AHMP Documentation Report

8/11/2019 AHMP Documentation Report

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ACCELERATED HUNGER-MITIGATION PROGRAM

(AHMP)

Program Implementation Review of thePromote Good Nutrition Component (PGN)

in the National Capital Region

April 6-8, 2010

Lagos Del Sol Resort, Cavinti, Laguna


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Introduction

The Promote Good Nutrition (PGN) is a component of the Accelerated Hunger-Mitigation Program

(AHMP). It includes the conduct of trainings on Infant and Young Child Feeding (IYCF) and Pabasa

sa Nutrisyon(PSN) for community-based implementers as well as distribution of IEC materials

promoting good nutrition particularly, the Nutritional Guidelines for Filipinos (NGF).

The PGN is being implemented to contribute to hunger-mitigation through improved food and

nutrition knowledge, attitude and practices of families in AHMP areas. Specifically, the PGN aims to

1) increase the number of 0-6 month old infants who are exclusively breastfed; 2) increase the

number of infants 6-11 months old receiving calorie and nutrient-dense complementary food; 3)

increase the number of households with improved diets in terms of quality and quantity; and 4)

increase the number of households involved in food production activities.

In 2007, the NNC-NCR Regional Office provided funds to all the cities and municipality in Metro

Manila for the conduct of trainings on Infant and Young Child Feeding and Pabasa sa Nutrisyonfor

community-based implementers covering 50% of barangays in the region. The NNC-NCR alsoprovided IEC materials promoting good nutrition particularly, the NGF. This year, NNC-NCR will

provide funds to cover the remaining 50% of the barangays once the training materials are available.

Prior to the expansion to the remaining 50% of the total barangays, a Program Implementation

Review (PIR) was conducted to assess how the program was implemented by the LGUs after

trainings were conducted and IEC materials were distributed.

Objectives

The three-day workshop aimed to:1.

determine accomplishments of the program vis--vis targets, program gaps and

recommendations for improving the program to ensure sustainability;2.

share and identify good practices, facilitating and deterring factors;

3. identify strategies and follow-through actions for the expansion of the program to other

barangays;4.

review the concept of breastfeeding support groups and to clarify other concepts in relation to

PGN implementation; and

5. reinforce IYCF counseling and practical skills learned from the training and identify commonproblems faced by participants in applying IYCF counseling.


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Day 1:

Opening Program

The PIR held on April 6-8, 2010 at Lagos del Sol Resort in Cavinti,

Laguna was attended by selected IYCF-trained doctors, nurses,

midwives, nutritionists, barangay nutrition scholars and volunteermothers from the 16 cities and municipalities in the region.

Unfortunately, there were no participants from Manila.

The program was moderated by NOIII Emerenciana D. Lagadia and

NOII Arlene A. Famoso. The invocation was led by Ms. Teresa

Abando, Nutritionist of Caloocan City. In her prayer, she thanked Godfor the safe arrival of the participants to the venue and she asked for the

guidance of the Almighty Father so that the participants will learn new

knowledge that they can share with their community.

After the prayer, Ms. Edna Cipriano, Nutritionist of Navotas City, ledthe singing of the National Anthem.

RNPC Milagros Elisa V. Federizo gave the welcome message. She thanked everyone for attending

the PIR even if the venue is far from Metro Manila. She expressed hope that the participant will enjoy

the view of nature and the company of each other. She said that the activities of the PIR will enablethe participants to review the program as implemented in their respective LGUs and assess what

activities have been done, what were done well, what were not done as planned, what could have

been done better and what still should be done. She expressed optimism that the objectives of thePIR will be achieved and that the activity will be a good opportunity to enhance the camaraderie

among the participants and establish a good working relationship among them even after the PIR .

The participants from the LGUs and facilitators were introduced by NO II Arlene Famoso. Withoutphoto is Mr. Anthony Benabese of San Juan City who came in later in the evening.

Mandaluyong:1.

Ms. Marivel Pornea

2.

Ms. Madgeline Soria

3. Ms. Amy Ruby Balmaceda

4. Ms. Marie Tess Belo

5. Dr. Shari Sabalvaro (Facilitator)

Navotas:

1.

Ms. Remedios Suaco

2.

Ms. Edna Cipriano


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Muntinlupa:

1.

Mr. Francis Tagle

2.

Ms. Rhonda Rabino

Marikina:

1.

Ms. Eileen Guevara

2. Ms. Rizalita Torrenueva

Valenzuela:

1. Ms. Elizabeth Provido

2.

Ms. Winona Villanueva

Quezon City:

1.

Ms. Minerva Victoria Perlada

2.

Ms. Judith Peralta

Caloocan1.

Ms. Maria Teresa Abando

2. Ms. Virginia Dagucon3.

Ms. Adela Villanueva

Taguig1. Ms. Julie Bernabe2.

Ms. Emma Espina

3.

Ms. Sylvia Maliton


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Malabon1. Dr. Ma. Rossana Miciano

2. Dr. Purita Javier

Pateros

1.

Ms. Joyce Parco2. Ms. Emerina Asuncion

Pasig1.

Dr. Nilda del Rosario

2. Ms. Marissa Almario

Paraaque1. Ms. Enrica Vallono

2. Ms. Girlie Mercado

Las Pias1.

Ms. Bernadette Mendez

2. Ms. Eileen Rimando

Pasay

1.

Ms. Josephine Galang2. Ms. Elizabeth Angat

Makati1. Ms. Adora Carandang2. Ms. Angeles Campo

3. Ms. Elvira Quinon

4. Ms. Sonia Zabala5. Ms. Femilina Tuazon

6. Ms. Marlet Despues (Facilitator)

7. Ms. Alma Gammad (Facilitator)


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NOIII Lagadia explained the mechanics and objectives of the PIR.Expected outputs of the PIR were as follows:

1.

Recommendations for sustaining the program

2. Good Practices3.

Plan for follow-through activities for expansion

The PIR has four workshops on the following:

1.

Assessment of accomplishments vis--vis targets2.

