The LAKASS Programme (Lalakas ang Katawang Sapat sa Sustansiya) 46 started in 1989 and is ongoing in selected areas throughout the Philippines. The programme is funded by the Government of the Philippines (GoP), from the GoP-Japan Increased Food Production Programme. It covers 175 nutritionally depressed municipalities in the country.
Objectives of the programme
LAKASS aims to: (a) improve the nutrition situation in all identified nutritionally depressed municipalities; and (b) provide effective and sustainable services for the community to improve their nutritional status.
LAKASS has demonstrated its effectiveness in attaining its immediate goals. Its operation has been expanded to other depressed barangays 47 within the targeted municipality through the initiatives of local chief executives and village-level core groups.
Significant improvements in the nutritional status of malnourished children (using weight-for-age) of as much as 71.4 percent and 46.6 percent in severe and moderately underweight cases have been observed (in the area of Pateros, 1997) although, of the total number of households with moderately and severely underweight preschoolers, only 90 percent were reached. An increase of the households’ purchasing power (28 percent increase in income) among LAKASS beneficiaries (Pateros, 1997) through the provision of small capital loan assistance was likewise noted.
As a community-based nutrition programme, community involvement was an integral component of LAKASS from project identification, implementation and management, and was based on an in-depth analysis of causes of malnutrition at the community and household levels. This programme has generally led to people’s empowerment and mobilization, which enabled the villagers as well as local chief executives to build and sustain their capabilities to improve their own nutrition situation. Innovative strategies for ensuring a high loan repayment rate and for generating resources ensured the expansion of LAKASS beyond the initial scope of loan provision, to increase the number of those able to access loans.
Initially, community participation was motivated by prospects of material incentives, in this case the loan. However, with advocacy, orientation, training, technical backstopping and recognition of good performance, communities eventually graduated to self-mobilization.
Strengths, weaknesses, opportunities, constraints/threats (SWOC)
After more than 10 years of implementation, LAKASS has a good chance of sustainability. The LAKASS rollover scheme is designed in such a way that funds are only provided once to the municipality. As loans are repaid, other households are expected to enter the scheme. Recognizing that the initial amount given is inadequate, local leaders and community people have generated additional resources for the project. The initial loan given has also in most cases built up confidence and made the households creditworthy, thus enabling them to access other lending institutions.
Location: The Philippines is an archipelago located in Southeast Asia, with a total land area of almost 300,000 sq km. It is located north of Indonesia, east of Viet Nam, and southeast of China.
Demography: The total population as of July 2000 was 81,159,644, with an annual growth rate between 2.0 percent to 2.5 percent. The age structure shows 37 percent of the population in the 0-14 years age bracket, with the majority of the population (59 percent) within the 15-64 years age bracket. Only 4 percent of the population is within the 65 years and over age bracket.
Health: Selected health indicators are shown in Table 1. Although the infant mortality rate is relatively high in the Philippines, a gradual decline in the trend has been observed since 1990 (from 56.7 per 1,000 live births in 1990). However, a large disparity in infant mortality rates has been observed within the population, where very high infant mortality rates were observed in certain provinces (ranging from 65.8-69.1 infant deaths per 1,000 live births). The top ten causes of infant deaths (five-year average from 1991-1995 and in 1996) were: respiratory conditions of the foetus and newborn, pneumonia, congenital anomalies, diarrhoeal diseases, birth injury and difficult labour, septicemia, measles, meningitis, other diseases of the respiratory system, and vitamin and other nutritional deficiencies. Infant deaths were higher in mothers who received no antenatal care or medical assistance at the time of delivery (DoH, 1999). A similar decline in the trend for under five and maternal mortality since 1990 was also noted, but large differences in child and maternal mortality rates exist among different provinces.
Access to health services appears to be a major obstacle to health care delivery. Recent data show that a lower percentage of children in rural areas are taken to a health facility compared to urban areas. Moreover, it was noted that children whose mothers have higher levels of education account for a greater percentage of those brought to health facilities.
