Republic of the Philippines

Department of Agriculture

NATIONAL NUTRITION COUNCIL

I. Rationale

Nutrition plays a vital role in an individual's growth and development. Growth is the gradual increase in size of the body and its organs. Development is the increase in the number of skills performed by the body, including the brain, and in the performance of such skills. Growth is one way of measuring an individual's health and quality of nutrition.

The most common method of measuring growth is through weighing. An individual's weight at a particular age, when compared to a standard is considered as the simplest and most sensitive indicator of one's nutritional status. It is useful for rapid screening and provides a rough estimate of an individual's nutritional status at present.

Two methods of growth measurements, which continue to be advocated and implemented, are through Growth Monitoring and the conduct of Operation Timbang (OPT).

Growth Monitoring is the regular monthly weighing of preschoolers by nutrition and health workers to monitor the growth pattern of the child so that appropriate measures can be taken to prevent the onset of malnutrition. It is child or individual focus. On the other hand, OPT is the annual weighing of all preschoolers 0-71 months old or below six (6) years old in a community to identify and locate the malnourished children. The activity is community-focused.

OPT is one of the components of the Philippine Plan of Action for Nutrition (PPAN) under its enabling mechanism on "Overall Planning, Management, Coordination and Surveillance". Data generated through OPT are used for local nutrition program planning, particularly in describing the nutritional status of the community, quantifying the number of malnourished and identifying which barangays have more malnourished children. They are also used for identifying who will be given priority in terms of specific interventions to be implemented. Results of regular OPT provide information on the progress in the nutritional status of preschoolers and the community in general, thus, providing information on the effectiveness of the local nutrition program. OPT results are also useful in generating resources for "new" programs from local governments and/or external sources.

 

II. Programmatic Developments

The conduct of OPT starting from the early '70s was regularly done by local government units through the local nutrition committees. It is now an integral part of the committee's annual nutrition planning activity to assess their current nutrition situation, identify priority barangays and groups for intervention and serve as basis for evaluating the successes and challenges of their programs.

When OPT started, the results were analyzed using the Gomez classification; children were categorized as either normal (90% and above of standard) or malnourished with "malnourished" further categorized as 1st degree (75-90% of standard), 2nd degree (60-75% of standard) or 3rd degree (60% and below of standard). In 1985, the Food and Nutrition Research Institute of the Department of Science and Technology (FNRI-DOST), in coordination with the Philippine Pediatrics Society (PPS), developed the Philippine Reference Standards (PRS), which was adopted for use in the national nutrition program starting 1992. However, in 1998, with the implementation of the Early Childhood Development (ECD) Project by DSWD, DOH, DepEd and its partner agencies and the re-writing of the Department of Health's Integrated Management of Childhood Illness (IMCI) manual, the use of international standards for height and weight was raised. This prompted the NNC to resolve the issue on which appropriate growth standards to use in the country.

In October 1999, NNC convened a roundtable discussion (RTD) on growth standards to evaluate the considerations and implications of the use of either PRS or International Reference Standards (IRS) for the assessment of the nutritional status of Filipino children. The results were elevated to the NNC Technical Committee for final deliberation. In April 2000, then Secretary of Health Alberto G. Romualdez, Jr. recommended to then Secretary of Agriculture and NNC Chair Edgardo J. Angara the nationwide adoption of the IRS to assess the nutritional status of preschoolers. This recommendation was supported by the Department of Nutrition for Health and Development (DNHD) of the World Health Organization (WHO) and UNICEF.

The shift on the standards to use, from PRS to IRS, involved a number of technical and programmatic considerations. As a result, the NNC Secretariat, upon the recommendation of the NNC Technical Committee, convened the Technical Working Group on IRS (TWG-IRS) to plan transition activities for the nationwide adoption of the IRS. The TWG-IRS was composed of representatives from FNRI-DOST, DOH, DepEd, Department of Social Welfare and Development (DSWD), Department of the Interior and Local Government (DILG), Philippine Pediatric Society (PPS), KAIN, and the NNC Secretariat. Transition activities include retooling of the instruments currently in use to adapt them to local setting and orientation training of nutrition and health program implementors on IRS to ensure effective use.

