EDCOM 2 calls for unified agency action to fix nutrition programs in early years

"NNC, DOH, and ECCD should really coordinate and talk. Policies and programs are not coordinated. Once the child is stunted at pumasok siya, the game is over. It is important for agencies to communicate, and that is the mandate of the law," says Second Congressional Commission on Education (EDCOM 2) Co-Chairperson Senator Win Gatchalian, during the Commission's probe into the implementation of early childhood nutrition programs.

During an EDCOM 2 public hearing on nutrition, the Commissioners expressed disappointment about the lack of coordination across agencies implementing nutrition and feeding programs in the country, specifically among the Department of Health (DOH), National Nutrition Council (NNC), and the Early Childhood Care and Development Council (ECCD), with mandates to oversee the implementation of critical nutrition programs.

Year 1 findings of EDCOM 2 emphasize the need to address governance, implementation, and resourcing issues as these impede the efficient monitoring, evaluation, and successful implementation of crucial health and nutrition programs. The lack of institutionalization of effective practices at the national level also hinders equitable access and opportunities in LGU practices for health and nutrition.

Addressing malnutrition, stunting

In an attempt to address the high prevalence of malnutrition and stunting in the country and reduce stunting prevalence to 13.5% in 2028, the DOH is currently implementing various nutrition programs.

Republic Act No. 11148 or the First 1,000 days law seeks to institutionalize the convergence and scale-up of programs from different sectors around the critical first 1,000 days of life, and also focuses on strengthening the implementation and enforcement of the existing nutrition-related laws and policies.

Aside from the existing nutrition programs, the Philippine Multisectoral Nutrition Project (PNMP) was also launched to increase the utilization of a package of nutrition-specific and nutrition-sensitive interventions and improve key behaviors and practices known to reduce stunting in targeted local government units (LGUs). Out of 1,4888 municipalities, 235 municipalities are covered by the project, prioritizing LGUs with the highest burden of childhood stunting.

While the efforts on nutrition specific interventions are commendable, the Commission pointed out how implementation of nutrition and feeding programs are fragmented, lacking coordination among agencies concerned.

Lack of local oversight, lack of local data

"How are we monitoring this and how do we know the status of implementation at the local level? In the law, you [DOH] are the lead agency meant to coordinate with the NNC and other agencies to make sure that it is being implemented. How is DOH leading the charge in monitoring implementation at the local level, especially those municipalities not covered by the PMNP?" asked ED Yee.

"We are constantly coordinating with the Centers for Health and Development across Luzon, Visayas, and Mindanao. We ask them to submit reports also including budgetary needs. Marami kaming meetings with them, kahit online, to update us on the status [of implementation]," says DOH Representative Dr. Noel Ballesteros.

However, despite the regular coordination with their local counterparts, the lack of data about the status of the local implementation of these nutrition related programs is apparent. The DOH states that they are only able to monitor provinces and cities, and not the municipalities that are not covered by the PMNP.

"The universe is huge. And it is understandably a very difficult responsibility. We have more than 1000 municipalities na hindi malinaw kung ano ang nangyayari," expressed Yee. Section 7 of the First 1,000 days law mandates the DOH, in coordination with the concerned NGAs and LGUs, to implement provisions of the law and provide oversight.

Despite requiring LGUs to develop their respective local nutrition plans, the NNC also has no clear mechanism to monitor the implementation of these plans.

The Commission likewise pointed out the confusion among LGUs as to the roles of the NNC and local health offices. "In my own experience, the relationship between NNC and DOH is not clear on the ground. It is not clear how the two are going to work together. In the work that we [volunteer groups] have been doing, the implementation in the early years is weakest because we cannot work well with DOH," shared EDCOM 2 Advisory Council Member Fr Ben Niebres.

"Most often than not, when it comes to health, there is really a gap between the national and local. The battleground is not in your office, it is in the LGUs," says Sen Gatchalian. He further emphasized how the lack of coordination and accountability across these implementing agencies can also impact the education agenda.

"We want to make sure that the accountability is clear, or else magtuturuan. This connects to our agenda in EDCOM, which is education. We all know that if the child is stunted, it will be difficult for the child to learn and will have problems in the future. So we are trying to make sure that all these government agencies are coordinated, and are clear with their accountabilities", explained Sen. Gatchalian.

The Commission and its standing committee members are set to meet with the DOH, NNC, ECCD and other concerned agencies to align their respective mandates and implementation plans on early childhood nutrition programs.