Law Summary
Declaration of Policy
- Reaffirms AO No. 2007-0045 regarding zinc and oral rehydration therapy.
- Complements DOH AO No. 2008-0029 on reducing maternal and neonatal mortality.
- Supersedes the 2003 Updated MS Guide (AO No. 119, s. 2003).
Guiding Principles
- Rights-Based Approach: Upholds rights of women and children per Philippine Constitution and international treaties.
- Systems Approach: Health service delivery, governance, financing, and regulation reforms are crucial.
- Life-Cycle Intervention: MS tailored to client’s life stage.
- Equity: Prioritize vulnerable and underserved populations.
- Complementation: MS integrated with other interventions like deworming, sanitation, immunization.
- Evidence-Based Interventions: Policies based on recent local and global data and research.
- Integrated Service Delivery: MS aligned with public health programs, integrated at service points, continuous through referrals, and delivered in non-health settings.
Objectives
- Ensure quality and appropriate MS provision nationwide.
- Guide health workers and providers on MS administration.
- Promote adherence by DOH, LGUs, and private sectors.
- Garner stakeholders’ support for MS policy implementation.
Scope of Application
- Applicable to all government levels, public and private health facilities, NGOs, development partners, and other stakeholders involved in MS delivery.
Key Definitions
- Diet Diversification: Changing diet practices to increase micronutrient intake through education.
- Emergency: Situations threatening basic survival needs.
- Elderly: Persons aged 60 or above.
- Food Fortification: Adding nutrients to food to improve diet quality.
- Health Providers: Health staff and facilities providing MS.
- Micronutrient Deficiency Terms: Iodine Deficiency Disorders, Iron Deficiency Anemia, Vitamin A Deficiency, Xerophthalmia.
- Micronutrient: Dietary elements required in small amounts.
- Micronutrient Supplement: Concentrated vitamin/mineral sources designed as supplements.
- Micronutrient Supplementation: Short-term high-dose intervention until food-based approaches are effective.
- Public Health Importance: WHO thresholds for severity of micronutrient deficiencies.
General Guidelines on MS Implementation
- Adopt MS where deficiencies reach public health significance and cannot be met by diet/fortification alone.
- Target priority groups: children under 5 years, pregnant/lactating women, non-pregnant women of reproductive age.
- Administer MS packages precisely by dosage, timing, frequency, and duration.
- Give priority to special groups in emergencies, endemic areas, or with clinical micronutrient deficiency.
- Therapeutic doses for older children, adults, and elderly if deficiencies diagnosed.
- Integrate MS delivery into Maternal, Newborn and Child Health and Nutrition (MNCHN) programs and other venues like schools and workplaces.
- Enhance LGU capabilities for program management, MS administration, counseling, referral systems, recording, monitoring.
- Sustain financing and ensure continuous supply and strengthened information management.
- Promote MS awareness and compliance through advocacy and education.
- Improve monitoring and evaluation by expanding scope and integrating MS into routine supervision and program reviews.
- Develop a Manual of Operations detailing standards and protocols.
Roles and Responsibilities
- Department of Health (National Level):
- Lead policy execution and dissemination.
- Coordinate management systems and technical assistance.
- Allocate funds and procure supplements.
- Collaborate with FDA and pharmaceutical industry for availability.
- Monitor LGU compliance and update policies.
- Organize expert panels.
- National Center for Health Promotion: Develop IEC materials, assist LGUs in behavior change.
- Procurement Service: Ensure procurement, storage, and distribution.
- Food and Drug Administration: Facilitate product registration.
- PhilHealth: Use MS provision as quality parameter, promote accreditation and enrollment.
- National Nutrition Council: Mobilize resources, coordinate nutrition activities, evaluate implementation.
- Food and Nutrition Research Institute: Conduct R&D, surveys, disseminate scientific data, participate in policy review.
- Centers for Health Development (CHD): Advocate policy adoption, ensure supply, monitor implementation, provide technical assistance.
- Local Government Units:
- Provincial/City Health Office: Train providers, advocate policy, manage supplies, ensure reporting.
- Rural Health Units/Health Centers: Update client lists, screen, provide MS, integrate services, monitor and report.
- Hospitals (Regional/Provincial/District): Integrate policies in treatment, conduct trainings, allocate budgets, educate patients, coordinate referrals.
- Development Partners: Participate in policy review, resource mobilization, training updates, monitoring, and campaign support.
Repealing Clause and Effectivity
- Rescinds AO 19, s. 2003 and other inconsistent issuances.
- Takes effect immediately following issuance.
This comprehensive directive outlines an integrated, evidence-based, rights- and lifecycle-focused approach for the delivery and enhancement of micronutrient supplementation in the Philippines to address critical nutritional deficiencies and support public health goals, including the reduction of under-five and maternal deaths consistent with Millennium Development Goals targets.