In March 2002, the use of the IRS as a tool to determine nutritional status of Filipino children was approved with the adoption of NNC Governing Board Resolution No. 5 Series 2002, "Adaptation of the International Reference Standards (IRS) in Determining the Nutritional Status of Filipino Children" (Attachment 1). The use of the IRS was favored for the following reasons: a) the IRS reflects the maximum growth potential of children, thus, it challenges any child to compete globally rather than nationally; b) the IRS provides a more realistic and accurate estimate of the prevalence of undernutrition, thus, providing greater impetus for policy level action; c) the IRS focuses on preventive and promotive programs rather than rehabilitative; and d) the IRS allows for inter-country comparability.

In 2003, a Task Force on OPT was formed to revise the Operation Timbang (OPT) guidelines and to settle the issues that arise from the shift in the use of standards. The Task Force is composed of representatives from the DOH-National Center for Disease Prevention & Control (NCDPC), FNRI-DOST, and Council for the Welfare of Children (CWC)-Office of the President, Makati Health Department Nutrition Office (local government unit), and the National Nutrition Council (NNC) Secretariat at Central Office, the NCR and Region IV.

In June 2003 in support to the adoption of the IRS, Health Secretary Dr. Manuel Dayrit signed Administrative Order No. 25 Series 2003, "Adoption of International Reference Standards (IRS) in Philippine Growth Table and Chart Materials" to fasttrack the implementation and mainstreaming of the IRS in the health and nutritional assessment system of the country.

To ensure proper implementation of the IRS, FNRI conducted a series of Trainors' Training in January 2002. Participants of the training are regional nutrition and health program implementers, which include NNC Nutrition Program Coordinators, selected NNC-CO staff, and representatives from DOH/Center for Health Development (CHD). Orientation-training on IRS were organized by DOH/CHD in coordination with the NNC regional offices for the members of the Regional/ Provincial/City/ Municipal Nutrition Committees (R/P/C/MNCs), the Provincial/City/ Municipal Nutrition Action Officers (P/C/MNAOs), Rural Health Midwife (RHM), Barangay Nutrition Scholars (BNSs) and Barangay Health Workers (BHWs).

In April, DepEd conducted its nationwide IRS orientation/training for its Medical Officers, Nutritionist-Dietitians, supervisors and nurses-in-charge. In particular, the weight-for-age indicator is used for children 6-9 years old while the Body Mass Index (BMI) is used for children 10-19 years old. Information generated from the various supervised training was incorporated in the development of the IRS handbook.

At present, all ECD project areas have adopted the IRS in assessing the nutritional status of preschoolers in the community.

The year 2003 served as the bridging year to prepare for the full-scale nationwide adoption in 2004 and the use of IRS in the conduct of MELLPI in 2005.

 

III. Objectives of Operation Timbang

General:

To generate data for nutrition assessment, planning, management and evaluation of local nutrition programs

Specific:

1. to locate families with preschoolers whose weight is below or above normal;
2. to identify and quantify preschoolers with below and above normal weights needing immediate assistance;
3. to locate families with preschoolers with cleft palate or harelip;
4. to detect growth faltering among infants and preschoolers as early as possible;
5. to encourage parents or guardians or caregivers to have their preschoolers weighed regularly;
6. to determine priority areas and individuals for local program implementation (e.g. food and/or micronutrient supplementation, livelihood program and others);
7. to provide appropriate health and nutrition services to preschoolers whose weights fall below normal; and
8. to assess the effectiveness of the local nutrition program.

 

IV. Uses of OPT Results

Data generated through OPT is used for nutrition assessment and local planning, evaluation and education. Through OPT, the magnitude of protein-energy malnutrition and the incidence of cleft palate or harelip among preschoolers in the barangay/ municipality/city/province/region can be estimated. The incidence of cleft palate or harelip in a community could be indicative of deficiencies in biotin, B6 (pyridoxine), vitamin A, folic acid and zinc.