Identifying good practices and facilitating and deterring

factors and recommendations

3. Assessment of IYCF competencies4.

Sustaining and expanding PGN and Re-entry plan

She expected the participants to be friendly, open, candid and ableto share their ideas.

Overview of AHMP-PGN and Plans for Expansion in P1 areasMs. Milagros Elisa V. Federizo

Regional Nutrition Program Coordinator, National Nutrition Council - NCR

RNPC Federizo gave a brief overview of AHMP-PGN and plansfor expansion in P1 areas.

The PGN consisted of three components: 1) conduct of socialmarketing activities; 2) promotion of IYCF and the increased

consumption of vegetables and other nutritious foods; and 3)

nutrition education in schools.

The PGN component aims to improve the nutrition knowledge,

attitudes and practices of families in the AHMP areas including

all cities and municipality of the National Capital Region being a

Priority One area. Specifically, the program aims to increase the

number of infants 0-6 months who are exclusively breastfed;

reduce the number of infants receiving food and drink other than

breast milk and increase the number of infants 6-12 months old

who are given calorie and nutrient-dense complementary foods.


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The promotion of good nutrition is anchored on two key messages:

1. for primary targets, especially mothers and caregivers to practice proper infant and young

child feeding, and

2.

for the general population, which includes children and other members of the family, to put

into practice the Nutritional Guidelines for Filipinos

To achieve the desired impact, the nutrition education component involves the following:

1.

Community-based promotion of the IYCF for local implementers and hospital practitioners

A. Training on IYCF andPabasa sa Nutrisyon

Along community-based promotion of IYCF and NGF, one of the major activities includes

the training on IYCF and Pabasa sa Nutrisyon strategy. Several sub-activities are being

conducted under this activity which includes the training of trainers and community-based

training on IYCF and PSN, nutrition counseling of pregnant and lactating women, and

conduct of nutrition education classes or Pabasa sa Nutrisyon.


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The Training of Trainers on IYCF and PSN was held last 10 April 2007 and attended by 33

participants composed of technical staff from NNC central office and regional offices and

nutrition workers from Lanao del Norte, Surigao del Norte, and Agusan del Sur. The

participants later composed the pool of national trainers who were deployed to conduct the

trainings for municipal and city IYCF trainers/implementers, who, in turn conducted the

barangay-based trainings. Among the topics covered during the training were breastfeeding,

complementary feeding, and NGF. The trainings for hospital-based implementers or

clinicians were held in September 2007 onwards.

All trained implementers from the municipal, city and barangays levels are expected to

counsel mothers on IYCF, particularly those in their catchment areas and conduct nutrition

education classes using Pabasa sa Nutrisyonas strategy. Barangay-based IYCF

implementers are expected to continuously identify pregnant and lactating women, visit

these women regularly, and counsel them on infant and young child feeding. They are

expected to intensify the promotion of exclusive breastfeeding from 0-6 months and proper

complementary feeding from 6 months onwards while continuing breastfeeding. They need

to help and guide pregnant women to prepare themselves for exclusive breastfeeding from

birth up to six months by explaining the proper techniques of breastfeeding, its importance

and advantages; the dangers of bottle-feeding; and by helping them prepare their bodies

physically for breastfeeding.

Counseling of mothers with 6-month old infants will focus on complementary feeding such

as what foods to give, in what quantities, and under what conditions (e.g. give

complementary food after a breastfeed not before, ensure that all the paraphernalia to be

used, including water, are clean and sanitized, etc.)

Nutrition education classes highlight topics on breastfeeding, complementary feeding and the

NGF.


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B. Multi-Media Campaign on NGF

a.

Printing of educational materials

b.

Airing of nutrition plugs/spots on breastfeeding an NGF

Airing of nutrition plugs in key radio and television stations were done andcontinuously being done at the national and local levels. These plugs highlight the

importance of fruits and vegetables, eggs, NGF and breastfeeding. Copies of the radio

and TV plugs were distributed to radio and TV stations nationwide for free airing.

c. Nutrition School on the Air (NSOA)

d. Drama series on nutrition and hunger

e.

Nutrition segment

f. Guestings in various radio and TV programs to discuss nutrition and AHMP

g. Conduct of special events as highlights of Nutrition month celebration and sectoral

celebration

2. School-based promotion of the NGF

School-based promotion of the NGF is being done as part of AHMP. Due to limited funds,

only 50% of public elementary schools in the region were targeted in 2007. Each schoolreceived a set of posters on the Daily Nutritional Guide for Filipinos, exhibit material on

Pagkaing Sapat at Abot Kayaand NGF tarpaulin billboard.

To ensure the utilization of the materials, NNC also coordinated with the DepED-Health and

Nutrition Center and the Bureau of Elementary Education for the development of a modulethat will guide teachers on the use of the materials. The teaching module is targeted to be

used this coming school year. The NNC is also coordinating with DepED for the issuance ofthe necessary memorandum circular to ensure that these materials are used by the teachers.

3. Multimedia campaign

4. Conduct of advocacy meetings


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The following are the actions requested from the LGUs:

1.

Breastfeeding promotion

a.

Organize and sustain community breastfeeding support groups

b. Revive the Mother-Baby Friendly Hospital Initiative

2. Nutrition Education Classes

3.

Capability Building

a.

Identify training participants and support their attendance i.e. travelling expenses

b. Cover additional barangays as local counterpart

c.

Implement post-training actions e.g. conduct of nutrition education classes and

counselling for pregnant/lactating women

4. Support materials

a.

CNAO or alternate(s) to receive, acknowledge and ensure security of ALL materials

b.

Distribute these to appropriate recipients properly documented

c. Maintain master list of materials received and recipients

5. IEC materials

a. Tarpaulins Hang in strategic place and ensure its security

Put in frame to make it permanent and prevent loss

b. Posters

Ensure posting in health centers; if space is filled up, post in barangay outpost

Encourage utilization of posters during nutrition education classes

6.

Program management

a.

Designate a full-time focal person to oversee hunger-mitigation program

b. Nutrition committee to monitor and evaluate AHMP implementation

c. Submit monthly status reports to NNC for inclusion in report to Cabinet

7.

Support materials for schoolsa.

