Micronutrient deficiencies can cause inter-generational consequences. The level of health care and nutrition that women receive before and during pregnancy, at childbirth and immediately post-partum has significant bearing on the survival, growth and development of their fetus and newborn. Undernourished babies tend to grow into undernourished adolescents. When undernourished adolescents become pregnant, they in turn, may give birth to low-birth weight infants with greater risk of multiple micronutrient deficiencies.
Micronutrient deficiencies have considerable impact on economic productivity, growth and national development. Widespread iron deficiency is estimated to decrease the gross domestic product (GDP) by as much as 2% per year in the worst affected countries. Conservatively, this translates into a loss of about Php 172 per capita or 0.9% of GDP. Productivity losses for anemic manual laborers have been documented to be as high as 9% for severely stunted workers and 5% and 17% for workers engaged in moderate and heavy physical labor respectively (Micronutrient Supplementation Manual of Operations)
Mandate: AO 36, s. 2010
Aquino Health Agenda (AHA): Achieving Universal Health Care for All Filipinos– Kalusugan Pangkalahatan
Goal of Micronutrient:
Achievement of better health outcomes, sustained health financing and responsive health system by ensuring that all Filipinos especially the disadvantaged group (lowest 2 income quantiles)have equitable access to affordable health care.
1. Contribute to the reduction of disparities related to nutrition through a focus on population groups and areas highly affected or at risk to malnutrition
2. To provide vitamin A capsules, iron and iodine supplements to treat or prevent specific micronutrient deficiencies
3. Go to scale with key interventions on micronutrient supplementation, food fortification, salt iodization and nutrient education.
4. Revive, identify, document and adopt good practices and models for nutrition improvement.
5. Build Nutrition human resource in relevant departments/ agencies.
1. Child Under nutrition
The 2008 National Nutrition survey, FNRI-DOST showed a significant decline in the prevalence of underweight-for-age under five children since 1990. However, the overall decline was not fast enough. In 2008 a 20.6% prevalence rate was recorded which is equivalent to an average annual percentage point decrease of 0.37%, however, it is lower than the targeted 0.55 annual percentage point reduction from 2000 to achieve one of the targets of Millennium Development Goal I. In addition, stunting (32.2%) among under fives (an indication of prolonged deprivation of food and frequent bouts of infections) and wasting indicative of a lack of food or infection or both on the hand, remained at bout the 6% from 2003 to 2008.
1. Maternal Under nutrition
For the past 10 years, the nutritionally-at-risk pregnant women gradually decreased since 1998, with an average change of 0.44% per year. (FNRI National Nutrition surveys 2008)
2. Micronutrient Deficiencies
The 2008 National Nutrition Survey reported significant gains as levels of Vitamin A deficiency among 6-months infants to 5 years old children, pregnant and lactating women but still is a public health problem based on WHO cut off 15%. Furthermore, the prevalence rate of Iron deficiency anemia among children decreased significantly. However, percentage levels of IDA among infants 6 years old (55.7%) and pregnant women (42.5%) remain at levels that are considered high as per WHO classification of <40% public health problem.
Iodine Deficiency is a public health problem among pregnant and lactating women. In 2008, the median UIE among 6-12 year old children was 132/ug/L, indicating adequate iodine status and only <20% of the children had UIE less than 50 ug/L. The elimination of iodine deficiency has been sustaines from 2003-2008.
Among pregnant women, the median UIE was 105 ug/L represents insufficient iodine intake. Iodine deficiency in this group persists. While lactating women the median UIE was 81 ug/L represents mild iodine insufficiency.
INTERVENTIONS/ STRATEGIES EMPLOYED OR IMPLEMENTED
1. Micronutrient Supplementation- is the provision of pharmaceutically prepared vitamins & minerals for treatment or prevention of specific micronutrient deficiency.
2. Food Fortification- the addition of essential micronutrients to widely consumed food product at levels above its normal state.
3. Improving diet/ dietary diversification- the adoption of proper food and nutrition practices thru nutrition education food production & consumption.
4. Growth monitoring and promotion- is an educational strategy for promoting child health, human development and quality of life through sequential measurement of physical growth and development of individuals in the community.
STATUS OF IMPLEMENTATION/ ACCOMPLISHMENT
The following policies were formulated and implemented:
- AO No. 2010-0010: revised Policy on Micronutrient Supplementation to support achievement of 2015 MDG Targets to reduce under-five and maternal deaths and micronutrient needs of other population groups
- AO No. 2007-0045: Zinc Supplementation and reformulated Oral rehydration salt in the Management of diarrhea among children
- ASIN Law- R.A. 8172, “An act promoting salt iodization nationwide and for other purposes”, signed into law on Dec. 20, 1995
- Food fortification law, R.A. 8976, “An act establishing the Philippine Food Fortification Program and for other purposes” mandating fortification of flour, oil and sugar with Vit A and flour and rice with iron by November 7, 2004 and promoting voluntary fortification through the SPSP, signed into law on November 7, 2000
- Department Memorandum No. 2011-0303 “Micronutrient powder supplementation for children 6-23 months”
- Micronutrient supplementation manual of operations was developed to guide local, regional and national managers and implementers in providing good quality micronutrient supplementation services to targeted populations nationwide
· Vitamin A Supplementation 2011 Coverage
FUTURE PLAN / ACTION
1. Focus on population groups and areas affected or at-risk to micronutrient malnutrition
2. Scale up with key interventions such as micronutrient supplementation, food fortification 7 dietary diversification through food based approach
3. Development & formulation of strategic plan 2012-2016
OTHER SIGNIFICANT INFORMATION
Micronutrient supplementation is a crucial for child survival, it significantly reduces:
1. The risk from mortality by 23-34%
2. Deaths due to measles by about 50%
3. Deaths due to diarrhea by about 40%