SEVENTEENTH CONGRESS OF TH E 
) 
REPUBLIC OF T H E  PHILIPPINES 
)
First Regular Session 
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SENATE
S. B. No. 1145
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SEP 14 
P I 148
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INTRODUCED BY SENATOR ANA THERESIA “RISA” HONTIVEROS
BARAQUEL
AN ACT FOR SCALING UP N U T R IT IO N  D U R IN G  T H E  FIRST 1000 
DAYS O F L IF E , ESTA BLISH IN G  A M A TERNA L A N D C H IL D  H E A L T H  
CARE PROGRAM , A PPR O PR IA TIN G  FU N D S T H E R E F O R  A N D  FO R
O T H E R  PU RPO SES
EXPLANATORY NOTE
This is for our children.
Despite global efforts to reduce hunger and malnutrition, undemutrition remains to 
be the underlying killer of our children, more than 2.6 million of them every year. Studies 
have shown that poor nutrition weakens immune systems of children, making them 
vulnerable to common diseases such as diarrhea, pneumonia, and malaria.1 Poor nutrition in 
the early years results in stunting, wasting, lowbirth weight, and micronutrient deficiency. 
These create irreversible damage to children during cmcial days when their bodies and minds 
are supposedly developing. The effects of undernourishment during first 1000 days do not 
stop at childhood, unfortunately. Children bring the damage with them as adults. Health 
experts agree that children whose bodies and minds are limited by stunting are at greater risk 
for disease and death, poor performance in school, and a lifetime of poverty.2 The effects are 
life-long.
Sadly, more than 170 million children do not have the opportunity to reach their full 
potential because of poor nutrition in the earliest months of their lives. Investment in good 
nutrition during the critical 1,000 days from pregnancy to a child’s second birthday is cmcial 
to developing a child’s cognitive capacity and physical growth. Ensuring a child receives 
adequate nutrition during this window can yield dividends for a lifetime, so they can perform 
better in school, more effectively fight off diseases, earn more as an adult, and become 
healthy, productive citizen.
This is for our mothers.
There is an inextricable link between the well-being of mothers and their children. 
Undernourished mothers are more likely to suffer difficult pregnancies and give birth to 
undernourished children themselves. They are also vulnerable to increased risk of death or 
giving birth to a pre-term, underweight or malnourished infant. Studies have shown that 
when mothers have health care, education and economic opportunity, both mother and child
1 Save the Children. Data .sources; Black, Robert E., Lind.say Allen, Zulfiqar Bhutta, Laura Caulfield, Mercedes de Onis, Majid Ezzati, 
Colin Mathers and .Juan Rivera, "Maternal and Child Undernutrition: Global and Regional Expo.surcs and Health Corusequences,” 
The iMiicet, Vol. 371, Is.sue 9608, .January 19, 2008, pp.243-260, and UNICEF, The State of the World’s Children
2 Ibid.


will have the best chance to survive and thrive.3 However, alarming numbers of mothers in 
developing countries, like the Philippines, are not getting the nutrition and healthcare they 
need.
This is for our future.
Malnutrition costs many developing nations an estimated two to three per cent (2- 
3%) of their GDP each year.4 Available data shows that stunted children will earn less on 
average as adults. In fact, the loss of human potential resulting from stunting was associated 
with 20 per cent (20%) less adult income on average.5 Globally, the direct cost of child 
malnutrition is estimated at $20 to $30 billion per year.6 In the Philippines in 2013, it is P328 
billion. The losses were due to PI66.5 billion worth of lost income as a result of lower level 
of education by the working population who suffered from childhood stunting, P160 billion 
in lost productivity due to premature deaths among children who would have been members 
of our current working-age population, P1.23 billion in additional education costs to cover 
grade repetitions linked to undemutritlon. This three hundred twenty eight billion (P328 
billion) amounted to three per cent (3%) of the Philippine GDP in 2013. Yet our 
government’s investment in nutrition programs to combat malnutrition is only at 0.52% of 
government expenditures, while the global average spending is at 2.1 %. The figures speak of 
a glaring finding that for every one dollar ($1) spent on programs to prevent stunting during 
first 1000 days, the Philippines could save over one hundred dollars ($100) in health, 
educadon, and lost productivity costs.7
Undemutritlon during the first 1000 days is critical to the future health, wellbeing, 
and success of a child. It affects the child’s ability to grow, learn and become productive 
adults. Poor nutrition hamis our children, our mothers, our nation. It can impede economic 
growth. It can extend the cycle of poverty.