School superintendent or alternate/s to receive, acknowledge and ensure security of ALL

materials

b.

Distribute to schools covered by FSP or schools with high prevalence of malnutrition

c.

Ensure that each school to receive complete set of materials

Changes made to PGN in 2009

1.

Training on IYCF/PSN now called Promote Good Nutrition Training

a.

To incorporate the other components including topics on MTPPAN, NGF, VegetableSyllabus

b.

Changes in the design of the training

Pabasa sa Nutrisyon, Egg and Vegetable first before IYCF sessions

IYCF to include topic on Lactation Amenorrhea Method (LAM)

2.

Training for barangay implementers

a.

Increased budget to P500/day for five days to allow live-in training


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b. To use the IYCF Flipchart (being developed) for the training as well as in orienting BFsupport groups

3.

Some minor changes in the Pabasasa Nutrisyonkit

a. Added 2 play cards for riceb.

Increased size of play cards and bag

Comments/issues raised and agreements:

1.

Cities of Pasig, Marikina and Muntinlupa shared that their posters and tarpaulins were

washed-out by typhoon Ondoy. They want to request that these materials be replaced by

NNC, if possible.

2.

NPC Federizo informed the group of the following:

NNC-CO will be giving additional IEC materials to LGUs to cover the remaining 50% of

the barangays. LGUs whose materials were destroyed/washed out by typhoon Ondoy cansend letter informing NNC about this and request for the PGN materials destroyed in the

typhoon be replaced. She assured the concerned LGUs that if there are still available IEC

materials, they will be given priority in the allocation and distribution.

NNC-NCR will also find out from NNC-CO if they can increase the allocation of

materials to the areas affected by Typhoon Ondoy.

Fund (partial) for the PGN training of the remaining barangays in NCR has already beendownloaded to NNC-NCR RO. Training funds will be provided to the LGUs once the

training materials are available so that the barangay-based trainings can commence. PGN

trainings are expected to start on August or even earlier, after election.

NPC Federizo requested those in-charge of the PGN at the local level to ensure that the IEC materials

to be given to them for the remaining 50% of barangays be well secured and to prepare

acknowledgement receipt and masterlist of recipients.

Regional Situation on Infant and Young Child Feeding PracticesMs. Myrna Lapuz

Nutritionist-Dietitian III, Center for Health Development-Metro Manila

Ms. Lapuz presented the regional situation on IYCF. From 1993 to 2008,

the proportion of children ever breastfed or has been breastfeed at some

point in time after birth in thePhilippines did not increase as

shown in the table.

Based on the 2003 National

Demographic and Health Survey

(NDHS), only 20.0% of infants inNCR were exclusively breastfed,

29.0% were not breastfed.

Year %

1993 87.0

1998 88.0

2003 87.0

2008 87.7


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In 2008, 80.7% of children were ever breastfed in NCR, which is lower than the national prevalenceof 87.7%.

Infant and Young Child Feeding (IYCF) Practices of 6-23 months

From the same survey, 99.1% of children were either given breastmilk or milk products. This figure

is higher than the national level of 95.0 %. On the other hand, only 76.2% of children were given

foods from the recommended number of food groups.

She also mentioned that 12 LGUs in NCR have already established their respective IYCF technical

working group. Only Pateros, Makati and Taguig have passed resolutions/ordinances supportingIYCF while Makati, Quezon City and Pateros have barangays resolutions supporting IYCF.

Regional Accomplishments on AHMP-PGNMs. Emerenciana D. Lagadia

Nutrition Officer III, NNC-NCR

NOIII Lagadia presented the Regional Accomplishment on AHMP-PGN.

Below is the status of Training on IYCF and Pabasa sa Nutrisyon:

City/ Municipality No of batches of brgy

trainings conducted

No. of brgys

covered

No. of implementers

trained

Caloocan 12 94 376

Malabon 2 11 44

Navotas 1 7 28

Valenzuela 2 16 64

Quezon City 8 71 284 (98.2%)

Marikina 1 8 32

Pasig 2 15 60

Pateros 1 5 20

Taguig 1 9 36

Manila 62 448 1,792

Makati 2 17 68

Mandaluyong 2 13 52San Juan 2 11 44

Pasay 10 100 400

Paraaque 1 8 32

Las Pias 1 10 40

Muntinlupa 1 5 20

TOTAL 111 (100%) 848 (100%) 3,392 (99.85%)

NCR PHIL

% Ever Breastfed 80.7 87.7

% Started Breastfeeding within 1 hr. of birth 49.1 53.5% started Breastfeeding with in 1 day of birth 82.3 82

% Received Pre-lacteal feeds 52 54.5


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There were 3,392 implementers trained on IYCF and Pabasa sa Nutrisyonin the 111 batches oftrainings conducted in 848 barangays in NCR.

In 2007, each LGU received:1.

Tarpaulin-Billboards

a.

1 NGF for every barangay hall or health center

b. 3 for every public market (1 each of NGF, Ang

Itlog and Kumain ng Gulay)

2. Posters (1 set per Barangay or Health Center)

a. Milk Codeb.

Breastfeeding

c. Egg

d. Nutritional Guidelines for Filipinose.

Vegetables

f.

Eat a Variety of Foods Every Day

Multi-media campaign participated were:

1.

Airing of radio & TV plugs

Part of the multi-media campaign on

PGN and IYCF were the TV and Radio

Guestings wherein RNPC Federizo andNOIII Lagadia were two of the resource

persons.


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2.

Nutrition-School-on-air module

There were 1,083 graduates from from the cities of Malabon,

Navotas, Las Pias, Quezon City, Taguig, Pasig and

Muntinlupa.

A total of 669 copies of the Veggie recipe book and 3,392 copies ofthe Lets learn more about veggiesyllabus were distributed to all

LGUs in Metro Manila.

Special Events:

Gulayan Contest (school and community-based levels) was

conducted by 10 out of 17 LGUs wherein P20,000 was

provided to each LGU that conducted the contest for their cash prizes.

Buntis Congress was held at SM Megamall

AHMP Media Forum Caravan was held in Mandaluyong City

Gawad Pagkain Search was held in September 2009 and awarding was held in October

wherein Taguig City won the Best AHMP LGU Implementer in 2008 Award.

