Sf. OF

Republic of the Philippines pave: 04 JUL 2016
House of Representatives a an
Quezon City
BY:
Seventeenth Congress
First Regular Session REGISTRATION UNIT
875 BILLS AND INDEX SERVICE
HOUSE BILL NO,__~*

Introduced by Representative Rogelio J. Espina

EXPLANATORY NOTE

‘This bill seeks to establish a mother and child health care program to protect
Filipino mothers and children from malnutrition and appropriating funds therefor.

The World Health Organization of the United Nations strongly recommends
proper health care on the first 1,000 days of a child, From the start of pregnancy until
the second year of the child is the most crucial stage of the child’s brain formation.
‘The right nutrition during this 1,000 days has a profound impact on the ability of the
child to grow, learn and lead a long-term healthy and stable life.

The 2013 national nutrition survey conducted by the Food and Nutrition
Research Institute-Department of Science and Technology (FNRI-DOSI) shows a
significant increase in cases of child malnutrition. While mortality rate for children
under five years old has declined slightly in recent years from 54 deaths per 1000
births in 1988-1992 to 48 deaths in 1993-1997, infant mortality rates have remained
unchanged at about 35deaths per 1,000 births.

‘The Philippine Statistics Authority (PSA) noted that because two-thirds of all
births are delivered at home, only 56% of mothers receive assistance from health
professionals during the delivery of their children. ‘The Philippines has a high
maternal mortality rate of approximately 200 deaths per 100,000 live births.
According to the 2000 State of the Philippine Population Report, ten Filipino women
die every twenty-four hours from causes related to pregnancy complications and
childbirth. One of the reasons is the irregular or lack of pre- natal check-ups.

From 2012, the Food and Nutrition Research Institute reported that 25%, or
one in every four pregnant women is undernourished. They are at risk to deliver
low birth weight babies and other negative pregnancy outcomes such as
stillbirths, miscarriages and abortions. The nutrition statuses of lactating mothers
are 11.9%, or one in every ten lactating mothers is underweight.

‘REPRESENTATIVES
RECEIVED



Durng pregnancy, under nutrition can have a devastating effect on the
growth and development of a child, Babies who are malnourished in the womb
have a higher risk of dying in infancy and are more likely to face lifelong cognitive
and physical defects and chronic health problems. Children under the age of two
will have weak immune system and more susceptible to dying from common
illnesses such as pneumonia, diarrhea and malaria.

‘This bill therefore seeks to protect the Filipino mothers and children from
malnutrition by institutionalizing a maternal and child healthcare program in every
local government unit. There is an imperative need to provide prenatal and post
natal matemity care service to a pregnant woman in order to protect her health as
well as ensure the nutritional diet of her new born child to eradicate mainutrition.

In order to have a future generation of youth who are physically and
mentally healthy, approval of this bill is highly and earnestly recommended.

Congressman
Lone District of Biliran


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

Seventeenth Congress
First Regular Session

-
HOUSE BILL NO.__ 875

Introduced by Representative Rogelio J. Espina

AN ACT
STRENGTHENING THE NATIONAL AND LOCAL HEALTH AND
NUTRITION PROGRAMS FOR PREGNANT AND LACTATING WOMEN,
INFANTS AND YOUNG CHILDREN IN THE FIRST 1000 DAYS AND
APPROPRIATING FUNDS THEREFOR

Be it enacted by the Senate and House of Representatives of the Philippines in Congress
assembled:

SECTION 1. Title. - This Act shall be known as the “First 1,000 Days Act”.

Sec. 2. Declaration of Policy. - ‘The right to health is a fundamental principle
guaranteed by the State, Section 15, Article 2, of the 1987 Constitution emphasizes
that “The State shall protect and promote the right to health of the people and instill
health consciousness among them.” Moreover, pursuant to various intemational
human rights instruments and agreements that the State adheres to, the State
guarantees the right to adequate food, care and nutrition to children, especially those
from zero to five-years old.

“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 women of reproductive age, pregnant women, and
children from 0 to 24 months.

‘The State finally refocuses the intervention program on malnutrition to the first 1,000
days of a child’s life, ie. the nine months in the womb and the first 24 months of
his/her life which are crucial in preventing malnutrition.


Sec. 3.Objectives.—This Act specifically aims to:

(a) Provide a more comprehensive, sustainable and multi-sectoral approach to
address malnutrition;

(b) Provide a policy environment conducive to nutrition improvement;

(©) Provide mechanisms, strategies and approaches in implementing programs
and projects to improve nutritional status and to eradicate malnutrition and hunger;

(a) Strengthen the National Nutrition Council (NNC) as the policy-making body
on nutrition; and.