The leading causes of morbidity (all ages) were largely the communicable diseases. However, the ten leading causes of mortality (all ages) during the same period were mainly non-communicable diseases, such as cardiovascular diseases, malignant neoplasms and diabetes mellitus.
Table 1: Health indicators: Philippines
Life expectancy at birth, 2001
Crude birth rate, 2001 (per 1000 popn), 1997
Crude death rate, 2001 (per 1000 popn)
Infant mortality rate, 1995: rate (per 1000 live births)
Maternal mortality rate, 1995: rate (per 100,000 live births)
Source: Department of Health, National Objectives for Health 1999-2004 (June 1999)
Economy: the Philippine economy is based on a mixture of agriculture, light industry, and supporting services. The GDP growth rate declined from 5.1 percent in 1997 to –0.5 percent in 1998, with much of the decline in growth seen in the agriculture and forestry sectors and also from decreased investments. Some economic recovery was noted in 2000 when the country experienced a 3.3 percent growth rate in GDP (National Economic and Development Authority, 2001). Recent economic thrusts include major changes in the taxation system to increase government revenues, deregulation and privatization of the economy, and improvement of infrastructure.
Minimum basic needs indicators: in October 1999, the National Statistics Office conducted a nationwide Annual Poverty Indicators Survey for the second time, covering 41,000 sample households all over the country. Minimum basic needs indicators were classified as those on survival, security, and enabling. Some examples of data collected are given in Table 2.
Table 2: Minimum basic needs indicators, Philippines (1999)
1. SURVIVAL INDICATORS
FOOD AND NUTRITION
Recipients of iron supplements
A total of 1.6 million or 10.7% of the total families had married female family members 15-49 years old who were pregnant and/or lactating from April 1 to September 30, 1999. Of these, about 1 million or 64.8% were recipients of the iron supplements.
Three out of five of these families belonging to the lowest 40% income stratum received iron to supplement the needed vitamins during pregnancy.
Recipients of iodine supplements
Approximately 910.0 thousand (or 57.5%) of families with married pregnant/lactating women received iodine supplement during the period April 1 to September 30, 1999.
Three out of five families with pregnant and/or lactating married members who were 15-49 years old in 1999 were given at least two shots of tetanus toxoid.
91.7% of families with married women 15-49 years old had access to family planning in 1999 but only 35.8% were practicing any family planning method.
ELECTRICITY, WATER AND SANITATION
73.3% of families had access to electricity at home.
The number of families with access to safe drinking water was 79.2% in 1999.
The number of families with sanitary toilets was 12.142 million in 1999.
2. SECURITY INDICATORS
A total of 7.750 million families (52.6 %) had housing units made of strong materials.
Percentage of families owning the house and/or lot they occupy was 68.6%. Of the 10.1 million families that owned their house and/or lot in 1999, only 5.9% were able to get the assistance of the government housing or financing programme.
One in every five families owned land for purposes other than residence. Of these families, 288.0 thousand (0.9%) acquired their land through the Comprehensive Agrarian Reform Programme (CARP) for 1999.
Labour force was estimated at 32 million in 1999. This was classified as agriculture 39.8%, government and social services 19.4%, services 17.7 %, manufacturing 9.8%, construction 5.8%, and others 7.5%.
3. ENABLING INDICATORS
Percentage of families with children 6-12 years old was 52.7% in 1999. Of this number, the percentage of families with children 6-12 years old who were enrolled in elementary schools was 83.9% in 1999.
INVOLVEMENT IN PEOPLE’S ORGANIZATION, NGO (*) AND/OR COOPERATIVE
Some 4.097 million families or 27.8% of the total number of families have at least one family member involved in any people’s organization/non-governmental organization involved in community development in 1999.
The number of families with members in cooperatives was 16.2%.
AVAILMENT OF LOANS FOR ENTERPRENEURIAL ACTIVITIES/ BUSINESS
Three in every five families in the country were engaged in entrepreneurial activities.
In terms of availing loans, the number of families availing of loans for business was 2.173 million (25%) in 1999.