At the barangay level, preschoolers with weights below normal and who belong to poor families can be identified and provided immediate intervention. The profile of the families with malnourished preschoolers can be assessed to determine the appropriate type of intervention needed. At the national level, nutritionally depressed municipalities, cities and provinces can be identified for targeting and planning purposes.

As an evaluation tool, results of OPT are used to assess the: a) impact of the intervention/s; b) overall nutritional progress of the community; and c) efficiency of the local nutrition program. Overall progress in nutrition could be determined through the change occurring in the entire community (improvement or deterioration). This, in turn, will indicate the effectiveness and efficiency of the intervention/s. Through monitoring and evaluation, remedial measures could be identified and taken to increase program impact.

While conducting OPT, nutrition and health workers could conduct relevant nutrition education activities, as appropriate. Brief nutrition counseling sessions could be held among parents and caregivers. Nutrition education/counseling/information sharing could focus on the importance of monthly weighing to monitor the children's growth and development especially for those whose weight is below normal. Information on the usefulness of weight-for-age indicator as the simplest way of determining the nutritional and health status of the child could be emphasized.

 

V. Mechanics of OPT Implementation

Before the enactment of the 1991 Local Government Code, the conduct of OPT was spearheaded by the Ministry/Department of Health with the participation of members of the local nutrition committees. The Rural Health Midwife (RHM) was assisted by the Barangay Nutrition Scholar (BNS), mother leaders - volunteers, Barangay Health Workers (BHWs), and other community volunteers. BHWs helped in the conduct of OPT but it was the BNS who kept records/reports which were furnished to the RHM. The OPT results were submitted to the City/Municipal Health Office (C/MHO) for consolidation and submission to the Provincial Health Office (PHO) which in turn consolidated all reports and submitted these to the Regional Health Office (RHO). All reports were consolidated at the DOH central office (CO) and included in the regular reporting of its Field Health Services Information System (FHSIS).

After the devolution and the localization of basic social services including health, reporting of OPT results was removed from the DOH-FHSIS. Only services provided to underweight children, e.g. number given food supplementation among severely/moderately underweight children were included at the DOH-FHSIS. However, DOH continued to advocate the institutionalization of growth monitoring and promotion.

The BNS with the help of BHW will continue to keep record/reports on OPT and for submission to the RHM for validation. Once the results are validated by the RHM, these will be presented to the Barangay Nutrition Committee (BNC) as basis for recommending the inclusion of families with preschool children whose weights are below normal among the target beneficiaries of the programs or projects to be implemented in the barangay. Validation will be done by the nutritionist/C/MNAO on the submitted OPT results, before these are consolidated to ensure accuracy of results.

 

A. The OPT Team

The OPT Team will be chaired by the RHM and co-chaired by the BNS. Other members of the OPT Team will come from the members of the Barangay Council (i.e. Committee Chair on Health and Nutrition, Sangguniang Kabataan Chairperson), the BHWs, and Day Care Worker (DCW). The team may be assisted by the purok or mother leaders, other community leaders or representatives from civic organizations, whenever necessary. The Municipal Health Officer (MHO) together with the nutritionist-in-charge/MNAO will supervise and monitor the conduct of OPT in the barangay.

