QuestionsQuestions (Republic Act No. 11148)
RA 11148’s short title is “Kalusugan at Nutrisyon ng Mag-Nanay Act.” The policy declaration recognizes the constitutional right to health (Art. II, Sec. 15), commits the State to adequate food, care, and nutrition—especially for pregnant and lactating mothers and children 0–2 years old—and prioritizes an integrated, whole-of-government approach to eliminate hunger and reduce maternal/child mortality and malnutrition, including stunting.
RA 11148 aims to: (1) provide comprehensive, sustainable, multisectoral strategies to address health and nutrition problems across the target groups; (2) create a conducive policy environment; (3) implement evidence-based nutrition interventions during the first 1,000 days integrating responsive caregiving and early stimulation; (4) strengthen the roles of DOH, NNC, and other agencies; (5) institutionalize and scale up nutrition in national/regional/LGU plans; (6) ensure meaningful participation of LGUs, NGAs, CSOs, and the private sector, prioritizing high-poverty, GIDA, and hazard/conflict areas; (7) strengthen enforcement of the Milk Code (EO 51) and RA 10028; (8) strengthen related nutrition laws and gender/UNCRC promotion; and (9) strengthen family and community support systems.
The DOH, NNC, and DA, coordinated with other NGAs, LGUs, CSOs, and stakeholders, must develop a comprehensive and sustainable first-1,000-days strategy to address health, nutrition, and development problems affecting infants/young children, adolescent females, pregnant and lactating women, operationalizing the latest national nutrition plan and linking to SDG goals to eradicate hunger and prevent/manage malnutrition.
RA 11148 covers nutritionally-at-risk persons, especially pregnant and lactating women (particularly teenage mothers and women of reproductive age/adolescent girls), and all Filipino children from newborn up to 24 months. Priority is given to those in disaster-prone areas and GIDA, unserved/underserved communities, vulnerable sectors, crisis/armed conflict communities recognized by a government body, and LGUs with (a) highest prevalence of undernutrition/nutrient deficiency among pregnant/lactating women and 0–2-year children, (b) capability to implement, and (c) willingness to provide counterpart resources.
It is the period from the nine (9) months in the womb starting from conception up to the first twenty-four (24) months of life—considered a critical window to promote health and development and prevent malnutrition and its long-term effects.
Implementation is primarily the DOH, coordinated with the NNC, DA, LGUs, and other NGAs. It must be implemented at the barangay level through rural health units and/or barangay health centers, in coordination with the Sangguniang Barangay. Barangay Nutrition Scholars (BNS) and Barangay Health Workers (BHWs) must be mobilized and provided resources/benefits.
Barangay Nutrition Scholars (BNS) and Barangay Health Workers (BHWs) are to be mobilized and provided resources/benefits to carry out tasks related to delivering health and nutrition services and interventions under the Act.
Interventions include ANC pregnancy tracking/enrollment, completion of quality ANC visits and referral for high-risk pregnancies, maternal immunizations (e.g., tetanus/diphtheria), birth/emergency and breastfeeding preparation plans, maternal nutrition and IYCF counseling, early identification and management of nutritionally-at-risk women/adolescent pregnant females with RUSF and dietary supplementation, micronutrient supplements (iron/folic acid/calcium/iodine, etc.), iodized salt/facilitated fortified foods, assessment for parasitism and anti-helminthic medicines, oral health services, hygiene/environment sanitation counseling, responsible parenthood/health services counseling, smoking cessation/healthy lifestyle counseling, PhilHealth linkage, social welfare support for poorest of the poor, maternity protection, responsive caregiving/early stimulation counseling, psychosocial support for high-risk/poorest/teens, and other evidence-based actions.
RA 11148 requires strengthening enforcement of EO 51 (Milk Code) and RA 10028, including considering WHA Resolution 69.9 recommendations to end inappropriate promotion of foods for infants and young children. It also includes breastfeeding/rooming-in and mother-friendly practices during labor/delivery, lactation management services, and prohibits unapproved donations of milk formula/breastmilk substitutes covered by the Milk Code during disasters.
Affected areas must be prioritized. NGAs/LGUs must immediately provide emergency services and food supplies for proper nourishment of pregnant and lactating mothers and children 0–2 years old, prepare women/infant/child-friendly spaces with daily necessities (food, clean water, shelter, clothing), ensure readily available breastfeeding support/counseling, and provide guidance on appropriate complementary feeding for children over six months. It also requires gender/culture-sensitive guidelines consistent with RA 10821.
It prohibits donations of milk formula/breastmilk substitutes and/or Milk Code-covered products without approval of the Inter-Agency Committee (IAC) under EO 51, to protect maternal and child health before, during, and after disasters. Donations/assistance from the private sector that involve no conflicts of interest and are not from manufacturers/marketers/sellers covered by the Milk Code may be allowed immediately in the aftermath, while maintaining strict Milk Code compliance and offering options for mothers with breastfeeding problems (e.g., breastfeeding support groups or local milk banks).
Across pregnancy, postpartum, newborn, and infancy/toddler phases, it mandates counseling and support to parents/caregivers on parent/caregiver-infant/child interaction for responsive care and early stimulation for early childhood development.
Examples: (1) “Responsive caregiving” is prompt, close attention with affection to a child’s signals and appropriate response to the child’s behavior, needs, and developmental state. (2) “Stunting” is chronic undernutrition measured as height-for-age below -2 SD (moderate) or -3 SD (severe) from WHO Child Growth Standards. Other definitional terms include BNS/BHW concepts (implied in implementation), SAM/MAM criteria, and “first 1,000 days”.
The Board includes the Secretary of DOH (ex officio Chair), Secretary of DA (ex officio Vice Chair), Secretary of DILG (ex officio Vice Chair), plus DepEd, DSWD, DTI, DOLE, DOST, DBM, NEDA, and three private sector representatives appointed by the President for two-year terms from specified sectors. It also states that heads may be represented by Assistant Secretary-rank or higher, and private sector members with conflicts of interest (as in EO 51) are prohibited.
The NNC formulates national nutrition policies/plans/strategies, oversees integration of nutrition policies among member agencies, coordinates/monitors/evaluates nutrition programs/projects for integration with national policies, receives grants/donations subject to Act policies, coordinates joint planning/budgeting and secures fund release and tracks public expenditure, and can call upon any government agency for assistance necessary to implement the Act.
Notwithstanding RA 9184, agencies must establish a liberalized procurement mode for the program, subject to approval of the Government Procurement Policy Board. Procurement must prioritize participation of local/community-based producers, suppliers, and/or contractors.
Within ninety (90) days from the effectivity of the Act, the DOH—coordinated with the NNC Governing Board and consulted with public and private stakeholders—must promulgate the IRR necessary for effective implementation.
Initial implementation costs are charged against appropriations of DOH, DA, NNC, and other relevant agencies. Continued implementation sums are included in the annual GAA. DBM, coordinated with DOF, DOH, DA, NNC and other relevant agencies, must consider prevalence of malnutrition and child mortality when determining annual appropriations. Priority LGUs identified by NNC may receive supplementary funds from concerned NGAs, included in the GAA.