High interest rates, having no collateral, and no knowledge where to get loans were among the reasons given by families in the bottom 40% income group who could not avail of credit for their entrepreneurial activities.
PRESENCE OF WORKING CHILDREN
The number of families with working children 5-17 years old was about 1.511 million (14.7% of total families with children 5-17 years old) in 1999 who allowed their children to be employed.
Source: Annual Poverty Indicators Survey, October 1999, National Statistics Office, 2000, Manila, Philippines.
The Department of Health (DoH) is responsible for the administration of regional hospitals, medical centres, and specialized hospitals. Each region in the country has a DoH regional field office. Some important developments have occurred in the country’s public health care system and health care delivery over the past 25 years:
After the devolution of health services to local government units (1992), provincial and district hospitals were administered by provincial governments, while Rural Health Units and Barangay Health Stations located in different municipalities were placed under the municipal governments.
To achieve national health objectives, GoP has identified general strategies to improve the health care delivery system at different levels (DoH, 1999). These strategies include:
Some significant national government policies and activities on nutrition have been undertaken over the past decades. These include:
Key players in nutrition in the Philippines
The Philippines has a Medium Term Philippine Food and Nutrition Plan (MTPFNP). This has also been referred to as the Philippine Plan of Action for Nutrition (PPAN), which serves as the country’s blueprint for nutrition improvement. The current PPAN covers the period 1999-2004. The PPAN is an integral component of the Medium Term Development Plan for the Philippines. The NNC is the main policy-making body for nutrition and is responsible for formulating the MTPFNP/PPAN. A distinct feature of the PPAN is the systematic collaboration of national government agencies, local government units, NGOs and the business sector. The PPAN uses existing organizational structures at the national and subnational levels for the implementation, monitoring, and evaluation of nutrition interventions.
The NNC is the main coordinator for all nutrition-related activities of both government and private sectors. At the national level, the NNC is composed of a Governing Board that includes ten department secretaries (Agriculture; Health; Education, Culture and Sports; Science and Technology; Trade and Industry; Economic Planning; Social Welfare and Development; Interior and Local Government; Budget and Management; Labour and Employment) and three representatives from NGOs. The NNC Governing Board is chaired by the secretary of the Department of Agriculture. The main functions of the NNC Governing Board are the formulation of national food and nutrition policies and strategies and the coordination of planning, funds release, implementation, monitoring and evaluation of nutrition programmes. Technical assistance is provided to the NNC Governing Board by the Technical Committee, which also facilitates interagency communication and coordination. The NNC Technical Committee is composed of representatives from government departments and agencies, the academe (University of the Philippines at Los Baños), and NGOs. The NNC also has a Council Secretariat that advises the Governing Board on matters related to food and nutrition policies, programmes, and projects, as well as providing technical, financial, and logistical support to local governments and agencies for the development and implementation of nutrition programmes and projects. At the local level, local nutrition committees, chaired by local chief executives, serve as the planning and coordinating body at the local level. A designated Nutrition Action Officer assists the local chief executives on matters and activities related to nutrition and food. At the barangay level are the frontline community-based or volunteer workers who provide basic nutrition-related services that include growth monitoring and promotion, promotion of home and community food production, and the conduct of nutrition education activities, among others (NNC, 1995).
Nutrition policy directions
The Philippine Nutrition Programme is premised on a nutrition-in-development perspective. It adheres to the principle that a healthy well-nourished population is a prerequisite to attaining national development goals. Health and nutritional well-being is considered an integral part of national socio-economic development, guided by the following policy directions (NNC, 1995):
Five nutrition interventions have been identified as the primary impact programmes of the PPAN (1993-1998). These are:
Five key enabling mechanisms have been identified to support the implementation of PPAN’s impact programmes. These include:
The magnitude of the malnutrition problem
The nutrition situation in the Philippines is in the transition phase of development (Acuin and Javellana, 1998), where undernutrition remains a major health problem and nutrition problems related to overweight and obesity such as cardiovascular disease, diabetes, and cancer have been emerging. These have been attributed to the disparity in rate of development, particularly between urban and rural areas, as well as the unequal distribution of wealth in the country. Nutrition problems prevailing in the country are protein-energy malnutrition, vitamin A deficiency, iron deficiency anaemia, and iodine deficiency disorders. Nationwide nutrition surveys conducted by FNRI, the latest of which was in 1998, have revealed that malnutrition remains a public health concern in the Philippines.