B. Roles and Responsibilities of the OPT Team

OPT Team Member	Function/Activity
Rural Health Midwife (RHM) (Chairperson)	1. Coordinate the activities of the OPT team Get the actual the number of preschoolers to be weighed from BNS; determine what and how many resources (e.g. team members, weighing scales) are needed Organize the team Schedule the meeting/s of the team (e.g. planning/preparation and processing of the OPT results) Check data recorded in OPT Forms 1, 1A & 1B Validate the OPT results before presentation to the BNC Keep and maintain duplicate copies of the OPT masterlist (OPT Form 1, 1A & 1B)
Barangay Nutrition Scholar (BNS) as co-chairperson of the OPT team	Inform the community on schedule & place of OPT Help RHM in soliciting volunteers from the community. Prepare a masterlist of preschoolers to be weighed using existing data from the Family Profile or interview during home visits. Update data, if needed, to include newborn infants. The masterlist of preschoolers should reflect the child's family name, his/her first name, and name of father, name of mother, date of birth of child, child's weight. Arrange the family names of the children in alphabetical order. Prepare a new spot map, if necessary. This step should be done before the conduct of the OPT Weigh the preschoolers Calculate the age & nutritional status of preschoolers weighed Inform the parents and/or caregiver on the child's nutritional status. Prepare the summary of OPT results using OPT Form 1A; list of priority preschoolers 0-24 months old; and list of preschoolers with below normal nutritional status using OPT Form 1B Present the OPT results to the team on a date to be decided during the conduct of OPT. Submit OPT results using OPT Form 1A to C/MNAO or C/DNPC copy furnished the Rural Health Unit (RHU). Update the barangay spot map by identifying families/households with malnourished children.
Other team members (BHW, DCW, CDW, mother leader, and others)	Arrange facilities for weighing i.e. site, weighing scales, tables and chairs for writing. Disseminate information regarding the purpose & schedule of OPT to ensure maximum community participation. Gather preschoolers at the site of weighing. Assist in calculating age of preschoolers. Assist in weighing the preschoolers. Assist in informing the mother/caregiver of the weight and nutritional status of preschoolers. Assist in preparing and updating the spot map. Assist OPT Team Leader in other related activities after conduct of OPT such as oral rehydration for diarrhea cases; promotion of breastfeeding; distribution of nutrition information leaflets, and campaigning for environmental sanitation.
Municipal Health Officer (MHO)/ Nutritionist in-charge/C/MNAO/ C/DNPC	Prepare communications for conduct of OPT in private and public schools and Day Care Centers for preschool children aged 36-71 months enrolled in schools. Supervise conduct of OPT in the barangay Validate OPT Forms 1, and 1A and consolidate OPT results

C. Actual implementation of OPT (See Attachment 3 Checklist for the OPT Team for reference.)

1. Target. All preschoolers aged 0-71 months or below six years old will be weighed by the OPT team.

The most recent population census of the barangay may be used in determining total number of preschoolers to be weighed. If census data are not available, multiply the total population of the barangay by 17.5% to arrive at the estimated number of preschoolers aged 0-71 months (DOH Administrative Order No. 25, Series 2003).

In urban cities/municipalities such as those in the National Capital Region (NCR) where OPT coverage does not reach 100% due to refusal of parents in private subdivisions to have their children weighed, the C/MHO or C/DNPC or C/MNAO will include a note to explain the non-100% coverage.

2. Frequency and Schedule. OPT shall be done in the barangay within the first quarter (January-March) of each year. The results of OPT will be used in targeting and/or retargeting of beneficiaries and interventions included in the nutrition action plan.

The OPT Team will reweigh all preschoolers aged 0-24 months or below 2 years old every month regardless of nutritional status. This is the age period when growth faltering is very critical. Reweighing them every month will facilitate regular monitoring of the child's growth pattern.

In addition, the OPT Team should weigh all children aged 25-71 months or below six years old every quarter. The growth and development patterns of these preschoolers are slower when compared during infancy and toddler periods.

The child's weight as well as the services given to the child should be plotted and indicated in the Early Childhood Care and Development (ECCD) card (Attachment 4).

The OPT Team together with the C/MNC should encourage parents and/or caregivers to have their preschoolers 0-24 months weighed monthly. The OPT team may conduct innovative schemes to encourage monthly weighing of these preschoolers. Reweighing of preschoolers may be done in health and nutrition posts, health centers and government hospitals.

3. Site of weighing. Weighing shall be conducted at any place convenient to both the families in the barangay and the OPT Team. It may be held in a barangay hall, day care center, health center, home or any place easily accessible to the target population. For preschoolers who are unable to go to the designated site of weighing, efforts should be exerted to weigh them in their homes.

4. Preparation/Updating of Spot Map. Update, if available, the previous spot map showing the houses, roadways and other geographic features of the barangay. This would entail the conduct of:

- an ocular survey of the barangay, noting down new houses, new roadways, or landmarks; and

- updating/preparing a list of families in the barangay. New families will have to be assigned their respective household numbers.