We need to scale up nutrition during first 1000 days of life. We need to have / \ealthy 
Buliiits who will grow up to become / leal thy Pinoys. The enactment of this bill is earnestly 
sought.
ANA THERESIA “RiSA” H O r^ V E R O S  BARAQUEL
Senator
3 Ibid.
< Horton, Susan. "Opportunities for Investments in Low Ineome Asia.” Asian Development Review. V0I.17, Nos.1,2. pp.246-273. 
Horton, Sasan, Meera Shekar, Chri.stine McDonald, Ajay Mahal and Jana Kiystene Brooks. Scaling Up Nutrition: What Will It Cost? 
(World Bank: Washington, DC:20io)
5 Grantham-Mc<jregor, Sally, Yin Bun Cheung, Santiago Cueto, Paul Glewwe, Linda Richter and Barbara Strupp. “Development 
Potential for the First 5 Years for Children in Developing Countries.” I'he /.aneet.Vol. 3 6 9 ,1.s,suc 9555. January 6, 2007. pp.60-70
6 Food and Agriculture Organization. The State of TihkI Insecurity in the World 2004. (Rome: 2004)
7 Save the Children. Co.st of Hunger: Philippines. (Philippines: 2016)


SEVENTEENTH CONGRESS OF TH E ) 
REPUBLIC OF TH E PHILIPPINES 
)
First Regular Session 
)
SENATE
S. B. No. 1145
C'. 1 7rt,
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• S H u i  o f tHjCjS'ffPp'.ltlj
*16 
SEP 14 
P I 148
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;- J i :
INTRODUCED BY SENATOR ANA THERESIA “RISA” HONTIVEROS
BARAQUEL
AN ACT FOR SCALING UP NUTRITION DURING TH E FIRST 1000 DAYS 
OF LIFE, ESTABLISHING A MATERNAL AND CHILD HEALTH CARE 
PROGRAM, APPROPRIATING FUNDS THEREFOR AND FOR OTHER
PURPOSES
Be it enacted by the Senate and I louse of Kepresentatives of the Philippines in Congress assembled:
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SEC. 1. Title. -  This Act shall be known as the “The Healthy Bui Hit Act. ”
SEC. 2. Declaration o f Policy. - The right to health is a fundamental principle 
guaranteed by the State. Article II, Section 15 of the 1987 Constitution emphasizes that 
“The State shall protect and promote the right to health of the people and Instill health 
consciousness among then^” Further, as party to international human rights agreements 
such as the Universal Declaration of Human Rights, International Covenant on the 
Economic, Social and Cultural Rights, the United Nations Convention on the Rights of a 
Child and to the Scaling Up Nutrition Movement, the State commits to its obligations that 
guarantee the right to adequate food, care and nutrition to pregnant and lactating mothers 
and children, specially those from zero to two-years old.
Furthermore, the State further commits to the Philippine Development Plan and the 
Philippine Plan of Action on Nutrition (PPAN) to contribute to the improvement of the 
quality of human resource in the coimtry, and the reduction of child and maternal mortality.
The State likewise declares its determination to eliminate hunger and to reduce all 
forms of malnutrition. The State further maintains that nutrition is both an end-goal and a 
means to achieve sustained development. It is a multi-faceted issue requiring committed 
inputs from all sectors. As such, nutrition shall be a priority of the government to be 
implemented by all its branches in collaboration with non-government organizations and the 
private sector, in an integrated manner.