Some salient findings of the most recent survey by FNRI (Fifth National Nutrition Survey, 1998) include the following:
A total of 1.5 million Filipino children (0-10 years old) are underweight and about 988,000 are stunted. Regions V (Bicol), VI (Western Visayas), and VIII (Eastern Visayas) appear to be more nutritionally at risk than other regions of the country. Based on the 1997 Family Income and Expenditures Survey (National Statistics Office, 1999) these three regions have the lowest average family income in the country, thus poverty appears to be a major factor involved. Remote rural communities and urban poor areas are more likely to be affected by the malnutrition problem.
Causes of malnutrition
Two immediate causes of malnutrition have been identified as having a major negative influence on the nutritional status of Filipinos. These are:
Three underlying causes of inadequate dietary intake and infectious disease are considered as exerting significant influence. These are:
Some basic causes of malnutrition are considered to contribute to the persistence of the malnutrition problem in the Philippines, including micronutrient malnutrition (Institute of Health Policy and Development Studies, Briefing Paper, 2001). Some of these factors include:
The Lalakas ang Katawang Sapat Sa Sustansiya (LAKASS) is a community-based nutrition action programme which combines the delivery of direct nutrition services with effective and sustainable development programmes to ensure the nutritional well being of the population within the framework of community development.
As a strategy to alleviate poverty and malnutrition in the most depressed areas of the country, the programme has the following objectives:
The programme embodies a number of key features including the use of a set of predetermined criteria for the selection of target areas and beneficiaries as preconditions for its implementation.
The LAKASS Programme was initially implemented in 125 of the most nutritionally depressed municipalities of the country in 1989, as a programme component of the PPAN, which was formulated and coordinated by the NNC. The latter is the main policy-making body for nutrition and is responsible for formulating the Medium Term Philippine Food and Nutrition Plan (MTPFNP) also known as PPAN. The programme was then launched by the NNC Governing Board as a strategy to alleviate poverty and malnutrition in the depressed areas of the country.
As a backdrop, the PPAN, an integral component of the Philippine Development Plan, is the government’s response to the country’s malnutrition problem. The PPAN is a broad, multilevel programme concerned with such far-ranging policies and programmes as food production and supply, industry, livelihood, infrastructure, health, education, population and employment, among others. Its overall objective is to promote food security, improve the nutritional status of the population and thus improve the quality of life of Filipinos. At the same time, the NNC Governing Board recognized the urgency to address the problem of malnutrition particularly in areas that remain unserved and depressed, and the need for a package of preventive and curative services that would reach the most needy areas in the shortest possible time. Further, the NNC Governing Board envisioned a programme that incorporated the government’s thrust of promoting the capabilities of communities in planning, implementing, and managing programmes and projects responsive to their needs: thus, the birth of the LAKASS Programme.
The 1992-1994 progress report on LAKASS Programme Expansion 1 records that 175 nutritionally depressed municipalities were covered since its inception in 1989. At the same time, the programme recognizes its bigger challenge in reaching a large number of nutritionally depressed municipalities. Anchored on a rollover scheme for implementation of projects, it is envisioned that once the loaned out funds are repaid more nutritionally depressed households can benefit.
In addition, the urban LAKASS was implemented in 1990 to improve the nutrition situation in the depressed areas in Metro Manila. It covered the following areas: the cities of Manila and Quezon, and the municipalities of Malabon, Marikina, Navotas, and Pateros. From each of these cities and municipalities, the two most depressed barangays were selected as initial project sites of the programme.
The programme reports improvements in nutritional status among the children in the coverage areas, and in the economic conditions of the family beneficiaries. Specifically, there was a significant decrease in the prevalence of underweight, stunting, and wasting by 16 percent, 21 percent, and 16 percent, respectively. The improvement in economic conditions of family beneficiaries relate to the increase in their annual income by 3 percent, and the improved diversity of foods consumed.