Advocacy meetings with LNCs

AHMP was always included in the agenda during the meetings of Regional Nutrition

Committee, Regional Management Group, C/DNPCs and BNS Federation

Field Monitoring Visits

Conducted in different LGUs to monitor the status of implementation of AHMP projects and

activities at the local level

Accomplishments on the School-based PGNMs. Arlene A. Famoso

Nutrition Officer II, NNC-NCR

DepEd-NCR failed to send a representative to the PIR to present the PGN

accomplishments in the public elementary schools in the region. Hence, Ms.

Famoso presented the status report on their behalf.

In 2007, NNC-CO distributed tarpaulin-billboard, posters on the Daily Food

Guide for school children and NGF, as well as exhibit materials on

Pagkaing Tama sa Abot Kayang Halaga. Only 50% of schools in LGUs

were given PGN materials.

In 2009, NNC distributed again IEC materials to public elementary schoolsin Metro Manila: one (1) set of NGF tarpaulin which was later posted at the

DepED-NCR office, copies of Syllabus on Lets Talk about Veggies and

Learning Modules on integrating Nutrition Education in the elementarycurriculum for use of public elementary school teachers.


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Status of distribution of AHMP-PGN materials in Public Elementary Schools

Division Office No. of SchoolsTarpaulin-Billboard

Posters ondaily Nutri-

Guide

Exhibit onPagkain

Abot Kaya

City of Manila 37 37 222 37

Quezon City No Report 49 No report No report

Pasay City No Report 10 No report No report

Caloocan City 29 30 180 30

Mandaluyong 8 8 48 8

Marikina 9 9 54 9

Makati 14 14 84 14

Pasig & San Juan 36 18 108 18

Paraaque 21 11 66 11

Las Pias 30 10 60 10

Valenzuela 37 19 114 19

Malabon/Navotas 22 22 132 22

Taguig/Pateros 29 15 90 15

Muntinlupa 17 9 54 9

Actions requested from DepED-NCR:

1.

Identify target schools provided with IEC materials (Schools Division Office of Taguig,

Pateros, Pasig and San Juan have not yet submitted the list of schools given IEC); 2.

Ensure installation of the tarpaulin-billboard and utilization of IEC materials; and

3.

Conduct an orientation on the use of the learning modules and other IEC materials.

Actions requested from the local Anti-Hunger Task Force and nutrition committees:

1. Monitor if the tarpaulin-billboard and posters provided are still posted in the schools;

2. Get feedback from the DepEd member of the local AHTF or C/MNC on the utilization of thePGN materials in the schools.


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Workshop 1: Assessment of Accomplishments vis--vis targetsMs. Soccoro Alma F. Gammad

Chief, Nutrition Office, Makati City

Ms.Gammad facilitated the first workshop. She explained themechanics as follows:

Each LGU to review the level of PGN implementation intheir area prior to the PIR.

Each LGU will refer to the PGN framework and determine

targets vs. implementation gaps; other accomplishmentsoutside of the framework that contributed to the

achievement of PGN objectives.

Each LGU should have accomplished and submitted the

matrix for the workshop.

Based on the matrix, LGUs fill up the blank summary of

accomplishments using color-coded metacards with this

legend:

Blue - above target

Green- within target

Red - below target


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This workshop was participated in by all LGUs in NCR except San Juan (participant came in late in

the evening of Day 1) and Manila (failed to send participants). Hereunder are the results of workshop:

A. Program Outputs

Indicators within targets are the following (Green):1.

Training for 50% of barangay with 4 participants per barangay conducted

2. All training materials were distributed to the barangay training participants3.

All IEC materials provided were distributed to the barangays

4.

Targets for multi-media campaign (TV, radio and print) reached

5.

Adequacy of support generated for the program to implement the program (e.g.allocation of budget, staff)

6.

Local ordinance or resolution adopted. Majority of the cities and municipality have

already passed local ordinance or resolution.

7. Adequate number of municipal and barangay implementers trained8.

At least 3 BF support groups established per city/municipality

9.

At least 50% of pregnant women and mothers with children below 2 years of age

provided with counseling on IYCF10.

At least 10% of mothers with children below 2 years old graduated/attended Pabasa saNutrisyonclasses

11. At least 10% of mothers with children below 2 years old attended classes using egg and

vegetable syllabi

Indicators that are below target and need to be improved (Red):1. At least 50% of families with home food production activities2.

At least 10% of mothers with children below 2 years old graduated/attended Pabasa sa

Nutrisyon classes

3. At least 50% of pregnant women and mothers with children below 2 years of ageprovided with counseling on IYCF


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Indicators which are above target (Blue):1.

At least 3 BF support groups established per city/municipality

2. At least 10% of mothers with children below 2 years old attended classes using egg and

vegetable syllabi

B.

Program outcome

Based on the consolidated LGU accomplishments, majority of the LGUs have increasedpercentage of 0-6 month old infants who are exclusively breastfed. Based on their perception,

there was an increased consumption of vegetables and eggs. However, this was based only on

their perception and need to be validated.

LGUs also do not have data on the percent of children 6 -24 months old with appropriate

complementary feeding.

All LGUs reported a decreasing number of underweight preschool children which they

consider as an indicator that their efforts in promoting IYCF are paying-off and that theirinterventions and strategies are working toward nutrition improvement of children.

NPC Federizo acknowledged and congratulated the LGUs who are well on-track in their

accomplishments and challenged them to sustain their accomplishments. She ended theworkshop by encouraging the LGUs to:

a. review the indicators which are below target (Red metacards) and identify specific

measures to improve accomplishment particularly with regards to the coverage of PSNclasses and IYCF counseling;

b.

organized community breastfeeding support groups should be sustained and made

functional through follow-through activities such as meetings, supervision andmentoring; recognizing the contributions being done by the peer counselors in the

promotion of IYCF in the barangays (i.e. giving incentives);

c.

trained peer counselors/BFSGs should be mobilized in order to increase number ofPSN graduates and pregnant and lactating women counseled on IYCF;

d.