The State furthermore allocates Its resources in a sustainable manner thereby 
eradicating malnutrition of adolecent girls, pregnant and lactating women, and children from 
zero to two-years old.
The State finally refocuses the intervention program on malnutrition to the first 1,000 
days of a child’s life, i.e. the nine months in the womb and the first 24 months of his/her life 
which is considered to be the critical window of opportunity to prevent malnutrition and 
life-long consequences.


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SEC. 3. Objectives.— This Act specifically aims to:
(a) Provide a more comprehensive, sustainable and multisectoral approach to address 
malnutrition.
(b) Ensure adherence to the commitments and obligations such as the International 
Covenant on the Economic, Social and Cultural Rights international Convention on the 
Rights of the Child (CRQ, A Promise Renewed, Scaling Up Nutrition (SUN), and the 2016 
Sustainable Development Goals, panicularly Goal 2 which states that it aims to end hunger, 
achieve food security and improved nutrition for all. And also Goal 3 which states that it 
aims to ensure healthy lives and promote well-being for all.
(c) Provide evidence-based nutrition interventions and actions over the life -  
course/stages as prescribed by the World Health Organization as well as nutrition specific 
and nutrition sensitive mechanisms, strategies, programs and approaches in implementing 
programs and projects to improve nutritional status and to eradicate malnutrition and 
hunger.
(d) Institutionalize scaling up nutrition in the first 1000 days in the Philippines Plan of 
Action for Nutrition and the Early Childhood Care and Development Intervention Packages 
developed by the National Nutrition Council and ttrengthen the role of the Department of 
Health, the National Nutrition Council (NNQ and other agencies tasked to implement the 
First 1000 Days Act;
(e) Ensure the meaningful, active and sustained participation, parmership and 
cooperation of N N G member agencies, other National Government Agencies (NGAs), 
Local Government Units (LGUs), Non-Government Organizations (NGOs), and the private 
sector, in an integrated and holistic manner, for the promotion of the nutritional well-being 
of the population prioritizing interventions in areas with high Incidence and magnitude of 
poverty, geographically isolated and disadvantaged and in hazard and conflict zones.
(f) Strengthen enforcement of the Milk Code (Executive Order Number 51), and the 
Expanded Breastfeeding Promotion Act (Republic Act Number 10028) to protect, promote, 
and support optimal infant and young child feeding.
(g) Strengthen other nutrition related policies, guidelines and laws such as the ASIN 
Law and Food Fortification Laws, promote good nutrition under the Accelerated Hunger 
Mitigation program and the DOH Adntinistrative Order 2015-055 entitled the National 
Guidelines on the Management of Acute Malnutrition under 5 years old.
SEC. 4. Definition o f Terms. - For the purposes of this Act, the following shall 
refer to:
a) '‘Geographically isolated and disadvantaged areas (GID. l)” are areas that are isolated due 
to distance, weather conditions and transportation, unserved and underserved 
communities and other areas identified to have high incidences of poverty, 
presence of vulnerable sector, communities in or recovering from situation of crisis 
or armed conflict and recognized as such by a government body
b) “lajw birth weight" refers to weight at binh of less than 2500 grams;
c) ‘‘Micronntrient deficiency ” refers to a deficiency of nutrients required by the body in 
small amounts for vital physiological functions. These include vitamin A  hon, folic


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acid, iodine, zinc and other nutrients. The deficiency of these micronutrients may 
result in: vitamin A deficiency (VAD), iron deficiency anemia (IDA), iodine 
deficiency disorders (IDD) among others;
d) “O/mmtj/y/” and ''obesity ” are defined as abnormal or excessive fat accumulation that 
may impair health. Body mass index (BMI) is a simple index of weight-for-height 
that is commonly used to classify overweight and obesity in adults. It is defined as a 
person's weight in kilograms divided by the square of his height in meters (kg/m1 2). 
