IN the front lines of the war against malnutrition are the barangay workers who fan out to the villages to look for the children who need help and link them to those who can provide it.
But while laws provide the framework and manpower for this task, the delivery of services to the undernourished has not been a smooth undertaking.
Presidential Decree 1569 ordered the provision of one barangay nutrition scholar (BNS) in every barangay. And Dr. Parolita Mission, nutrition program coordinator of the National Nutrition Council (NNC) 7, said all barangays in Cebu had complied with this order.
“In some cities, they can no longer hire, so they select the most mature barangay health worker for designation as the barangay nutrition scholar. The barangay health worker (BHW) is relieved from his role as BHW, to act as BNS to comply with the law. These are the ones that we train,” she said.
“Only one BNS is required. But in bigger local government units (LGU), if they can afford it, they hire two,” she said.
The BNS is principally responsible for the nutrition program of the barangay.
“She coordinates with the barangay health worker, day care worker, agri-technician and non-government organizations operating in that barangay, so that they will work for the nutrition program of the barangay. She will collect the weight and height results of the Operation Timbang. She is the repository of the nutrition data in the barangay,” Mission said.
Electioneering
With serial regularity, however, politics hampers the work of the barangay nutrition scholars.
“During elections, there is electioneering. They replace the BNS with someone (allied with the) barangay captain or mayor. This is our headache. We would have to start from scratch and retrain again, because skill is involved in weighing (children),” she said.
Mission said they cannot stop the LGUs from making the personnel changes; they can only tell them that it would be better not to change the BNS because it costs a lot for government to retrain them.
Action officer
The NNC official said barangays were also required to have a Barangay Nutrition Action Officer (BNAO) and to form a Barangay Nutrition Committee (BNC).
The barangay captain chairs the Barangay Nutrition Committee, she said, while the BNAO is the point person for nutrition in the BNC. The BNS, on the other hand, is the secretariat of the BNC.
“Most often, the BNAO is the chair of the committee on health in the Barangay Council. In other LGUs, sometimes the midwife is the BNAO,” she said.
Mission said all Cebu barangays already have a BNAO, “but the problem is the functionality of the Barangay Nutrition Committee.”
Asked to elaborate on her statement last November that only 50 percent of LGUs in Central Visayas were supportive of nutrition programs, Mission said: “You will know if the LGU is supportive by looking at the functionality of its local nutrition committees.”
Local nutrition committees give reports to the provincial level committees, which transmit the data to the NNC. And the NNC also randomly selects municipalities to test and visit.
“We assess the performance of Cebu Province by randomly selecting five municipalities,” she said.
“We look at their Nutrition Action Plan, if they were able to achieve the target based on the plan, the number of agencies involved in the local nutrition committee, frequency of meetings. Ideally, we suggest they meet once a quarter. We look for their minutes of the meeting, the topics tackled, how they resolved the issues. Then we assess the outreach. For instance, the intervention of the Department of Agriculture and Department of Health, how much was achieved based on the target?” she said.
They also check the budget allocation for the nutrition program, and whether local nutrition policies were formulated or national laws adopted in their area along nutrition.
“All LGUs already have a budget for a nutrition program, except for the barangay level sometimes,” she said.
Then the NNC checks if there was a reduction in the undernutrition in the area.
“We do validation weighing. We locate the children weighed last year based on the master list, and we weigh them ourselves to assess if the child deteriorated or improved in condition,” she said.
Self-reporting
According to reports sent to the Department of the Interior and Local Government (DILG)-Cebu Province signed by their health officers, all towns and cities, except for four LGUs, had functional barangay nutrition committees as of the first half of this year.
Well, actually, some of these LGUs, like Talisay, Ronda, Sibonga and Moalboal, reported on the functionality of their municipal or city level nutrition committees only.
Functionality was measured by whether monitoring visits had been conducted on the delivery of nutrition services and documented at least twice a year by the LGU.
The DILG-Cebu Province covers the cities of Bogo, Carcar, Danao, Talisay, Naga and Toledo and the 44 municipalities.
Change of the guard
Boljoon, Malabuyoc and Bogo City had not yet submitted reports, while Bantayan said it had “no functional nutrition council nor a municipal nutrition action officer (MNAO).”
“With the change of administration, the newly designated MNAO was terminated… The Council has also been inactive,” local government operations officer Lyn Aguelo wrote in a July 5, 2017 letter to DILG Provincial Director Jerome Gonzales. “The barangays also do not have functional nutrition committees.”
Last May, Arthur Despi was unseated as mayor of Bantayan by Ian Christopher Escario after the Commission on Elections disqualified him for invalid substitution.
Of the three highly urbanized cities, only Mandaue said all its BNCs were functional. Lapu-Lapu said only 27 of its 30 BNCs were functional. Cebu City said its 80 barangays had BNCs, of which 65 were functional.
Not validated
But the NNC’s validation of the claims showed a different story.
From March to April this year, NNC officials visited 12 towns—Cordova, Compostela, Liloan, Sogod, Medellin, Daanbantayan, Bantayan, Tudela, Pilar, Poro, Aloguinsan and Minglanilla—and found “no functional BNC,” said Dave Bargamento, NNC 7 nutrition officer II assigned to the Cebu Provincial Nutrition Council.
“In each town, we visited a minimum of two barangays to check if they had met at least twice a year, which is 50 percent of the four times a year requirement,” but none of the barangays had even issued an executive order on the creation of their BNC, he said.
“Usually, the barangay captain would just say they had already included (nutrition issues) in their barangay level meetings. But these are just discussed under ‘Other Matters,’” he said.
Beyond the BNS reporting to the barangay captain the number of underweight children, there was not much else in the way of a nutrition program in most of the barangays visited, he said.
The NNC 7’s own monitoring of the nutrition committees at the municipal level shows that of the 44 municipalities, only 17 had organized a municipal nutrition committee (MNC), with “organized” meaning they had “passed an executive order (EO) in the municipal level ordering the creation of the MNC.”
And of the 17 MNCs organized, only two were deemed “functional,” meaning that they met four times a year, and had an approved budget and municipal nutrition action plan.
Four were “non-functional,” three were “newly organized,” while eight were “partially functional,” which means they had an EO and met twice a year, but had no approved plan or budget, Bargamento said.
Priorities
Asked why the nutrition committees were not active, Mission said: “Their nutrition committee is not active because the nutrition program is not their priority. They prefer to use their money on other projects, like infrastructure. In health and development programs, they can’t indicate so much that these are ‘Through the efforts of Mayor so and so…’ This is our challenge.”
“It’s (Spending is) a political investment. That’s the reality in Philippine politics,” she said.
Why don’t they just ask for money so they can spend on both infrastructure and nutrition?
“Some of them are not aware that they are responsible for the nutrition program. So we orient them,” she said. (CTL)
Factors for malnutrition in the family or community
(Source: National Nutrition Council nutrition program coordinator Dr. Parolita Mission)