In terms of food production, FAITH Gardening technique or container gardening can

be done to increase number of families engaged in vegetable gardening.

Since there are data gaps on complementary feeding and vegetable consumption, NPC

Federizo encouraged the LGUs to undertake local studies or surveys to generate these

information which are important for monitoring and evaluation as well as program planning.

Day 2

Before proceeding to the workshop proper, Ms. Marlet Despues of Makati City led the openingprayer and a recapitulation of the previous days discussion was given by Ms. Arlene Famoso.


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Workshop 2: Identifying good practices, facilitating, deterring factorsand recommendationMs. Myrna Lapuz

Nutritionist-Dietitian III, CHD-MM

Ms. Lapuz facilitated Workshop 2.

The participants were divided intofive groups. Each group was givenspecific questions to answer. They

were asked to identify the

facilitating and deterring factors thataffected program implementation

and identify concrete

recommendations to improveprogram implementation.

.


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Each group posted their outputs on the wall for gallery viewing. Participants shared their commentsand suggestions on the outputs of the different groups during the plenary. The group outputs are as

follows:

Workshop Outputs by Group

Group 1: Distribution and use of IEC materials

Before the distribution of the IEC materials, training for

health center staff on the use of the materials was conducted.IEC materials are used during the pre-clinics lectures,

mothers classes and community assemblies. They also

hanged the tarpaulin-billboards in strategic places to be seen

by as many people in the area as possible.

The IEC materials were very useful to the community as

these help increase the knowledge of families on goodnutrition practices and the types/kinds of vegetable, their

nutritive value and functions in the body. The IECMs alsoserve as reference materials for barangay implementers in theconduct of nutrition education sessions. The IEC materials are

easy to understand since they are written in simple language

and the PSN kit features enjoyable games that even childrencan enjoy while learning.

Problems encountered in the use of IEC materials are:

some of hanged tarpaulins (NGF) were stolen

some of the featured dishes in the veggie recipe book

are impractical, tedious and time consuming to

prepare for the mothers.

Suggestions to improve distribution and use of IEC materials:

1. Use T-shirts as IEC material instead of tarpaulin-billboards which are usually stolen; t-shirts havewide coverage since many people tend to read the prints on the T-shirt.

2.

LGUs must allot budget for the reproduction and purchase of IEC materials in order to augment

what NNC has provided.

3. One NGF message per tarpaulin is effective instead of putting all messages in one tarpaulin.

Group 2: Training for barangay implementers

Modifications made during the trainings at the barangay level are as follows: The original schedule of five (5) whole days training was changed into ten (10) half days to

give the mothers time to do their household chores.

Filipino or Tagalog was used in the discussions for better understanding of the topics by theparticipants.

Discussions on HIV-AIDS and Replacement Feeding were not included to avoid confusionamong the participants.


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Participants trained at the city and municipal level served as trainers and facilitators during barangaytrainings. They also conduct and monitor the

follow-through activities of the barangay

implementers.

The city/municipal trainers and the barangay

implementers were able to apply what they

have learned in the IYCF and PSN training byorganizing community assembly, conducting

PSN sessions, doing one-on-one counseling

for mothers and conducting meeting with thebreastfeeding support groups.

Comments/ issues raised and agreements:1.

Ms. Lapuz shared that the cities of Makati and Caloocan were given fund by CHD-MM for the

conduct of follow-through activities, e.g. meetings of BFSGs

2. Ms. Thess Abando of Caloocan shared that they do the mentoring and follow-up training throughregular quarterly meeting, monitoring the accomplishment through monthly reports on number

of mothers counseled, initiated to breastfeeding, etc.3. Ms. Lagadia explained that follow-up is different from the follow- through activities which they

have shared.4.

NPC Federizo clarified the difference between follow-up training and follow-through activities.

Follow-up training is conducted by IYCF trainers among local trainers and implementers to

assess their competencies using a checklist/tool and following a prescribed procedure asdiscussed in the follow-up training manual given during the IYCF ToT. She also informed the

participants that NNC-NCR has a budget for follow-up training this year. This is also the reason

why Ms. Lagadia pointed out that what Caloocan shared are follow-through activities and notfollow-up training. LGUs to be visited in the follow-up training will still be identified.

Group 3: Organization of BF support groups and conduct of counselling for pregnant andlactating women

Most of the LGUs have already established at least three (3) breastfeeding support groups in their

locality. Activities that were done include advocacy meetings, teambuilding, IYCF training,

recruitment of mother leaders and networking with the NGOs. They were able to maintain it by

having regular follow-up meetings, updates and provision of tokens/incentives like t-shirts, umbrellas

and tote bags.

The BFSG members have their respectivecatchment area. Their primary activities include

counseling of pregnant women and lactating

mothers. Monitoring form is used when doing

home visits. BFSG members consolidate their

accomplishments and submit it to the nutrition

office during their meetings. The NDs who


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serve as the supervisors of the BFSG members also provide mentoring during their meetings.

The BFSGs contribute significantly in improving the communitys awareness on the importance of

IYCF practices. They provide support in educating mothers on breastfeeding and giving appropriate

complementary foods.

Success stories shared by Quezon City and Muntinlupa:

1.

Quezon City After the typhoon Ondoy, in one of the evacuation areas, a lot of mothers were seen not

breastfeeding their babies. One of these mothers was encouraged by a peer counselor to re-

lactate. The mother was able to breastfeed her baby after being counseled and shown proper

technique of breastfeeding.

2.

Muntinlupa

Ms. Rhonda Rabino shared that after her IYCF training, one fellow ND asked her about the

re-lactation. Because the knowledge is very fresh to her, she was able to share it to her fellow

ND and that ND was able to successfully relactate and breastfed her baby until 2 years old.

3.

Pasig

After the typhoon Ondoy, they were able to put up breastfeeding station in the evacuation

centers. Because of this, a lot of mothers were encouraged to breastfeed their babies.

Comments, issues raised and agreements:

1. The participants have good practices and success stories to share. However, most of them lack theknowledge/skills in documenting these.

2.

