QuestionsQuestions (DOH ADMINISTRATIVE ORDER NO. 2010-0015)
It is DOH Administrative Order No. 2010-0015 (dated June 8, 2010). Its main purpose is the adoption of the WHO Child Growth Standard (WHO-CGS) for assessing the nutritional status of Filipino children aged 0–5 years and for conducting Growth Monitoring and Promotion (GMP) and Operation Timbang (OPT), repealing AO 25 s. 2003.
The AO explains that the NCHS-IRS does not adequately represent early childhood growth at individual or population level assessment. WHO launched the Child Growth Standard (CGS) for 0–5 years old, and DOH agreed to adopt it to provide a better benchmark, enable comparison using a single international standard, establish breastfeeding as the normative model, detect malnutrition earlier, and include core development milestones.
To promote optimum child growth and development through enhanced implementation of GMP activities using the WHO-CGS.
All national, regional and local government units; public and private medical practitioners and health facilities; and other agencies and stakeholders involved in assessing nutritional status of children and conducting GMP and OPT activities.
Children 0–71 months old (0–5 years).
Their weights and lengths shall be measured once a month.
Their weights and heights shall be measured twice a year.
Every time the child comes in contact with the health care system (e.g., when sick and brought for consultation).
Weights of children 0–71 months taken during OPT shall be done once a year (January–March), covering at least 16.2% of the total population.
Weight-for-age (0–71 months); length-for-age (0–23 months) or height-for-age (24–71 months); and weight-for-length/height (0–23 months or weight-for-height for 24–71 months).
It reflects body weight relative to the child’s age on a given day and provides a rough estimate of the child’s present nutritional status.
It reflects attained growth in length or height at the child’s age during a visit. Combined with age, it gives a good indication of stunting, which reflects past and chronic malnutrition.
It reflects body weight in proportion to attained length/height. It can distinguish current malnutrition (acute) from past malnutrition (chronic).
They must be given an ECCD card (Essential services record) as a tool for growth monitoring and promotion from 0–71 months. It records essential services, contains a chart where weights and heights are plotted to observe trends and detect growth faltering for immediate interventions.
Filling up is to be administered by health professionals (e.g., doctors, nurses, midwives, nutritionists). Trained BHWs and BNS may administer but under the supervision of a health professional.
WHO-CGS growth tables and charts, ECCD cards, and equipment such as weighing scales, infantometer, microtoise, and height/length boards must be used and made available in rural health units, public/private health and hospital facilities, and other places where measurements are taken. Reproduction of ECCD cards is the responsibility of the LGU, with augmentation from national agencies and other stakeholders/partners/donors.
Integration is to be done into existing MNCHN service delivery channels and other approaches reaching children 0–71 months old, including contact points such as Garantisadong Pambata, Operation Timbang, IMCI, and EPI.
Hospitals must ensure all growth tables/charts are WHO-CGS based; provide budgetary allocation for ECCD cards and equipment; conduct orientation/training; and monitor implementation. LGUs must ensure funding; ensure availability of scales/equipment/cards/WHO-CGS tables and charts; ensure charts/tables are WHO-CGS based; conduct orientation/training of field workers (including BHWs/BNS); monitor and evaluate implementation; and coordinate with concerned agencies.
It repeals Administrative Order No. 25 s. 2003 and all other inconsistent orders/issuances. The AO takes effect immediately.