6th National Conference of Nutrition Action Officers
08 October 2020
Ellen Ruth F. AbellaNutrition Officer IV &
Officer-in-Charge, NSD
National Nutrition Council
Operation Timbang Plus
Minimum Health Standards
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▪ Background
▪ Guidance in the OPT in the context of the pandemic
▪ Bonus: Electronic OPT tool for Acute Malnutrition
Outline
Click to edit title Background
▪ The COVID-19 pandemic has threatened food security and nutrition
▪ Hunger, declining incomes and accessibility to food have worsened
▪ Movement restrictions have affected the local health and nutrition workers to conduct routine activities, including OPT Plus
Source: https://www.washingtonpost.com/graphics/world/2020/04/11/meet-health-care-workers-spearheading-philippiness-fight-against-coronavirus/
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Guidelines for Continuous (but safe) Service
Delivery
DOH-Department Circular 2020-0167
Continuous Provision of Essential Health Services
during the COVID-19 Epidemic
DOH-Department Memorandum 2020-0237 Interim Guidelines for the Delivery of Nutrition
Services in the Context of COVID19
Pandemic
“still be done during health facility
visits, community outreach…strict
observance of infection prevention
and control (IPC) measures”.
suggests the use of MUAC tapes
instead of the weight and
length/height measuring tools to limit
health care provider contact with the
infant or child
Click to edit title Key Considerations for in-person data
collection 1/3
Refer to DOH-Department Memorandum 2020-0157 for the guidelines on cleaning and disinfection in various settings
as an IPC measure against COVID-19
▪ Thoroughly disinfect the weight and
height/length measuring tools, MUAC
tapes, and other frequently-touched
surfaces and objects
▪ Use diluted household bleach
solutions or alcohol solutions with at
least 70% alcohol after every use
and between measurements
▪ Thoroughly disinfect or wash (for at least
20 seconds) measurers’ hands/gloves
between measurements
Source: https://www.greenseal.org/blog/how-to-safely-disinfect-for-coronavirus
Click to edit title Key Considerations for in-person data
collection 2/3
▪ Practice physical distancing between the
mothers/caregivers and their children and
OPT members of OPT team until its time to
measure.
▪ Wear face masks, face shield and gloves
when taking measurements.Sample photo during immunization in Camarines Norte.Both mother and health worker are maintaining safe physical distance and wearing face masks/shield.
Click to edit title Key Considerations for in-person data
collection 3/3
▪ Read measurements from behind, e.g.,
MUAC measurement to potentially
reduce risk of droplet exposure
▪ consider using this opportunity to train
mothers/caregivers on how to take
MUAC measurements of their children.
▪ Utilize the video on how to measure
MUAC downloadable in NNC website
(https://www.nnc.gov.ph/covid19/im/m
uac)
Click to edit title Guidance on OPT and GMP in the
Context of the Pandemic
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Guidance on OPT and GMP in the Context of
the Pandemic 1/4
▪ OPT Plus results collected prior to the localized quarantine should have
been used as basis to provide interventions and monitor nutritional
status
▪ Weight and length/height measurements collected pre- ECQ/
localized quarantine during OPT Plus (1st quarter) should be
consolidated and processed, and submitted to NNC
▪ Recording and reporting for the Field Health Service Information
System (FHSIS) shall be sustained per DOH-Department Circular 2020-
0167.
Recording and Reporting OPT, Nutrition Screening, and Growth Monitoring Results
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Guidance on OPT and GMP in the Context of
the Pandemic 2/4
Recording and Reporting OPT, Nutrition Screening, and Growth Monitoring Results
▪ MUAC of children aged 6-59 months with normal nutritional status and no
bilateral pitting edema should be measured
▪ monthly for 6 to 23 months old
▪ quarterly for 24 to 59 months old.