According to the WHO, a BMI greater th.m or equal to 25 is overweight. While a 
BMI greater than or equal to 30 is obesity.
e) "Stunting" refers to low height-for-age which is less than negative 2 standard 
deviations (SD) of the WHO Qhild Growth Standard median and which is an 
indicator of long standing or chronic malnutrition;
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“( ]mknveight"xtitn to low weight-for-age which is less than negative two (2) SD of 
the WHO Child Growth Standard median;
g) "Wasting or "thinness" indicates in most cases a recent and severe process of weight 
loss, which is often associated with acute starvation and/or severe disease. 
However, wasting may also be the result of a chronic unfavorable condition. 
Wasting refers to low weight-for-height which is less than negative 2 SD of the 
WHO Child Growth Standard median.
h) "Anaemia ” is a condition in which the number of red blood cells or their oxygen­
carrying capacity is msufflclent to meet physiologic needs, which vary by age, sex, 
altitude, smoking, and pregnancy status. Iron deficiency is thought to be the most 
common cause of anaemia globally, although other conditions, such as folate, 
vitamin B12 and vitamin A deficiencies, chronic inflammation, parasitic infections, 
and inherited disorders can all cause anaemia. In its severe form, it is associated 
with fatigue, weakness, dizziness and drowsiness. Pregnant women and children are 
particularly vulnerable.
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"Chronic linergy De/iciency’’or "CUD”or "acute iiniknmtntion”results from negative 
energy balance due to inadequate food and nutrient intake, problems in absorption 
(relatively rare) or excessive nutrient loss (e.g. due to infections and malignancies). 
Undemutrition can be acute as in famine, natural disasters or man-made. This is 
one of the major public health problems in SEA Region countries.
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"Severe Acute Malnutrition (S. IM) ” refers to having a very low weight for height 
(below -3z scores of the median WHO growth standards), by visible severe 
wasting, or by the presence of nutritional oedema. Decreasing child monality and 
improving maternal health depend heavily on reducing malnutrition.
1^ "Nutrition-specitic interventions and programmes", as termed by the Scaling Up Nutrition 
Movement, refers to interventions or programmes that address the immediate 
determinants of fetal and child nutrition and development— adequate food and 
nutrient intake, feeding, caregiving and parenting practices, and low burden of 
infectious diseases
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"Nutrition-sensitive interventions and programmes", as termed by the Scaling Up Nutrition
Movement, refers to interventions or programmes that address the underlying 
determinants of fetal and child nutrition and development— food security.


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adequate caregiving resources at the maternal, household and community levels; 
and access to health services and a safe and hygienic environment— and 
incorporate specific nutrition goals and actions. Nutrition-sensitive programmes 
can serve as delivery platforms for nutrition-specific interventions, potentially 
increasing their scale, coverage, and eff ectiveness
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SEC. 5. Sculing Up Nutrition in the first 1000 days. - There shall be a
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comprehensive and sustainable strategy to address the health and nutrition problems in the
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country affecting pregnant and lactating women, infants and young children. This shall be
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formulated by the Department of Health (DOH) and the NNC as a program to
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operationalize the latest Philippine Plan of Action for Nutrition (PPAN) which integrates
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short, medium and long term plan of the government in response to the global call to
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eradicate hunger and malnutrition.
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The LGU through its health officers, will develop a / Icjl/hy Wiih/il Pro^nm, a
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comprehensive program for first 1000 days which shall be integrated in the local nutrition
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action and investment plan. A local nutrition committee will be convened for this purpose
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and will be composed of the officers representing the planning office, agriculture, health,
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social welfare, education, budget office and representatives from NGOs and GSC>s engaged
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in health and nutrition interventions.