Ms. Almario and the group requested NNC-NCR for a training on documentation so that they can

enhance their skills in documenting their best practices and success stories.3.

NPC Federizo informed the group that they have already included that in their WFP for 2010 and

will seek the approval of and funding from NNC-CO for this training.

Group 4: Implementation of thePabasa sa Nutrisyonand use of Egg and Vegetable Syllabi

When they conduct sessions on PSN, Eggand vegetable promotion, they made sure

that they were able to meet their targets and

plans or schedules were followed. Theywere also able to submit the reports needed.

The sessions on PSN including the use of

egg and vegetable syllabi improved thefood and nutrition practices of the target

families. It also motivated them put up

vegetable gardens and engage in other food

production activities. The mothers were able to practice what they have learned during cooking

demonstrations. These activities resulted to positive change in the nutritional status of the children.


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The good practice shared by the group is the 24/7 info assistance that they provide through SMS.

Mothers can send text messages to them regarding breastfeeding problems and concerns and these

inquiries will be answered by the trained IYCF personnel.

Group 5: Program management

The nutritionists, nurses,midwives, BNSs, BHWs and

IYCF coordinator supervise the

conduct of: (a) barangay-based

IYCF trainings, (b) pabasa sa

nutrisyon sessions, and (c)

organization of breastfeeding

support groups. They also

conduct regular meetings and

field monitoring visits. In

Makati, a matrix developed bythe Nutrition Office is used to

record and report accomplishments. The monitoring form or ledger is used to collect indicators

like: personal information of mother and child, problems encountered and recommendations given by

the IYCF-trained health personnel and peer counselors.

Review of Community Support on IYCFDr. Shari Ludivina L. SabalvaroIYCF Coordinator, Mandaluyong City

Dr. Sabalvaro gave a brief review of the community support on IYCF. Theobjectives of the session are as follows:

1.

Describe a mother-baby friendly community

2. Enumerate key actions to promote and protect infant and youngchild feeding in the community

3.

State the importance of community support groups for promoting

infant and young child nutrition

4. List the steps in organizing community support groups

The National Plan of Action on IYCFis anchored on the Global Strategyfor Infant and Young Child Feeding, which aims to contribute to

improving the nutritional status and health of children and reduce infantand young child mortality and morbidity.

The policies are further translated into the National Plan of Action on IYCF for 2005-2010. Atechnical working group identified key strategies in implementing the IYCF policy. The plan was

anchored on the Global Strategy on IYCF developed by the World Health Organization and UNICEF.


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The plan of action aimed to contribute to nutrition improvement and reduction of infant and childmorbidity and mortality, which will contribute to the achievement of the UN Millennium

Development Goals.

Four main objectives of the plan are:

1.

promote IYCF practices;

2. increase political commitment at different levels of government, international organizations,

NGOs, private sector and civil society;3.

provide a supportive environment to enable families and communities to implement optimal IYCF

practices; and

4. ensure sustainability of interventions along IYCF.

Four key strategies are:

1. Development of policies and standards2.

Improvement of systems for effective IYCF

3.

Mobilize stakeholders to IYCF and

4. Involve families and communities to promote and adopt IYCF.

These strategies will focus on transforming various settings as mother-child-friendly. The six (6)settings include:

1. Health facility including hospitals2.

Workplace

3. Schools

4. Public places5.

Families and communities and

6.

Industry

Key actions are recommended to transform each setting into mother-child-friendly for IYCF.

Particularly for health facilities, the major strategy is the Mother-Baby Friendly Hospital Initiative

along with the implementation of related laws such as the Rooming-In and Breastfeeding Act and theMilk Code.

To implement the plan the following can be done:

1. Present the concept to the:a.

Barangay City Council to obtain the necessary support

b.

Health Center staff and other health facilities based in the barangay

c. schools, work places and other public places in your barangayd.

existing groups and organizations /partners related with the protection, promotion and

advocacy of childrens rights

2.

The group then will develop a Plan of Action that will:a.

Clearly define goals and objectives

b. Define target audiences

c. Link with current activities/programs in your barangayd.

Identify counseling channels

e. Discuss structure and resources needed

f. Analyze training and IEC needsg.

Define supervision, monitoring and evaluation


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h. Design timelinei.

Identify needs in terms of funds

3. Identify how each one of them can help in settingup the model community (role identification)

a.

Training

b. Technical Assistance

c.

IEC Materialsd.

Supervision and Monitoring

e. Others

f.4.

Organize Community Assembly to: inform the

community about the program to identify pregnant women and mothers with infant and children

up to 2 years old

5.

Select BF counselors from each purok/sitio with the following qualifications:

a. basic literacy levelb.

a woman with successful breastfeeding experience

c.

has a similar background to the women to be counseledd. has experience in community work

e. lives in the communityf.

is respected by the community

g. can allocate and commit time

h. is motivated to help other mothers

6.

Train / Orient the selected peer counselors to facilitate support groups

Workshop 3: Assessment of IYCF counseling competencies andcommon problem

Workshop 3 was divided into 3 parts:

Part 1: Individual written exercises

For those who were trained on IYCF, activity was done to reinforce knowledge and skills

learned during the training. Each participant answered written exercises.

Part 2: Self assessment of competencies

Each trained participant was given a list of competencies, then they assessed themselves

by competency for both knowledge and skill by putting a check against the competencythat they are confident they possess; they mark an X for those they were not confident

about

They were given 15 minutes to do the self-assessment.


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Part 3: Discussion of skills practiced and problems encountered

Participants were asked to reflect on their competencies and determine which of these are

being practiced, the problems that they have encountered or competencies that they finddifficult to practice. They wrote these on meta cards and posted them on the manila

paper.

The participants were divided into 4 groups. Group members and facilitators for each group areshown below:

Group 1Facilitators:Josie & Mila

Group 2Facilitators:

Doc Shari & Arlene


Marlet & Myrna


Alma & Meren

Peng

FrancisSylvia

Eileen R.SoniaJudith

Beth P.

