate.

11. Water and Sanitation

● Ensure the availability of potable water.

● Promote hand-washing, environmental sanitation, and personal hygiene.
● Support household sanitation to reduce food, water, and vector-borne
diseases.

12. Parent and Caregiver Counselling

● Counsel and support parents/caregivers on child interaction, responsive care,

and early childhood stimulation.
● Refer children with developmental delays and disabilities for early
intervention.

13. Social Welfare Support

● Provide social welfare support for health and nutrition services.

● This includes dietary supplementation, access to complementary foods, and
referral for disabilities, especially for children from the poorest families.

14. Home Kitchen Gardens

 ● Support home kitchen gardens where feasible, for improved access to
nutritious food.

15. Agricultural Support

● Provide locally grown crops, vegetables, and fruits to complement feeding

and dietary supplementation efforts.

16. Protection from Abuse and Injuries

● Protect children from abuse, injuries, and accidents.

● Provide first aid, counselling, and proper referrals when necessary.

Health and Nutrition of Adolescent Females

To address malnutrition among the population, the delivery of health and nutrition
services for adolescent females (ages 10 to 18) at facility, school, and community
levels shall include, but not be limited to, the following:

1. Health and Nutrition Assessment

○ Identification of nutritionally-at-risk adolescent girls.
○ Provision of ready-to-use supplementary or therapeutic food for
those at risk, as appropriate.
2. Immunization
○ Age-appropriate immunizations based on the latest Department of
Health (DOH) guidelines.
3. Oral Health Services
○ Oral health assessments and services.
4. Deworming
○ Provision of anti-helminthic drugs for deworming.
5. Hygiene and Sanitation Counseling
○ Counseling on proper hand-washing, environmental sanitation, and
personal hygiene.
6. Micronutrient Supplementation
○ Provision of micronutrient supplements in accordance with DOH
guidelines, in collaboration with the Department of Education
(DepEd).
7. Nutrient Fortification Promotion
○ Promotion of iodized salt consumption and other
micronutrient-fortified foods as necessary.
8. Menstrual Health and Anemia Management
 ○Referral to health facilities for the management of menstrual
irregularities or abnormalities, anemia, blood loss, and other illnesses
like moderate to severe acute malnutrition.
9. Counseling on Lifestyle and Nutrition
○ Counseling on proper nutrition, mental health, avoidance of
risk-taking behaviors, smoking cessation, adoption of a healthy
lifestyle, and family health.

Nutrition in the Aftermath of Natural Disasters and Calamities

1. Prioritization of Health and Nutrition Services

● Affected Areas: Emergency services, health, nutrition, and psychosocial

support must be prioritized in disaster-affected regions.
● Mandates for NGAs and LGUs:
○ Provide emergency food supplies for pregnant and lactating women
and children, particularly those aged 0-2 years.
○ Establish women, infant, and child-friendly spaces offering necessities
(food, clothing, clean water, shelter).
○ Ensure availability of breastfeeding support and counseling for
mothers with children up to 2 years old and guidance on
complementary foods for children over 6 months old.

2. Regulation of Donations

● Prohibited Donations:
○ Donations of milk formula and breastmilk substitutes covered by the
Milk Code require approval from the Inter-Agency Committee (IAC)
established under Executive Order No. 51, Series of 1986.
● Allowed Donations:
○ Donations from the private sector not involved in manufacturing or
selling Milk Code products are permitted.
○ Strict adherence to the Milk Code and its revised rules is required.
○ Support options for breastfeeding problems include mobilizing
breastfeeding support groups and establishing local milk banks.

3. Coordination and Guidelines

● Responsibilities:
○ The Department of Health (DOH) and other relevant departments, in
collaboration with the National Disaster Risk Reduction and
Management Council (NDRRMC), will develop guidelines and
mechanisms.
○ Guidelines must adhere to humanitarian, inclusive, gender, and
culture-sensitive standards.
○ Compliance with Republic Act No. 10821 ("Children's Emergency Relief
and Protection Act"), its implementing rules, and the Comprehensive
Emergency Program for Children is mandatory.