For barangays without a spot map, the OPT Team shall assist the Barangay Nutrition Committee in preparing one. On the spot map, the team gives each house a household number. If more than one family lives in one house, the families are given the same household number, but the letters A, B and C differentiate each family, as the case may be.

After consolidation of OPT results, houses and families with underweight preschoolers should be indicated on the updated spot map.

Below is a diagram on the conduct of OPT and growth monitoring in the barangay led by the OPT team (Figure 1).

Figure 1. Conduct of OPT and growth monitoring in the barangay

5. Actual Weighing of Preschoolers

a. A schedule of OPT, which includes the time, date and place of weighing should be posted in the health center and other strategic places (waiting sheds, chapel, health and nutrition post, sari-sari store, etc). If the barangay has its own public address system, the schedule must be announced every day at least one week before the actual weighing.

Members of the OPT team should ensure that parents and/or caregivers are informed of the exact time and place of weighing.

b. On the scheduled day of weighing, the OPT Team goes to the designated place taking along the old spot map (if existing), calibrated Salter scale; OPT Form No. 1, age-in-month table, and Weight for Age table for boys and girls, 0-72 months old, masterlist of preschoolers and family profile (updating of family information), rope, pencils and paper.

c. Each member of the OPT Team should have clear and specific assignments during the conduct of OPT:

For example:

c1. Member 1 will organize the preschoolers (e.g. preschoolers with mother to line up);

c2. Member 2 will look for the name of the child in the masterlist by noting his/her name, name of mother/father, address, date of birth);

c3. Member 3 will weigh the preschooler;

c4. Member 4 will record weight results; and

c5. Member 5 will explain to the mother/caregiver the nutritional status of the preschooler/s, especially for those preschoolers whose weights are "below normal" and need referral.

d. In weighing the preschoolers, the procedures in proper weighing should be observed.

d1. Hang the weighing scale from a tree branch, ceiling beam or pole held by two people. Keep the bar or the dial at eye level of the person who will read the weight so that the weight can be read easily and correctly. Ask the mother to remove unnecessary clothing from the child, including shoes and slippers.

d2. Attach a pair of the empty weighing pants or crib to the hook of the scale and adjust the pointer to zero. Most scales have a knob or screw to make this adjustment. Remove the weighing pants or crib from the scale.

d3. Place the child in the crib with the help of the mother. When using the salter scale, let the mother hold the child. Put your arms through the leg holes of the weighing pants. Hold the child's feet and gently pull his/her legs through the leg holes.

d4. Attach the strap of the weighing pants to the hook of the scale. DO NOT CARRY THE CHILD BY THE STRAP ONLY. Gently lower the child and allow the child to hang freely. The child's feet should not touch the ground.

d5. Hold the salter scale and read the weight to the nearest 0.1kg. WAIT FOR THE NEEDLE TO STOP MOVING BEFORE READING THE WEIGHT. Relay the child's weight to the recorder/assistant who records the weight in the OPT Form 1.

d6. Gently lift the child from the weighing pants by his/her body. DO NOT LIFT THE CHILD BY THE STRAP OF THE WEIGHING PANTS.

 

6. Computing the Age of Preschoolers in Months

For quick calculation of age in months, use the Age in Months Table (Attachment 5). If said table is not available, use the long hand method below:

a. See to it that the date of birth of the child is correct. To ensure that the birth date is correct, validate the data with RHM or a record for the newborn infants can be counterchecked with the records of local nutrition and health workers, e.g. midwife, BNS or BHW.

b. Compute the age of the child to the nearest month as of the child's last birth date using this formula:

 

c. Convert age in years into months by multiplying by 12. Add the age in months to the product and the total gives the age in months. Disregard the number of days.

To illustrate:

Example 1

Date of birth : November 10, 2001
Date of weighing : November 29, 2001

To compute:

Year		Month	Day
2001	11	29	- Date of weighing
- 2001	11	10	- Date of birth
0	0	19

Since the age of child is only 19 days, compute the age in months as zero (0).

