Guest Blog: Scaling Up Nutrition Through Advocacy

Dyan Aimee Mabunga-Rodriguez is an Advocacy and Good Governance Referent at Action Against Hunger | ACF- Philippines.

Two weeks ago, a government nutritionist sent me harrowing images of a child suffering from severe acute malnutrition in a rural area. This means that the child has very low weight for his height, characterized by wasting or skin-and-bones appearance. She ensured the child was brought for treatment to a government hospital six hours away in Davao City, which provides free treatment.

This hospital has adopted the concept of Integrated Management of Acute Malnutrition (IMAM), which is recognized by UNICEF and World Health Organization as the only established, evidence-based intervention that successfully addresses the problem of acute malnutrition and saves children’s lives[1].

The Philippine government has yet to sign a protocol on the treatment of acute malnutrition, hence, treatment is not accessible in all public hospitals or community health centers. But through persistent lobbying, nutrition advocates in Davao City have bolstered the institutionalization and integration of IMAM in the local health system, including public and certain private hospitals. The mayor executed a policy to sustain IMAM integration, has allocated 142,000 USD for the initial phase of the program, and has also increased funding for nutrition programs and projects broadly. In moments like this, my conviction that nutrition advocacy is imperative gains more insight. 

But despite successes such as these, in this day and age when knowledge and solutions to save lives abound, it is disturbing that the gnawing gaps between solutions and the people who need them most remain deeply-entrenched.

This is at heart of nutrition advocacy – bridging this gap through political discourse to save more lives.

August is Breastfeeding Awareness Month in the Philippines and advocates have capitalized on this key moment to talk about the first 1,000 days of a child’s life. Undernutrition during this time will hinder a child’s cognitive and physical development – permanently.

Nutrition advocacy must therefore focus on convincing legislators and decision-makers to invest in ensuring good nutrition in the first 1,000 days. This can be achieved through policies and programs to promote good nutrition for pregnant mothers and adolescent girls and improve the following:  breastfeeding practices (0-6 months), complementary feeding practices (7-24 months), protection against undernutrition and disease (6-24 months); and feeding of children who are sick and undernourished including those who have severe acute malnutrition. In this occasion, nutrition advocates from the Philippine Legislators’ Committee on Population and Development Foundation, Inc. (PLCPD) and UNICEF have organized a series of events at the Philippine Congress to raise awareness on proposed bills related to the First 1,000 days. The Philippine Coalition of Advocates for Nutrition Security (PhilCAN) – a coalition of 11 NGOs advocating for improved nutrition among vulnerable and marginalized populations – has expressed its solidarity to the legislators who have taken huge steps to propose these bills.

PhilCAN intends to promote exclusive breast feeding through the First 1,000 Days Program in every village to augment the provisions in existing breastfeeding laws reinforcing the value of continuous, practical, and effective education for caregivers on the proper nutrition of their children.

Another exciting proposed Senate bill is the “Malnutrition-Free Act.” PhilCAN proposes that preferential treatment must be provided for the poorest and most vulnerable Filipinos, many of who live in isolated and disadvantaged areas. Data on malnutrition found in local government plans should be regularly collected and analyzed to serve as a basis for the prioritization of national government programs and projects. Nutrition surveillance should identify those who need additional help to overcome undernutrition.

PhilCAN emphasizes the need of mothers to be given support while exclusively breastfeeding their children, including longer maternity leaves. Thus, the support to the call on the immediate passage of the bills on extending maternity leaves for pregnant and lactating mothers. PhilCAN proposes that maternity leave periods be responsive to the needs of lactating mothers but at the same time sensitive to the economic implications. PhilCan believes the bill must mention provisions to ensure women will not be discriminated against, especially on hiring, because of their required maternity leave period. In addition, it supports the provision on non-diminution of benefits for mothers and appeals to the authors to include in their agenda provisions that would cater the needs of our mothers who are in the informal sectors. This would include post-partum follow ups, nutrition counselling among others.  Since fathers play a vital role in the care of their children especially in the first 6 months, PhilCAN suggests that fathers will have extended paternity leave.

Aristotle wrote, “The law is reason free from passion.” Policies on the first 1,000 days are significant and require every fibre of passion, intent, and debate because the first 1,000 days of the Filipino child’s—and each and every child’s--life are priceless.

[1] Draft IMAM Protocol, Department of Health, April 2015.