▪ If the child has normal MUAC but has bilateral pitting edema,
immediately refer to a trained staff at the nearest barangay health
center or rural health unit for further assessment and appropriate
management
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Guidance in the OPT in the Context of the
Pandemic 3/4
Recording and Reporting OPT, Nutrition Screening, and Growth Monitoring Results
▪ MUAC of children identified severely acute malnourished (SAM) shall
be measured every 2 weeks and moderately acute malnourished
(MAM) every month until MUAC is greater than 12.5cm.
▪ Monthly reports should be generated at city/municipal level through
the health officer and the nutrition action officer.
▪ Quarterly and annually consolidated and analyzed reports should be
submitted to the next higher level.
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Guidance in the OPT in the Context of the
Pandemic 4/4
Recording and Reporting OPT, Nutrition Screening, and Growth Monitoring Results
▪ Growth monitoring results of children measured using traditional
weight and height measuring tools and MUAC can be recorded in
the e-OPT tool for Acute Malnutrition
▪ Conduct regular follow up of children using SMS, Facebook
messenger and other available virtual platforms and during home
visits
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Scenarios at the LGUs and Nutrition Screening,
Growth Monitoring and Promotion Activities 1/3
Scenario
(based on
DOH-DM No.
2020-0237)
Nutrition Screening, Growth Monitoring and Promotion Activities
Normal Nutritional Status
SAM children MAM children0 to <6
months old
6 to 23 months
old
24 to 59 months
old
Recognition
Phase Stage 1
Zero Cases or
importation
Weight-for-
length
Weight-for-
height or
MUAC
Weight-for-
height or
MUAC
• Weight-for-length
for less than 6
months old
• Weight-for-height
or MUAC for 6 to 59
months old
• Weight-for-length
for less than 6
months old
• Weight-for-height
or MUAC for 6 to
59 months old
Monthly monitoring Quarterly
monitoring
Monitoring every 2
weeks
Monthly
monitoring
Follow-up through virtual platforms, home visits, and primary health care facilities
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Scenarios at the LGUs and Nutrition Screening,
Growth Monitoring and Promotion Activities 2/3
Scenario
(based on
DOH-DM No.
2020-0237)
Nutrition Screening, Growth Monitoring and Promotion Activities
Normal Nutritional Status
SAM children MAM children0 to <6
months old
6 to 23 months
old
24 to 59 months
old
Initiation
Phase
Stage 2
Localized
Transmission
Health and
nutrition staff
are engaged
in COVID-19
response
Weight-for-
length
MUAC MUAC • Weight-for-length
for less than 6
months old
• MUAC for 6 to 59
months old
• Weight-for-length
for less than 6
months old
• MUAC for 6 to 59
months old
Monthly monitoring Quarterly
monitoring
Monitoring every 2
weeks
Monthly
monitoring
Follow-up through virtual platforms, home visits, and primary health care facilities
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Scenarios at the LGUs and Nutrition Screening,
Growth Monitoring and Promotion Activities 3/3
Scenario
(based on DOH-
DM No. 2020-
0237)
Nutrition Screening, Growth Monitoring and Promotion ActivitiesNormal Nutritional Status
SAM children MAM children0 to <6 months
old6 to 23 months old 24 to 59 months old
During
Acceleration Phase
Stage 3
Community
Transmission
All health and
nutrition staff
and other
health office
personnel are
engaged in
COVID-19
response
Weight-for-
length
MUAC MUAC • Weight-for-length
for less than 6
months old
• MUAC for 6 to 59
months old
• Weight-for-
length for less
than 6 months
old
• MUAC for 6 to
59 months old
Monthly monitoring Quarterly
monitoring
Monitoring every
2 weeks
Monthly
monitoring
• Visits to non-emergency concerns to primary health care facilities are suspended.