(@) Ensure the meaningful and active participation, partnership and cooperation
of NNC-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.

Sec. 4. Types and Definition of Malnutrition, - The following types of malnutrition
are hereby defined:

a) Low birth weight refers to weight at birth of less than 2500 grams or 5.5
pounds;

b) Underweight refers to low weight-for-age which is less than negative two (2)
standard deviations (SD) of the WHO Child Growth Standard median;

©) Stunting refers to low height-for-age which is less than negative 2 SD of the
WHO Child Growth Standard median and which is an indicator of long standing or
chronic malnutrition;

a) Wasting refers to low weight-for-height which is less than negative 2 SD of
the WHO Child Growth Standard median.

e) Overweight refers to weight above normal for height, which is greater than
positive 2 standard deviations (SD) of the WHO Child Growth Standard median;

SEC. 5. Comprehensive Anti-Malnutrition Program.-There shall be a
comprehensive and sustainable strategy to address the health and nutrition
problems in the country to be formulated by the DOH-NNG, in cooperation with
other government agencies, LGUs, the private sector, relevant civil society
organizations and industries, within three (3) months from the effectivity of this Act.
‘The health program shall focus on pregnant and lactating women as well as the
health and nutrition of their newborn children from 1 to 1,000 days.


Sec. 6. Coverage. - This Act covers all Filipinos who are nutritionally at risk, with
specific focus on women of reproductive age, pregnant and lactating women,
particularly teen-age mothers, and all Filipino children from birth to ages zero to two
(2) years old that reside in Geographically Isolated and Disadvantaged Areas
(GIDA), ie, 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 the
Food and Nutrition Research Institute (FNRI).

Sec. 7. Program Phrases. The program shall consists of three phrases, namely:

a) Pregnancy until birth, - Pregnant mother’s nutrition is crucial to the
developments of infants. Mothers who are not in good health could result
to premature delivery, unhealthy infants, or even death. Prenatal care
services at the facility level shall include: pregnancy tracking and
enrollment to prenatal care services; identification of nutritionally-at-risk
pregnant women; micronutirient supplementation with iron-folic acid and
use of iodized salt and fortified foods; prevention of neonatal tetanus, oral
health; empowering women on the preparation of birth plans; Philhealth
enrollment and linkage to community health volunteers.

b) 1 day to 6 months ~ Health services shall focus on breastfeeding for the
newborn with emphasis on early initiation of breastfeeding within the first
hour of life and exclusive breastfeeding for all infants until 6 months of
age; immunization services (at birth up to one year of age)

c) 6 months to 2 years - Health services shall cover timely introduction of
safe, appropriate and nutrient dense quality complementary food with
continued and sustained breastfeeding for all infants up to 2 years of age;
micronutrient supplementation from 6 months with iron sulfate, Vitamin
A and/or micronutrient powder; growth and development monitoring
and promotion and deworming for child at 1_year of age.

Sec. 8. Program Components. - ‘The strategy or program on Health and Nutrition
shall include the following component
a. Nutritional supplements for the pregnant women to include iron-folate
supplementation and for the infants starting at 6 months vitamin A
supplementation and Micronutrient in complementary feeding
b, _ Check-ups to include support for teenage mothers and those coming from
geographically isolated and depressed areas (GIDA); nutritional support
for nutritionally at risk mothers; lactation support for women with infants
in the workplace and the informal sector
©. Vaccination to cover all the recommended available vaccines that can
prevent childhood disease.



d. Counselling should be skilled (based on technical standards) and should
include exclusive breastfeeding for 0-6 months and age appropriate
complementary feeding from 6-24 months with continued breastfeeding
up to 2 years of age and beyond; water, sanitation and hygiene promotion

e. Public information drive using quad media approach not to be limited in
the schools but to include health facilities, workplaces, communities and
public places

f, Monitoring shall involve all the relevant stakeholders with a monitoring
tool jointly developed by all agencies involved to include civil society
organizations (CSOs)

g Breastfeeding stations can also be established in the informal sector to
include public places like markets, transportation stations, agriculture and
fishing industries and public malls.

Sec. 9. Program Implementation. The DOH and NNC shall establish a framework to
monitor the status of women during and after their pregnancy and the status of their
children,

‘The DOH shall monitor the overall implementation of the program and lead in the
distribution of supplements, administration of check-ups and vaccinations in the
different barangays nationwide.