As a component of the PPAN, the LAKASS Programme utilizes the existing structure of the PPAN (see Appendix). In this structure, the NNC Governing Board is the country’s highest policy-making body on nutrition. It is composed of ten national government agencies and three private sector representatives, with the Secretary of Agriculture as chairman. Similar interagency structures called local nutrition committees operate at subnational levels. At the regional level, the Regional Nutrition Committee (RNC) is usually chaired by the regional director of a national government agency. However, the local chief executive chairs the provincial, city, municipal, or barangay nutrition committee. Even prior to the LAKASS Programme, local chief executives have served as chairpersons of local nutrition committees. They assume a lead role in planning, organizing, implementing, and monitoring their local nutrition programmes.
The NNC Governing Board sets policies and guidelines for the implementation of the LAKASS Programme. The NNC secretariat provides technical support to the NNC Governing Board. It also attends to the day-to-day operations of the LAKASS Programme at the national level. It likewise provides technical assistance on nutrition programme management to local nutrition committees, primarily through its Regional Nutrition Programme Coordinators. The RNCs and the Provincial Nutrition Committees (PNCs) provide technical assistance and supervise programme implementation at regional and provincial levels, respectively. The City/Municipal Nutrition Committee (MNC) manages the municipal or city nutrition programme. These are the people who provide the most direct assistance and supervise the programme implementation at barangay level.
The GoP through the Department of Agriculture funds LAKASS. Each municipality is provided with seed money of about P 230,000 for viable and sustainable projects. This amount supplements the available resources of the community, as well as those of government and non-governmental organizations. In this context, the general funding scheme of the programme is viewed as a means of channelling additional resources more quickly and effectively to nutritionally needy groups.
During the period 1992-1994, the National Agricultural and Fishery Council of the Department of Agriculture allocated a total of P 15 million, of which P 14.96 million has been released to the NNC. Fifty percent of this was earmarked to fund projects in 42 nutritionally depressed municipalities and their priority barangays. Funds were sourced through the Republic of Philippines-Japan Increased Food Production Programme.
The core of programme implementation is at the municipal and barangay levels. At the municipal level, the MNC directs and manages the implementation of the LAKASS Programme. It reviews project proposals for LAKASS funding and packages these into the municipal LAKASS proposal for submission to the NNC. The MNC also generates additional funds for LAKASS projects. It likewise assists barangays in implementing LAKASS projects. Thus, the municipal mayor, as chairman of the MNC, is accountable to the NNC for the full implementation of the programme. At the barangay level, LAKASS projects are implemented and managed by community-based organizations or LAKASS core groups, with the guidance of the Barangay Nutrition Committee (BNC). Provincial and municipal LAKASS officers, hired or designated by the governor or mayor, attend to the day-to-day operations of the programme at their respective levels.
The programme, being an area-based nutrition action programme, requires mobilization of people and communities, to bring together as many individuals and groups as possible whose capabilities and resources can be harnessed in order to improve the nutritional status of the population. The strategies and activities of this component at various levels are as follows:
This component views people as the key factor in the success of the programme. As such, the conduct of training aimed at providing participants with necessary knowledge, skills and attitudes on various topics depending on identified training needs are as follows:
Formulation of nutrition action programmes has been an institutionalized activity of local nutrition committees. The nutrition action plan serves as the key document and basis for the integration of nutrition considerations into the local development plans. It also serves as the working document and guide for field implementers and for monitoring and evaluation. The planning activity is initiated by the Municipal Mayor as Chairman of the MNC, while the municipal nutrition action officer coordinates the activity.
The provision of funding support to local government units is intended only to supplement the municipality’s existing resources. It may be used for the implementation of new projects identified by the community as well as ongoing intervention activities of the local Food and Nutrition Programme.