• Follow-up through virtual platforms and home visits
Click to edit title Electronic Operation
Timbang Plus (eOPT+) Tool
for Acute Malnutrition
Click to edit title Recap of the (original) eOPT+ tool 1/2
▪ Microsoft excel-based tool which may be used for data
collection
▪ Aids in report preparation (less time required)
▪ Helps in quicker identification and follow up
▪ Automates calculation of encoded data such as:
▪ Age in months
▪ Nutritional status (weight-for-age, height-for-age,
weight-for-height)
Click to edit title Recap of the (original) eOPT+ tool 2/2
▪ Facilitates detection of errors (and their correction), such
as:
▪ Out of range values (e.g. flags errors in keying in
weights and heights)
▪ Duplicate names (color-codes duplicate names and
error messages to flag users)
▪ Overaged children not counted (automatic crossing-
out of names of children >59 months)
Click to edit title Key Features of the Updated e-OPT Tool
▪ Labelled as “Acute Malnutrition Tool” to distinguish it from the regular tool
▪ Distinct color on data entry worksheets so users can easily differentiate from original tool
▪ Has only one version (for 1000 children only)— previously for 500 and 1000 children separately
Click to edit title Key Features of the Updated e-OPT Tool
▪ Step by step instructions are located on the first sheet named ‘Instructions’
▪ On the ‘NutStatus_Tool’ sheet, user can also click the link for easier navigation to the instructions
Click to edit title New Feature: Automated dropdown
▪ Renamed as “Community-level eOPT Tool
▪ Can be used for Purok/ Zone, Barangay, and Evacuation Center
▪ Dependent dropdown list for Region, Province and City/Municipality
Click to edit title New Feature: Estimated population
▪ Province-level multipliers for estimating the total number of 0-59 and 6-59
months old children are automatically generated after user enters the
province/city name
Click to edit title New Feature: MUAC
▪ Requires the following minimum set of data to be entered, otherwise auto-
generated results will not be displayed
▪ Name of mother or caregiver
▪ Full name of child
▪ Whether IP child or not
▪ Sex
▪ Date of Birth
▪ Actual Date of Visit
▪ Bilateral pitting edema
▪ MUACCompletely filled-out:
No data on height (not required):
No data on name of mother or caregiver (required):
Click to edit title New Feature: Weight for Length/Height
▪ Requires the following minimum set of data to be entered, otherwise auto-
generated results will not be displayed
▪ Name of mother or caregiver
▪ Full name of child
▪ Whether IP child or not
▪ Sex
▪ Date of Birth
▪ Actual Date of Visit
▪ Weight
▪ HeightCompletely filled-out:
No data on MUAC (not required):
No data on IP membership (required):
Click to edit title New Feature: Improved error-checking feature
▪ If a child’s name was entered more
than once, the second or repeated
entries will not be tallied in the
summary (first entry will be considered)
‘Summary’ Sheet:
‘Summary’ Sheet header:
Click to edit title New Feature: Additional Information on the
Summary Sheet
▪ Space added to show estimated number of 06-59 months old children measured
Click to edit title New Feature: Additional Information on the
Summary Sheet
▪ Summary breakdown of MUAC status by age group▪ Number of IPs measured
Click to edit title New Feature: Improved BNS Printout
▪ The ‘BNS_Printout’ worksheet will help BNSs locate children:
o Alphabetically
sorted (given that
appropriate name
format is followed)
o Overaged children
are cross-out and
duplicate names
are highlighted
Click to edit title New Feature: Auto-generated List of children
▪ List of MAM and SAM
Click to edit title New Feature: Auto-generated List of children
▪ List of Wasting and Severely Wasting
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Find Opportunities to build capacity of workers and community along nutrition assessment
Call to Actions for NAOs
Ensure:• Quality of data• Use of local data in planning and appropriate interventions• Adherence to set guidelines, e.g. timely submission of reports, tools• Regular maintenance of measuring equipment (calibration, verification
Continue supervision of community workers along OPT Plus and
growth monitoring activities while adhering to minimum health protocols
Click to edit title Thank you!
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nncofficial/
Visit our webpage:
https://nnc.gov.ph/
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