 

Example 2

Date of birth : January 30, 2001
Date of weighing : July 16, 2001

To compute:

Year		Month	Day
2001	07	16	- Date of weighing
- 2001	01	30	- Date of birth
0	5**	16*

Note: * (30 means 30 days in a month); 16 + 30 = 46 - 30 = 16 days

** 07 became 06 because of the 1 month borrowed for the above, hence, 7 - 1 = 6 - 1 = 5 months

The child's age is 5 months and 16 days. Disregard the number of days. The child's age in months is 5.

 

Example 3

Date of birth : October 1, 1998
Date of weighing : August 31, 2001

To compute:

Year		Month	Day
2001	08	31	- Date of weighing
- 1998	10	01	- Date of birth
2	10	30

Note: * add 12 months (borrow 1 yr) to 8 months, hence, 20 months (20 - 10 = 10 months) **2001 become 2000 from above explanation, hence, 2001 - 1 yr = 2000 (2000 - 1998 = 2 yrs)

The child's age is 2 years, 10 months and 30 days.

Following step 3, the child's age is 2 years and 10 months and 30 days.

(2 years x 2 months) + 10 months = 34 months and 30 days

Disregard the number of days. Therefore, the child's age in months is 34.

(Source: FNRI-DOST. IRS User's Manual, 2003)

 

7. Determination of Nutritional Status

The weight-for-age table using the IRS will be used by all nutrition and health workers to determine the nutritional status of children aged 0-71 months. The table is useful in assessing the child's growth and development in terms of body weight relative to the child's age.

a. How to use the weight-for-age table:

a.1 In the weight-for-age table, look for the point where the child's age in months intersects with the actual weight of the child under the column corresponding to the sex of the child.

a.2 Assess the nutritional status of the child using the suggested cut-off points for normality.

b. How to interpret the weight-for-age table:

Each age under the first column of the weight-for-age table has a corresponding ±2SD (plus or minus 2 standard deviation) values in the succeeding columns for both sexes. The ±2SD values represent the minimum and maximum "boundaries" for the measurement of the child to be classified as within the acceptable limits of normality. Thus, if the weight of the child is less than the -2SD value, the child's weight is below normal or "low" for the child's age. However, if the weight of the child falls above the +2SD value, the child's weight is above normal or "high" for the child's age.

The nutritional status of preschoolers using the weight-for-age indicator is classified into:

1. Normal has a ±2SD (plus or minus 2 standard deviation) value, meaning the child's weight is within the normal limits.

2. Below normal (low) has a <-2SD (less than minus 2 standard deviation) value, meaning the child's weight is below normal or "low" for his/her age.

3. Below normal (very low) has a <-3SD (less than minus 3 standard deviation) value, meaning the child's weight is lower than below normal limits or very low for the child's age.

4. Above normal has a >+2SD (more than plus 2 standard deviation) value, meaning the child's weight is above normal or "high" for the child's age.

Look for the column in the weight-for-age table (Attachment 6) that corresponds to the weight of the child, i.e. determine if the child's weight is normal, below normal (low), below normal (very low) or above normal.

Example:

1) A 5-month old girl weighing 5.5 kg - Normal
2) A 17-month old girl weighing 7.5 kg - Below Normal (Low)
3) A 71-month old boy weighing 11.2 kg - Below Normal (Very low)
4) A 54-month old boy weighing 25.5 kg - Above Normal

(Source: FNRI-DOST. IRS User's Manual, 2003)

 

8. Services after OPT

After the conduct of OPT, the OPT Team will process and fill up OPT Form 1B to come up with the masterlist of preschoolers whose weights are below normal (very low), below normal (low) and those with cleft palate/harelip. The list will be presented to the Barangay Nutrition Committee (BNC) for inclusion as beneficiaries of programs and projects implemented in the barangay such as supplementary feeding, micronutrient supplementation (vitamin A, iron & iodine), nutrition education, food production (backyard gardening), small animal dispersal/raising (poultry, swine, goat), and income-generating projects (handicraft, food vending), among others.

The identified families of the preschoolers will be monitored by the OPT Team and the barangay officials to ensure improvement of their nutritional status.