The preparation, appraisal and implementation of projects for funding under the LAKASS Programme are guided by the following:
The NNC, through the Nutrition Programme Coordinator and the PNC, releases the LAKASS project funds in the form of cash advance to the Municipal/City Mayor in his/her capacity as chairperson of the MNC. The participating Governors and Mayors are responsible for the monitoring of all project funds to the NNC. The Nutrition Programme Coordinator assists the local chief executives and ensures the proper disbursement of project funds.
The project components of the LAKASS programme are monitored and evaluated to determine the following: (1) extent of project implementation relative to the approved project plan; (2) status of fund utilization; (3) problem and difficulties encountered during project implementation; (4) beneficial effects for the project beneficiaries and the community.
Decentralization was implemented in 1992. While the LAKASS Programme is a national programme, its concepts, approaches, and main features reflect the decentralization process. A feature of decentralization is the strengthened networking of line agencies at the local level. Member agencies of the NNC are represented at the local level team as members of various nutrition committees together with the representatives of various line agencies.
At the national level, the ten member agencies from the government sector are as follows:
The private sector agencies represented in the Council are: Nutrition Centre of the Philippines, Philippine Business for Social Progress and the Rural Improvement Club. LAKASS utilizes existing intersectoral organizational structures (specifically the development council and nutrition committees) at various administrative levels, namely: regional, provincial, municipal or city and village or barangay.
A historical perspective of the development and implementation of LAKASS as a government initiated strategy to address the prevalent and persistent problem of malnutrition in the Philippines is indeed very complex.
Coordination has been a key feature of LAKASS’s success. Good coordination is essential in the LAKASS Programme because most activities are budgeted for and implemented by independent groups. In fact, coordination seems to require an almost continuous process of coalition building.
The country is at a stage where popular participation is strongly promoted, in line with the 1991 Local Government Code. Under this law, local government units are recognized as individual and independent corporate entities, responsible for the delivery of basic services which include those of nutrition. Also, making sure that nutrition concerns are integral to local development plans and programmes has become an important challenge to address. Likewise, the prevailing policy environment in rural development and poverty alleviation is generally supportive of the goals of the LAKASS Programme. However, it would be naïve to claim at this point that nutrition is a priority concern at the different government levels in spite of the heightened awareness that the programme has generated.
The concerns of the programme, namely poverty and nutrition, are universally articulated such that they transcend movements in administration and organization. Nevertheless, it is important that decisions are reaffirmed or altered with each new budget passed or leader installed, or new structures of potential cooperation are installed to enlarge and deepen the scope of LAKASS.
While the programme appears to have drawn clear-cut components and procedures, there exist considerable variations between and among municipalities, and even within them. Considering the range of possibilities that come with the ‘community-based’ nature of the programme, examining manifestations leaves no room for rigid comparisons. Thus, the programme cuts across the range in levels of community participation. However, functional and interactive participation seem to be the dominant levels regardless of actual details at project levels.
Many of the differences in programme implementation lie in the kind of participation that it receives at the community level, not to mention the range of alternative modes for solving different or same types of problems. The programme is broad enough that it attracts and involves most of the groups in the community. It encompasses a range of issues that appeal to the many interest groups that constitute the community. The structures and procedures described earlier inevitably draw in many people to take part in the joint decisions and actions of the programme or its projects. The leaders and members realize that their purpose is to build a strong network that can be a capable partner with government and the private sector in the community’s development efforts and that can mobilize resources for real self-help projects. Participants are able to identify their problems on their own and plan out their course of action. Leaders emerge from the community, because of their proven ability to help and serve the people.
The kind of participation observed in LAKASS, encompasses the following: people’s involvement in decision-making processes, involvement in implementing projects and decisions by contributing various resources or cooperating in specific activities, sharing in the benefits of development projects and involvement in efforts to evaluate such projects.
Following the structure of the programme, community participation cuts across the following groups: local residents, local leaders, government, and private personnel. It is often difficult for local people to participate as a group in decision-making, thus the emergence of local leaders. What distinguishes them from other local people is their role as acknowledged spokespersons for the community or group. Sometimes, it is difficult to distinguish them from government personnel as they may be appointed by the government or even receive some remuneration. What sets them apart is that they are not civil servants or bureaucrats.