Sec. 10, The National Nutrition Council. - The composition of the NNC Governing
Board is hereby amended and the same shall now be composed of the following:

(a) Secretary of Health (Chairperson);

(b) Secretary of Agriculture(Vice Chairperson);

(©) Secretary of the Department of Social Welfare and Development;

(4) Secretary of the Department of Education;

(©) Secretary of the Department of Science and Technology - Food and
Nutrition Research Institute (FNRI);

() Secretary of the Department of Budget and Management;

(g) Secretary of the Department of Trade and Industry;
Secretary of the Department of Interior and Local Government;

(i) Secretary of Labor and Employment;

() Chairperson of the Philippine Commission on Women;

(k) The Executive Director of the National Economic and Development
‘Authority; and

()) Three representatives from the private sector to be appointed by the
President of the Philippines who shall come from the food, nutrition
industry, and women sectors, respectively. Said representatives shalll serve
for a term of two (2) years.

In the event that any cabinet member cannot attend a council meeting, said
member shall be represented by an undersecretary or assistant secretary.


The composition of the NNC’s Secretariat and Technical Committee as defined in
Executive Order No. 234, Series of 1987 shall be maintained.

Sec. 11, Functions and Powers of NNC.-The NNC shall have the following
functions and powers:

(a) Formulate national nutrition policies, plans, strategies and approaches for
nutrition improvement;

(b) Oversee and serve as a focal point in the integration of nutrition policies
and programs of all member agencies and instrumentalities charged with
the implementation of existing laws, policies, rules and regulations
concerning nutrition;

(©) Coordinate, monitor and evaluate programs and projects of the public and
private sectors and LGUs to ensure their integration with national policies;

(a) Receive grants, donations and contributions, in any form, from foreign
governments, private institutions and other funding entities for nutrition
programs and projects: Provided, That no conditions shall be made
contrary to the policies or provisions of this Act;

(e) Coordinate the release of public funds for the promotion of the nutritional
well-being of the country in accordance with the approved programs and
projects; and

() Call upon any government agency and instrumentality for such assistance
as may be required to implement the provisions of this Act.

Sec. 12. Role of Member-Agencies, - The DOH and the NNC shall lead
implementation of the program with the help of the following agencies: the DSWD,
the DILG, state universities and the local government units (LGUs).

‘The DSWD, in furtherance of any of its programs, shall help and coordinate in the
implementation and monitoring of the program in all barangays nationwide

‘The DILG through the LGUs and their respective Barangay Health Workers (BHWs),
Rural health Workers, and Barangay Nutrition Scholars (BNS) shall assist the DOH
in the implementation of the program, The LGUs shall likewise endeavor to provide
sustained capability building skills to BNSs and BHWs in support of local nutrition
programs.

‘The consortium of State Universities and Colleges (SUCs) shall intensify nutrition-
related training, research and extension support activities through the Barangay
Integrated Development Approach for Nutrition Improvement (BIDANI) Network
Program of the Rural Poor and other relevant approaches, thereby strengthening
delivery systems in partnership with the LGUs.

NGOs shall be encouraged to undertake nutrition-related researches and to
recommend procedures and guidelines promotive of good nutrition among
employees of agencies or members of NGOs.


The Private Sector shall also be encouraged to provide technical and financial
assistance to community-based nutrition projects though their corporate social
responsibility programs, as their participation in the country’s bid to enhance human
development and human capital formation.

Sec. 13, Nutrition in the Aftermath of Natural Disasters and Calamities. - Areas
that are struck by disasters must be prioritized in the delivery of nutrition programs.
National, regional, and local governments are mandated to immediately provide
emergency food supplies for proper nourishment of lactating mothers and children,
specifically those from zero to two (2) years old,

Private sector donations in emergency situations shall be allowed immediately in the
aftermath of natural disasters and calamities. The National Disaster Risk Reduction
and Management Council (NDRMMC) is hereby mandated to formulate guidelines
in pursuit of this Section.

National and local disaster risk reduction and management councils are hereby
enjoined to involve women in the decision-making process, allowing them to take
part in implementing disaster preparedness, recovery and rehabilitation programs.

Sec. 14. Appropriations ~ ‘The amount necessary for the implementation of this Act
shall be charged to the current appropriations for the Department of Health.
‘Thereafter, such sum as may be necessary for the continued implementation of this
Act shall be included in the annual General Appropriations Act.

Sec. 15, Implementing Rules and Regulations - Within ninety (90) days from the
effectivity of this Act, the Secretary of Health shall, in coordination with the
Secretary of the Interior and Local Government and Secretary of Social Welfare and.
Development promulgate rules and regulations necessary for the effective
implementation of this Act.

Sec. 16. 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.17. Effectivity. This Act shall take affect fifteen (15) days after its publication in
the Official Gazette or in a newspaper of general circulation.

Approved,