 

9. Recording and Reporting OPT Results

a. The OPT Forms (Attachment 7)

To facilitate the recording and reporting process, the OPT results will be recorded at different geo-administrative levels using different OPT forms. A summary of the OPT forms by level, is shown in Table 1.

b. Reporting OPT Results

Figure 2 shows the flow of reporting OPT results as described below:

b1. Upon completion of OPT and recording in OPT forms by the BNS or the BHW, the RHM checks the OPT Forms for correctness and accuracy.

b2. The RHM as the chairperson of the OPT Team presents the results of the OPT to the Barangay Nutrition Committee (BNC) for information, validation and prioritization of beneficiaries for nutrition services.

b3. The BNS through the BNC submits the OPT results to the City/Municipal Nutrition Action Officer (C/MNAO) for consolidation. The consolidated barangay OPT reports are then forwarded to the City/Municipal Health Officer (C/MHO) for validation.

b4. The C/MNAO presents the OPT results to the City/Municipal Nutrition Committee (C/MNC) for information and targeting. The MNAO will submit the municipal OPT results to the Provincial Nutrition Action Officer (PNAO). The CNAO will submit the results directly to the NNC Regional Offices c/o NPC.

b5. The consolidated municipal OPT results are then forwarded to the Provincial Health Officer (PHO) and the DOH-CHD (Regional Director (RD)) for validation, respectively.

b6. The validated provincial OPT results are now presented to the Provincial Nutrition Committee (PNC) for information and targeting. These are submitted to NNC NPC for consolidation and validation by the DOH-CHD (RD).

b7. The regional consolidation of OPT results by province is presented to the Regional Nutrition Committee (RNC) for information and reference for planning, monitoring and evaluation.

b8. The regional OPT results are then submitted to NNC-CO for consolidation.

b.9 NNC-CO consolidates the OPT results, a copy of which is provided to DOH through the NCDPC

Figure 2. OPT Reporting Flow

National
Regional
Province/City
Municipal
Barangay

 

10. Prioritizing for Intervention

The Weight (kg) for Age of Boys and Girls 0-72 months Table classifies children as normal, below normal (low), below normal (very low) and above normal. The below normal (very low) was added to the original IRS classification of normal, below normal and above normal to provide means for the local government units (LGUs) to prioritize recipients/ beneficiaries for interventions.

From OPT Form 1B, the team can determine the actual number and identify who are the more at-risk-preschoolers to be targeted for nutrition and health interventions. Priority could be given to children who were classified as Below Normal (Very Low) and Below Normal (Low). If the resources are more than enough, then all preschoolers listed in OPT Form 1B can be targeted.

 

VI. References

A. Publications

1. Department of Health. Revised Operation Timbang Guidelines. (1990)
2. Food and Nutrition Research Institute. DOST. A Handbook on International Reference Standards (IRS) Growth Tables and Charts Adopted for Use in the Philippines. 2003.
3. _____________. User's Manual The International Reference Standards (IRS) Growth Tables and Charts adopted for Field Use in the Philippines. 2003
4. Food and Nutrition Research Institute and Philippine Pediatric Society. Anthropometric Tables and Charts for Filipino Children. 1992.
5. National Nutrition Council. Operation Timbang Workbook. (1975)
6. _____________. The Philippine Nutrition Program: Implementing Guidelines. June 1981.
7. _____________. Procedural Guidelines for Growth Monitoring of Preschool Children. 1986.
8. _____________. Glossary of Terms for the Philippine Plan of Action for Nutrition. Developed by the Technical Working Group on Nutrition Research and Surveillance. September 1996.

 

B. Circulars/Orders

1. Department of Health Administrative Order No. 25 Series 2003. "Adoption of International Reference Standards (IRS) in Philippine Growth Table and Chart Materials"
2. National Nutrition Council Governing Board Resolution No. 5 Series 2002. "Adaptation of the International Reference Standards (IRS) in Determining the Nutritional Status of Filipino Children"

 

C. IEC Material

1. Early Childhood Care and Development (ECCD) Card. 2002.