Child stunting is a complex problem that requires multisectoral and well-coordinated interventions among different sectors and stakeholders. Evidences suggest that nutrition-specific evidence-based interventions should be scaled up to attain 90% coverage to reduce child stunting by 20%. These interventions include iron-folic acid and other micronutrient supplementation for pregnant women and children, promotion of iodized salt, dietary supplementation, implementation of essential newborn care (ENC) protocol, neonatal vitamin K administration, vitamin A supplementation, and promotion of breastfeeding and complementary feeding practices. Better coverage of nutrition-sensitive interventions especially for women and children should also be prioritized.

In 2018, the Republic Act 11148 or the “Kalusugan at Nutrisyon ng Mag-Nanay Act” was passed into law to scale up national and local health programs and strengthen delivery of services and interventions in the first 1000 days of life. One of the key players mobilized by the law are the local government units (LGU). LGUs should directly supervise the implementation of the First 1000 Days program in the health centers, rural health units, and/or barangay health stations.

How can LGUs scale up the First 1000 Days Program?

• Formulate their own Local Nutrition Action Plans (LNAP) focusing on the First 1000 Days of life;
• Designate or appoint Nutrition Action Officers to coordinate nutrition strategies and activities among stakeholders and other LGUs;
• Align the First 1000 Days Integrated Framework and Strategy into their barangay development plans and annual budget;
• Involve community groups, leaders, and families in planning, budgeting, implementing, and monitoring activities and create accountability for the results;
• Organize and mobilize communities for the advocacy and identify local champions who can become drivers of change in their communities;
• Invest in capacitating frontline service providers in their community and sustain their motivation to deliver quality services.

The Regional Nutrition Committee of NCR also issued resolutions mobilizing LGUs to strengthen their programs and projects in support of the First 1000 Days (F1K) by doing these specific actions:

• Issuing local legislation to strengthen First 1000 Days Program;
• Provide resources for First 1000 Days tool (weighing scales, height boards, ECCD cards) and training for workers;
• Organize and sustain infant and young child feeding support groups to provide counselling and do complementary recipe demonstrations;
• Conduct dietary supplementation program for pregnant women and 6-23 months old children;
• Scale up other services on nutrition, health, early learning, and social services. 
• Issue an executive order or memorandum designating a focal person/ nutritionist-dietitian for the F1K;
• Integrate the LNAP in the local development and investment plan; and
• Closely monitor the implementation of the F1K programs and projects integrated in the LNAP.

If all LGUs will develop their LNAPs highlighting the First 1000 Days services and these LNAPs will be integrated in their provincial, city and municipal plans and budgets, and if services and interventions along the First 1000 days cover at least 90% of the target population, then child stunting will be reduced, and help us win the war against malnutrition.

We must act now and scale up critical interventions in the First 1000 days of life. Invest in nutrition, invest in the First 1000 Days now!

Written by: NOII Theresa A. Rivas and NPC Milagros Elisa V. Federizo


References:

• The Implementing Rules and Regulations (IRR) of Republic Act (RA) 11148
• Reducing stunting in children: equity considerations for achieving the Global Nutrition Targets 2025. World Health Organization (2018)
• RNC-NCR Resolution No. 02, Series of 2017 “Enjoining All Local Government Units to Strengthen Programs and Projects in Support of the First 1000 Days by Allocating Funds and other Purposes”
• RNC-NCR Resolution No. 02, Series of 2018 “Mobilizing Local Government Units for the First 1000 Days (F1K)”