DOH approves rules to implement law on pregnant women, infants

FULL EFFECT. DOH Secretary Francisco Duque III leads the ceremonial signing of the Implementing Rules and Regulations (IRR) of RA 11148 or the Kalusugan at Nutrisyon ng Mag-Nanay Act.

Photo by Jene-Anne Pangue/Rappler

MANILA, Philippines – The Department of Health (DOH) launched on Thursday, May 2, the implementing rules and regulations (IRR) of a law boosting government services for pregnant women and infants. 

Health Secretary Francisco Duque III led the signing of the IRR in a nutrition forum conducted by the National Nutrition Council (NNC), attended by representatives from member agencies of NNC Governing Board, other national government agencies and non-government organizations (NGO) among others. 

Republic Act 11148 or the Kalusugan at Nutrisyon ng Mag-Nanay Act (Health and Nutrition of Mothers and Their Children Act) seeks to scale up government programs addressing nutrition through a more comprehensive and sustainable strategy in the first 1,000 days of life. Because of this, it's also popularly known as the first 1,000 days law.

Ensure delivery of services 

The IRR framework presents the policy direction, budget and expedinture plans, operational guidelines and intervention programs in the first 1000 days in order to achieve zero hunger, improve health and nutrition, and address malnurtrition.  

The law covers pregnant and lactating women, particularly teenage mothers, women of reproductive age, adolescent girls and children from 0 to 2 years old. 

Also included are the women and children in geographically isolated and disadvantaged areas (GIDAs), areas with high risk for disasters, and localities suffering or recovering from armed conflicts and crisis. 

The approval of the IRR comes nearly 6 months since President Rodrigo Duterte signed the Kalusugan at Nutrisyon ng Mag-Nanay Act into law on November 29, 2018.

The law stipulates the programs and services to be delivered for women and babies at prenatal period, women about to give birth and immediate postpartum period, postpartum and lactating period, birth and newborn period, first 6 months of infancy, and infants 6 months up to 2 years of age. 

Although most of the services are already available,  Duque said that the law institutionalizes the sustained efforts of the health sector in ensuring that services concerning the different life stages of women and children are provided. 

Timely immunization, promotion of breastfeeding and complimentary feeding, micronutrient supplementation, and assurance of women and child-friendly spaces during calamities, disasters and other emergencies, are some of the program components. 

DOH, NNC, the Department of Agriculture (DA), Department of the Interior and Local Government (DILG), Department of Social Welfare and Development (DSWD,) and local government units are tasked to ensure its implementation. 

Execution weighs more 

In Duque's keynote address before the signing, he emphasized that although the IRR serves as an important guide, it is in the execution that makes all the difference.

“The time to act is now. We don’t have all the time in the world to be doing all these, crafting too many laws. Today, we have to take [into] account: What have we done, how have we moved?” Duque said.

Duque emphasized the importance of the implementation of the first 1,000 days law, citing the need to sustain nutrition programs for children and infants. (READ: Malnutrition, Peter Pan and never growing up)

“Ito ay tutugon sa pangangailang nutrisyon ng mga bata...Ito yung kontexto ng pagsasagawa ng batas na ito: na ang health ng mga bata, ang kalusugan ay direktamenteng naapektuhan ng kanilang kinakain, ng kanilang mga micronutrient supplementation, breastfeeding and all other complementary feeding programs,” Duque added.

(First, this will answer the nutrition needs of the children…This is the context of this law: that the health of the children will be directly affected by what they eat, their micronutrient supplementation, breastfeeding and all other complementary feeding programs.)

Public health concern

Duque also emphasized that around 4.2 million children are found to be stunted, which means that they are short for their age. Meanwhile, about 300,000 children under 5 years old are wasted (have muscle wasting) which means that their weight is low for their height.

Nutrition Information and Education Division chief of National Competitiveness Council Jovita Raval said that the concept of the first 1000 days of life covers the period of conception until the child reaches 2 years old. (READ: PH among the worst places for children to grow up – report

Raval also highlighted how critical it is to provide interventions involving health, nutrition, early learning and social services, so children will develop fully in this period. 

“In the Philippines, particularly, we have a very high prevalence of child stunting. We can address child stunting by improving the first 1,000 days, by providing the child with all the needed help, nutrition, early learning and social services within the context of early childhood care and development,” Raval said.

She added how stunting is irreversible after 2 years, emphasizing the need to address nutritional problems in the first 1,000 days.

Children who are stunted have a higher risk of dying. If the child reaches beyond 5 years, they will likely have poor performance in schools because their physical and mental development is compromised. –