DetteMatet

Doc Purita

Ruby

TessRemy

DangSallyAngeles

Enrica

MarivelMarissa

Doc Rossana

Doc Nilda

Eileen G.Anthony

GirlieMarivicMadgelin

Virgie

EmmaJulie

Emerina

JoyceAdora

JojieBeth A.Nona

Edna

ElviraAdela

Processing of workshop 3

The following is a summary of competencies that participants are not able to practice with

confidence: Assess a breastfeed.

Help a mother to attach her baby to the breast.

Explain to a mother about the optimal pattern of breastfeeding.

Help a mother to cup feed her baby.

Plot and interpret a growth chart.

Support exclusive breastfeeding for the first six months of life

Help mother to sustain breastfeeding up to 2 years of age or beyond

Help a mother with not enough milk

Help a mother with a baby who cries frequently

Help a mother whose baby is refusing to breastfeed

Help a mother who has flat or inverted nipples Help a mother with engorged breasts

Help a mother with sore or cracked nipples

Help a mother with a non-breastfed child over six months of age who is not growing well

Counsel a pregnant woman about breastfeeding.

Teach a mother the 10 key messages for complementary feeding.

Take a feeding history for an infant or young child 0 24 mos.


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While the competencies that they were not able to practice or have difficulty practicing are:

Use Confidence and Support skills to counsel a mother.

Teach a mother the 10 key messages for complementary feeding.

Take a feeding history for an infant or young child 0 24 mos.

Help a mother with mastitis.

Help a mother to breastfeed a LBW or sick baby.

Counsel an HIV woman antenatally about feeding choices.

Support an HIV mother in her feeding choice.

Follow up the infant of HIV mother 0 - 6 months who is receiving replacement milk.

Help an HIV mother to cease BF early and make a safe transition to replacement feeds.

Help mothers whose babies are over 6 mos. of age to give complementary feeds.

Help a mother with a BF child > 6 mos. who is not growing well.

Help a mother with a non-breastfeed child > 6 mos. who is not growing well.

Use listening and learning skills to counsel a mother.

Facilitators answered their queries and concerns regarding the competencies which they found

difficult to practice. Participants also shared good experiences in practicing the different

competencies as they promote IYCF in the community that they serve.

Workshop 4: Sustaining and Expanding PGN and Re-entry Planning

A. Sustaining and Expanding PGN

Ms. Lagadia facilitated this workshop. After explaining the mechanics, the participants were

divided into four groups. Each group was given a general question to answer: What strategies

and actions could be done at the barangay, municipal, city, regional and national levels to

ensure sustainability of the PGN?

The participants answers to the question per category are as follows:

1.

Getting political support

Big-Bang advocacy and invite a high ranking official

Send letter requesting for support

Padrino system

Present a situationer (Facts and Figures)

2. Availability of trained personnel and volunteers Continuous recruitment of volunteers by existing trained personnel/barangay official

Assurance of volunteers commitment by providing incentives

3. Improving management of the program

Develop booklet/pamphlet guidelines/flyer/operational guidelines on how to set up orstart the program

Organize/re-organize/strengthen the TWG on PGN

Lobby for the passage of ordinances/resolutions in support of PGN, particularly the

provision of budget for PGN

Appoint focal person who has been trained on IYCF

Develop monitoring tool for BFSG


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4. Generating Resources

Inclusion of PGN in the City Investment Plan and Barangay Development Plan

Tap NGOs for support

Conduct of fund raising activities e.g. Bingo, cake raffle etc.

Solicit political support

Presentation of program/project proposal

Utilization of GAD funds

B. Re-entry planning

Each LGU worked on their re-entry plan. They have identified follow-through actions based onthe results of the workshops.

Due to the limited time, four (4) LGUs coming from the four (4) districts in NCR were randomlychosen through draw-lots to present their respective re-entry plan. These were cities of

Mandaluyong, Caloocan, Pasig and Las Pias.

All the presenters gave a detailed presentation on their re-entry plan. They were able to give

details on the activities that they will do after the PIR. Highlights of the group presentations areas follows:

MandaluyongMs. Marie Tess Belowas asked to share their strategies on how they were able to get the support

of barangay captains. She shared the following:

Most of their barangay captains to date are achievers, they want to achieve something in

very short time

Their Congressman has an attitude/power to mobilize the barangay captains

They also give recognition to barangay captains who are very supportive to the nutrition

program in the barangay. Recognition rites are done during the Nutrition Month

Celebration. Their CNAO, being the wife of the mayor, is very dynamic and influential in a sense that

she can mobilize the barangay officials with ease.

CaloocanMs. Thess Abando presented their re-entry plan. Among their activities they are committed to do

after the PIR are:

1. Feedbacking2.

Conduct follow-through activities among breast feeding support group

3.

Conduct training of Egg and Vegetable syllabi among mothers of underweight preschool

children.

4.

For their PGN trainings, the following activities will be done:

Recruitment of participants

Submission of participants recruited

Identification of/coordination for possible venue

Solicit commitment/ availability of trainers/ facilitators

Delineation of tasks and assigned topics among the trainers/facilitators

Coordination with NNC-NCR for the training fund and materials

Get training fund, materials from NNC-NCR


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Preparation of training materials, syllabus, venue, etc.

Actual training

PasigDr. Nilda delos Reyes shared the following activities that they plan to do:

1.

Feedback the proceedings of the training to their Local Chief Executive

2. Lobby for the passage of resolution on IYCF

3.

Conduct advocacy orientation among barangay captains4.

Train Mother Leaders of Bgy. Maybunga, NDs, HC staff of Maybunga HC on IYCF for

BF support group.

5. Conduct training on PGN for the 50% of the barangays.6.

As part of their routine activities, conduct PSN sessions, Egg and Veggie Syllabi and BF

counseling

7. On the 4th

quarter of 2010, they target to set up a breast feeding station in City Hall andBahay Kalinga.

8.

Every quarter they will conduct monitoring and follow-through activities to make sure that

the skills of the BFSG trained in IYCF are enhanced and also to identify problems andthresh out problems.

9.

Every time they conduct activities on PGN, she will make sure that these are documentedand more importantly, all the good practices along IYCF

10. Regularly submit accomplishment and reports.

Las Pias

Ms. Bernadette Mendez shared that Las Pias City has no IYCF task force and support group yet.