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The / lea/t/>y Vndi/it Program will be implemented at the barangay level through the
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barangay health centres, in coordination with the barangay council, with the employment of
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the barangay nutrition scholars as frontline service providers.
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The NNQ through DOH and DILG, will provide technical assistance and budgetary
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support to the development, formulation, and Implementation of the first 1000 days city,
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municipal, and barangay nutrition action and investment plan.
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SEC. 6. Coverage. - This Act covers all children covered in the first 1000 days of life 
from conception to age 24 months and shall include in its protection adolescent girls, 
women in their reproductive age, pregnant and lactating women, particularly teen-age 
mothers.
This Act shall prioritize those who reside in geographically isolated and disadvantaged 
areas (GIDA) identified by DSWD, poor families identified through the National Household 
Targeting System (NHTS), and hazard/conflict-prone areas identified by 
DSWD and 
DOST /  NDRRMC
SEC. 7. Program Components - The / ieallhy bulilit Program shall include the 
following components:
(a) Family, health and nutrition counseling services;
(b) Immunization and nutrition supplements;
(c) Breastfeeding and feeding;
(d) National and local health and nutrition investment planning and financing;
(e) Health and nutrition service delivery,
(f) Advocacy, social mobilization and community participation;
(g) Health and nutrition human resources capacity development; and
(h) Program development to support the implementation of this Act.


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SEC. 8. Baningay Nutrition Scholars. Each barangay shall have barangay nutrition 
scholars (BNS) who will serve as focal persons for the implementation of the / leuliby hulilit 
Prot^ram. A capacity development and training program shall be provided to BNS for the 
implementation of this Act. The DOH and DILG, through the LGUs, shall develop 
incentive programs for the BNS.
SEC. 9. Nutrition in the Aftcrmiith o f Natural and Hum an-Induced Disasters 
and Calamities. - Areas that are struck by disasters mtist be prioritized in the delivery of 
health and nutrition services and interventions. National, regional, and local governments are 
mandated to immediately provide emergency services, food supplies for proper nourishment 
of children specifically those from zero to two (2) years old, and pregnant and lactating 
women.
No milk formula donations or products covered by the National Code of Marketing 
of Breastmilk Substitutes and Breastmilk Supplements shall be allowed in order to protect 
the health and nutrition of pregnant, lactating women, infants and young children before, 
during and after a dLsaster.
In emergency situations, donations or assistance from the private sector, with no 
conflicts of interest or those not covered by the Milk Code, shall be allowed immediately in 
the aftermath of natural disasters and calamities. Strict compliance with the E.Q No. 51 or 
the Milk Code and its revised implementing rules and regulations shall be observed and 
options for mothers with breastfeeding problems will be provided.
The DOH and other departments, in coordination with the National Disaster Risk 
Reduction and Management Council (NDRRMQ, shall formulate guidelines and 
mechanisms in pursuit of this Section taking into consideration Republic Act 10821 or the 
Childrens Emergency Relief and Protection Act.
SEC. 10. Implementing Rules and Regulations - Within ninety (90) days from 
the effectivity of this Act, the Secretary of the DOH shall, in coordination with the 
Secretaries of the DILG, the DSWD and the Executive Director of the NNQ in 
consultation with stakeholders in the public and private sectors, promulgate rules and 
regulations necessary for the effective implementation of this Act.
SEC. 11. Appropriation. -The amount necessary to carryout the provisions of this 
Act shall be included in the General Appropriations Act of the year of its enactment into 
law. Tliereafter, the expenses for Its continued implementation shall be included in the 
subsequent General Appropriations Act from the funds of the DOH and the LGUs.
SEC.12. Repealing Clause. - All laws, decrees, executive orders, administrative 
orders or parts thereof inconsistent with the provisions of this Act are hereby repealed, 
amended or modified accordingly.
SEC.13. Effectivity. This Act shall take affect fifteen (15) days after its publication in 
the Official Ctdcytk or in a newspaper of general circulation.
Approved,