Analysis of the elements needed for ensuring sustainability such as administrative capability at various operational levels and management processes involved in the implementation of LAKASS show that there is sufficient evidence to conclude that the programme has a good if not excellent chance of sustainability.
Management resources (social mobilization, training, leadership, implementing structure and support) and management processes (planning, implementation, monitoring, and evaluation) are all embedded in the programme’s features and strategies. The regular feedback or monitoring and evaluation which is a feature of LAKASS allows programmatic adjustments from time to time or troubleshooting to address weaknesses and constraints in programme implementation.
The implementing structure of LAKASS closely adheres to the decentralized, and organizational framework of the national food and nutrition programme making it more workable. With a largely democratic and consultative leadership coupled with clear delineation of roles and responsibilities of various line sectoral agencies, integration and coordination is achieved through a shared view of the goals and objectives of LAKASS. Moreover, while most municipal and barangay governments are unable to provide funding for loans, they have provided counterpart funds for the salaries of employees or incentives for overseers of the LAKASS programme.
Acuin, C.S. & Javellana, J. 1998. Nutrition in the Philippines: Areas for Health Policy and Systems Research. In Lansang, M.A. & Rebullida, M.L.G. eds. Towards Improved Health Policy and Systems Research. HPSR Monograph Series.
Department of Health (DoH). 1999. National Objectives for Health 1999-2004. HSRA Monograph Series no. 1. Dept. of Health, Manila Philippines.
Food and Nutrition Research Institute. 1993. Fourth National Nutrition Survey. Dept of Science and Technology (FNRI-DOST). Philippines.
Food and Nutrition Research Institute. 2000. Fifth National Nutrition Survey, 1998. Dept. of Science and Technology. Philippines.
Government of the Philippines. 1991. Local Government Code, 1991.
Government of the Philippines. 1999. Executive Order 102: Functions and Operations of the Department of Health.
Institute of Health Policy and Development Studies. 2001. Briefing Paper on the Philippine Food and Nutrition Situation. National Institutes of Health, University of the Philippines, Manila.
National Economic and Development Authority. 2001. Economic Performance for 2000. NEDA website (available at www.neda.gov.ph). Philippines.
National Nutrition Council (NNC). 1995. Philippines Plan of Action for Nutrition 1993-1998. National Nutrition Council, Makati, Philippines.
National Statistics Office. 1998. National Demographic and Health Survey, 1998. Dept. of Health, Manila, Philippines and Macro International Inc., Calverton MD, USA.
National Statistics Office. 1999. Family Income and Expenditures Survey, 1997. Philippines.
National Statistics Office. 2000. Annual Poverty Indicators Survey (APIS). Second nationwide survey conducted in October 1999. NSO, Manila, Philippines.
Stuart, T.H. 1995. Past Experiences and Needs for Nutrition Education: the LAKASS Programme in the Philippines. FAO, Rome.
Structure for implementing LAKASS
46 LAKASS is an intensive nutrition action programme formulated and coordinated by the National Nutrition Council of the Philippines. LAKASS is an acronym standing for a Philippine statement meaning: “The body will become robust and healthy with adequate nutrition” (Stuart, T.H. 1995. Rome, FAO).
47 The smallest political subdivision of the Philippines.
48 “Ningas-cogon means a lot of initial interest which fades fast. It is used to describe people’s attitude of being very enthusiastic at first, but this enthusiasm dies rapidly.” Source: personal communication to the editor by Prof. Delia Rodríguez Amaya, University of Campinas (UNICAMP), Brazil.
49 Sangguniang Panlalawigan = Provincial Council.
50 Editor’s note: The Sangguniang Bayan is composed of the Municipal Vice-Mayor as Presiding Officer and eight (8) regular Sanggunian members. It serves as the legislative arm of the municipal government. The body enacts ordinances and lays down policies and programmes for the upliftment of the community. Sources: www.sanmateorizal.net/sb.htm www.buhi.com/buhi/government/sbayan.htm