They will start on scratch and commit to undertake the following activities:1.

Feedback the proceedings to their supervisor

2.

Propose for the creation of TWG on IYCF (or taskforce)

3. Lobby for the passage of Barangay Ordinances supportive to PGN on the 2nd

quarter of the

year.

4.

Lobby among the Councilor for Health and Social services the passage of a city resolutionon IYCF.

5. On the 3rd

quarter of the year, IYCF trainings will be conducted in the remaining 10barangays.

6.

Quarterly meeting will be done to monitor the program.


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Reactions and Impressions from Participants

Dr. Rose Miciano (health center physician) of Malabon, in her

response, said that this PIR is very useful and they can now

better promote IYCF to the community with the support of thebreastfeeding support group. She said that she is happy that

she was able to share ideas during the activities and also was

able to learn a lot from what was shared by the otherparticipants.

Ms. Emerina Asuncion (midwife) of Pateros, said that she isnow very inspired in promoting IYCF in their health center

and in the barangays as well as influencing other midwives

doing private practice. She thanked the facilitators for the opportunity of beingone of the participants in the PIR.

Ms. Sylvia Maliton (BNS) of Taguig City, said that she isvery lucky to have been chosen to become one of the

participants. She gained new knowledge during the

workshops which she can share to her co-BNSs.

Ms. Elvira Quinon (mother leader) of Makati City thanked

everyone for the new knowledge she have learned from the

PIR.

Ms. Enrica Vallono (ND) of Paraaque said that in spite

of their busy schedule in Paraaque because of HATAW

activity, she is fortunate to attend the PIR. She thanked the

participants and the facilitators.

Ms. Marissa Almario (ND) of Pasig shared that last year

was not a good year for her. She was gone for a while

because of some personal matters but this PIR served as agood comeback for her. She was so excited and

enthusiastic about the PIR. However, she was quite disappointed on the venue because she did not

expect that the venue was very far. She mentioned that the participants will appreciate if lunch on thefirst day was served.


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In response to the feedback of Ms. Almario, NOIII Lagadia explained that the PIR was supposed tobe a leave-out activity as per guidelines provided by NNC-CO. But because of the request of the

LGUs during the CDNPC meeting last 5 February to have the PIR in an out-of-town venue, NNC-

NCR tried to accommodate their request and made arrangements to make it an out of town activity.She shared that Tagaytay was also considered as a venue. Unfortunately, most of the hotels are fully

booked and that the quotations received from the hotels were quite high and did not meet the COA

guidelines. Lagos del Sol Resort was also mentioned during the C/DNPC meeting as a possible venue

but since there was no negative comment, and the quotation they submitted was COA-ble, it waschosen as the venue of the PIR. Map going to the venue as well as information how to get there was

sent through fax to all LGUs as an attachment to the letter sent to the LCEs. It was also clearly stated

in the letter to the LCE that the transportation to and from the venue will be shouldered by thesending LGU as counterpart. Participants were also informed through sms and phone call that lunch

will not be provided since the activity will start at 2pm and the budget allocated for the PIR cannot

anymore cover the expenses for lunch on the first day.

Many participants also said that inspite of the resort being far and the hassle experienced by some in

going there, Lagos del Sol Resort has positive points such as good service and nice view. An addedbonus was the opportunity to see ABS-CBN actors/TV personalities who were there for a shoot for a

TV program. Many were excited to witness and see how a TV shoot is being done.

Pledge of Commitment

The participants were divided into five (5) groups. They were instructed to express their commitment

by drawing their right hand with their name.

We commit to support the PGN program forthe health of the whole family in our

communities. We will continue to advocate the

IYCF policy and the activities of the PGN.

.. AHMP is like a tree that grows and gives life

and shade to protect us from heat. We commit

to ensure that the AHMP will continue to grow

like a tree to protect the infant and young

children through PGN


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We commit ourselves in expanding andsustaining the breastfeeding support group,

creating a strong PGN TWG and continue

spreading the virus of IYCF.. and NO to milk

formula!!!

With the song, Sa Ugoy ng Duyanasbackground music, the group vows to

.. maintain our commitment in promoting

IYCF deep inside our hearts and we promise

that as long as we live we will continue to

support the IYCF. We will continuously

guide the BNS in advocating IYCF in their

barangays, sustain IYCF and organize

breastfeeding support group and spread the

IYCF in the world

We commit to continue to

provide assistance to BFSG in

promoting PGN, continue the

mission and vision of IYCF in the

community, contribute in the

realization of AHMP objective by

promoting good nutrition and

continue to be breastfeeding

advocates by counseling mothers..


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Awarding of certificates

The certificate of appreciation was awarded to the facilitators for sharing their time and expertise inthe AHMP PIR of the PGN in NCR.

Certificates of the participants were placed randomly on their tables prior to the awarding ofcertificates. Each participant has the certificate belonging to another participant. Their task is to find

the intended recipient of the certificate and hand it over to him or her after giving a short message.

The giving of certificates turned out to be an enjoyable one and gave the participants an opportunityto give a message to their co-participant.


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Synthesis and Closing Message

Before giving her closing message RNPC Mila Federizo

synthesized the proceedings of the PIR. She reviewed the

objectives of the program and check with the participants ifthese were achieved or not. She pointed out that the PIR was

able to successfully deliver the expected outputs of the activity

and enable the participants to look back and assess their

performance in the past years since the implementation of PGNin 2007. What is more important is that the participants were

able to identify the next steps to take in order to realize the

objectives of the PGN component of AHMP.

She expressed optimism that based on the pledge of commitment

shared by the participants, the PGN implementation in NCR willbe a success and eventually will contribute significantly in

improving the lives of families, particularly women and

children, through better nutrition. She firmly believes that withthe strong network of PGN advocates and implementers, the desired outcomes of AHMP and PGN in

particular, will be realized. She acknowledged and thanked the attendance and active participation of

the PIR participants and the expertise and assistance provided by the facilitators. She wished

everyone a safe trip as they return to their families and loved ones.

Documents

AHMP Documentation Report