Situation Analysis of ECCD-F1KD Initiatives in the Province of Samar
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DECEMBER 2019 DISCUSSION PAPER SERIES NO. 2019-30 Situation Analysis of ECCD-F1KD Initiatives in the Province of Samar Aubrey D. Tabuga and Carlos C. Cabaero The PIDS Discussion Paper Series constitutes studies that are preliminary and subject to further revisions. They are being circulated in a limited number of copies only for purposes of soliciting comments and suggestions for further refinements. The studies under the Series are unedited and unreviewed. The views and opinions expressed are those of the author(s) and do not necessarily reflect those of the Institute. Not for quotation without permission from the author(s) and the Institute. CONTACT US: RESEARCH INFORMATION DEPARTMENT Philippine Institute for Development Studies [email protected] 18th Floor, Three Cyberpod Centris - North Tower https://www.pids.gov.ph EDSA corner Quezon Avenue, Quezon City, Philippines (+632) 8877-4000 Situation Analysis of ECCD-F1KD Initiatives in the Province of Samar Aubrey D. Tabuga Carlos C. Cabaero PHILIPPINE INSTITUTE FOR DEVELOPMENT STUDIES December 2019 (Updated February 2020) 1 Abstract Children are more likely to develop and reach their full potential when they are protected from disease, provided proper nutrition, and live in stimulating and safe environments. Unfortunately, many children are deprived of nurturing care and favorable environment. In the Philippines, one-third of children under five years old were stunted based on 2015 estimates. This study aims to contribute in determining appropriate strategies for early childhood care and development interventions (ECCD) for the first 1000 days in a child’s life by conducting a situation analysis in selected local government units in the province of Samar. It aims to examine the contextual factors underlying ECCD-F1KD interventions with emphasis on the policy and governance, the inputs and processes of planning and implementation of ECCD- F1KD programs and services, and the nurturing care practices of parents and caregivers. Results from the study emphasize the need for more integrated planning amongst local offices and clearer delineation of roles for ECCD F1KD initiatives. There is also a need to establish objective metrics during planning and implementation, as well as capacitation of LGUs to conduct M & E. The capacity of the human resources and health infrastructure may be further optimized through ample capacitation and compensation for personnel, as well as rethinking deployment and positioning of health workers and facilities to even out service burden. Finally, initiatives must be designed for improving health knowledge of parents, providing safe and stable environments for children, and providing sustainable livelihoods to greater enable proper nurturing care in the household. Keywords: early childhood care and development, children, nurturing care practices, policy and governance, program and service delivery 2 Table of Contents 1. Introduction ................................................................................................................................. 5 2. Objectives of the Study ............................................................................................................ 8 3. Methodology ................................................................................................................................ 9 4. Study Sites ................................................................................................................................. 13 5. Results ........................................................................................................................................ 21 5.1. Policy, Leadership and Governance ............................................................................... 22 5.2. Program and Service Delivery ........................................................................................ 32 5.3. Nurturing Care Practices ................................................................................................... 53 5.4. Other contextual factors .................................................................................................... 58 6. Recommendations .................................................................................................................. 59 6.1. Policy, Leadership and Governance ............................................................................... 59 6.2. Program and Service Delivery.......................................................................................... 61 6.3. Nurturing Care Practices ................................................................................................... 64 Bibliography .......................................................................................................................................... 66 Appendices ............................................................................................................................................ 67 Annexes ................................................................................................................................................. 85 3 List of Tables Table 1 Resource groups and discussion themes ................................................................................. 10 Table 2.2 Key economic and child nutrition indicators in UNICEF project areas .................................. 12 Table 2.3 Poverty incidence of Samar province and cities/municipalities ........................................... 15 Table 2.4 Number and prevalence of stunted children in Samar and cities/municipalities ................. 16 Table 2.5 OPT data, 0 to 59 months old, Catbalogan City ……………………………………………………………... 20 Table 2.6 LGU health workers in Catbalogan and Calbayog ................................................................. 41 Table 2.7 Public health facilities and their assigned BHS and population covered, Calbayog City ...... 48 Table 2.8 Barangay Health Stations and their assigned population, Catbalogan City .......................... 50 List of Figures Figure 1 Prevalence of stunting among children aged below 5 years .................................................... 5 Figure 2 ECCD profile in the Philippines .................................................................................................. 6 Figure 3 Continuum of Nurturing Care Results Framework ................................................................... 9 Figure 4 Map of Samar Province ........................................................................................................... 14 Figure 5 Population by barangay, Catbalogan City ............................................................................... 18 Figure 6 Stunting prevalence by age group, Catbalogan City …………………………………………..…………….. 20 Figure 7 Population by barangay, Calbayog City................................................................................... 20 Figure 8 Stunting prevalence by age group, Calbayog City………………………………………………..…………… 23 Figure 9 Health expenditures, Catbalogan City .................................................................................... 23 Figure 11 Health expenditures, Calbayog City ...................................................................................... 24 Figure 12 The process of Operation Timbang in Calbayog City* .......................................................... 31 Figure 13 Core Organizational structure* for nutrition in Catbalogan City and Calbayog City ............ 38 Figure 14 Organizational structure concerning volunteer health workers, Calbayog City* ................. 39 Figure 15 Process of program delivery of feeding program, Calbayog City*........................................ 44 4 Situation Analysis of ECCD-F1KD Initiatives in the Province of Samar Aubrey D. Tabuga and Carlos Cabaero1 1. Introduction The role of leaders, implementers, and frontline workers at the local level is vital to efforts related to promotion of health and nutrition in communities. Similarly, the ability of parents and caregivers to nurture the growth of infants and young children and seek help and education as the need arise are likewise important. Furthermore, the need to identify and address any contextual barrier towards effective delivery of programs and services on the ground cannot be overemphasized. Despite the sustained economic growth in recent years, the Philippines has relatively high levels of stunting, at 33%, among children under five years old in 2015 (Figure 2.1). This is far off the regional averages in the East Asia and Pacific (11% stunting prevalence). Childhood wasting affects about 7% of all children under five years old. Malnutrition problem in the country as with many other parameters of development is characterized by wide regional disparities reflecting evident inequality across the sub-national regions. Figure 1 Prevalence of stunting among children aged below 5 years Source: 2015 Updating of the Nutritional Status of Filipino Children and Other Population Groups, DOST & FNRI In the Philippines’ country profile (Nurturing Care for Childhood Development, n.d), the support and services for early childhood development specifically nurturing care shows that 87 percent have antenatal care (4 or more visits) while 86 percent have postnatal visits (Figure 2.2). However, much remains to be done in treating HIV-infected pregnant women, in care- seeking for child pneumonia, and in the ECCD’s nutrition component, particularly exclusive breastfeeding.