BNS Form No.

2, Revised January 2018

BARANGAY NUTRITION SCHOLAR ACTION PLAN CY 2019

Name of BNS:_______________________________________________________ City: STO. TOMAS

Barangay: __________________________________________________________ Province: BATANGAS

Annual Duration/ Schedule of Activities

Activity Target Group
Target No. Frequency J F M A M J J A S O N D
A. WEIGHING ACTIVITIES
1. Full Weighing (OPT+) All children, 0-59 months old (Total population (TP) x 0.10714) Once a year / / /
2. Monthly reweighing and height Children, 0-23 months old (based on OPT data) actual # Monthly / / / / / / / / / / / /
monitoring
Underweight children 0-59 months (based on OPT data) actual # Monthly / / / / / / / / / / / /
Severely underweight children 0-59 months old (based on OPT actual # Monthly / / / / / / / / / / / /
data)

Wasted children 0-59 months old (based on OPT data) actual # Monthly / / / / / / / / / / / /
Severely wasted children 0-59 months old (based on OPT data) actual # Monthly / / / / / / / / / / / /
Overweight children 0-59 months old (based on OPT data) actual # Monthly / / / / / / / / / / / /
Obese children 0-59 months old (based on OPT data) actual # Monthly / / / / / / / / / / / /
Stunted children 0-59 months old (based on OPT data) actual # Monthly / / / / / / / / / / / /
Severely stunted children 0-59 months old (based on OPT data) actual # Monthly / / / / / / / / / / / /
3. Semestral weighing and height Children, 24-59 mos. old (TP x 8.1%) actual # Twice a year / /
monitoring

B. NUTRITION SPECIFIC PROGRAMS

1. Infant and Young Child Feeding (IYCF)
a. Refer for breastfeeding or Pregnant women Monthly / / / / / / / / / / / /
(as of January
lactation counseling survey)
Lactating mothers Monthly / / / / / / / / / / / /
b. Counseling on breastfeeding Pregnant women Monthly / / / / / / / / / / / /
and complementary feeding
Lactating mothers (as of January
Monthly / / / / / / / / / / / /
survey)
Mothers with acutely malnourished children 0-59 months old Monthly / / / / / / / / / / / /
Page 1 of 45
 Annual Duration/ Schedule of Activities
Activity Target Group Target No. Frequency J F M A M J J A S O N D
c. Assist in organizing IYCF actual #
community support groups

d. Other activities, specify

2. Integrated Management of Acute Malnutrition

a. Assist in case finding
b. Refer cases to In-patient Severe acute malnutrition (SAM)cases with medical complication
therapeutic care (ITC)

c. Refer cases to out-patient SAM cases without medical complication

therapeutic care (OTC)

d. Refer cases to supplementary Moderate acute malnutrition (MAM) cases

feeding

e. Assist in operations of OTC and SAM cases without medical complication and/or MAM cases
supplementary feeding of MAM
cases

3. Dietary Supplementation
a. Refer cases Underweight pregnant women
Other pregnant women
Infants 6-23 months old
Other groups, specify

b. Assist in dietary Underweight pregnant women

supplementation activities
Other pregnant women
Infants 6-23 months old

Page 2 of 45
 b. Assist in dietary
supplementation activities

Other groups, specify

Annual Duration/ Schedule of Activities

Activity Target Group Target No. Frequency J F M A M J J A S O N D
4. National Promotion Program for Behavior Change
a. Conduct nutrition education Mothers or caregivers of children 0-23 months old
classes (Idol ko si Nanay, Pabasa
sa Nutrisyon, cooking Mothers or caregivers of children 24-59 months old
demonstrations, others Other mothers
Pregnant women
Fathers or other male members of the family
Other groups, specify

b. Do home visits for nutrition Mothers or caregivers of children 0-23 months old
counseling and follow-up
Mothers or caregivers of wasted (SAM or MAM) children 0-59
months old

Mothers or caregivers of moderately or severely underweight

children 0-59 months old

Mothers or caregivers of stunted children 0-59 months old

Mothers or caregivers of overweight or obese children 0-59 months
old

Pregnant women
5. Micronutrient Supplementation
a. Assist in administration of Children 6-59 months old
vitamin A supplements
Post-partum mothers
Measles cases
b. Assist in iron-folic acid Pregnant women
supplementation, including
follow-up home visits to check on
actual use Page 3 of 45
 b. Assist in iron-folic acid
supplementation, including
follow-up home visits to check on
actual use

Annual Duration/ Schedule of Activities

Activity Target Group Target No. Frequency J F M A M J J A S O N D
c. Assist in distribution of multiple Children 6-23 months old
micronutrient powder, including
follow-up home visits to check on
actual use

d. Assist in distribution of iodized Women of reproductive age

oil capsules (if available)
Pregnant women

6. Mandatory food fortification

a. Promotion on the use of iodized General population
salt

b. Assist in monitoring the sale of Market

iodized salt where salt is sold
Grocery/supermarket
Sari-sari store
Eating places
7. Nutrition in Emergencies
a. Assist in rapid assesssment Evacuees with children 0-59 months old
b. Assist in distribution of vitamin Children 6-59 months old
A capsules

c. Refer cases of SAM and MAM As identified

d. Assist in OTC As needed
e. Assist in supplementary feeding As needed
of MAM cases

f. Assist in following up SAM and As needed

MAM cases

Page 4 of 45
 g. Conduct counseling on infant As needed
and young child feeding

h. Conduct nutrition education As needed

i. Other, specify As needed

Annual Duration/ Schedule of Activities

Activity Target Group Target No. Frequency J F M A M J J A S O N D
8. Overweight and Obesity Management And Prevention Program
a. Refer cases to service provider Overweight and obese children 0-59 months old
b. Assist in weight management Overweight and obese children 0-59 months old
intervention

c. Assist in promoting healthy

environment

d. Others, specify
C. NUTRITION SENSITIVE PROGRAMS
1. Home, school and community food production
a. Refer to programs and projects Families with pregnant women
that distribute seeds, seedlings,
other planting materials, and Families with children 0-23 months old
small animals Families with wasted & severely wasted children 0-59 mos. old
Other families
b. Assist in distributing seeds, Families with pregnant women
seedlings, other planting
materials, and small animals Families with children 0-23 months old
Families with wasted & severely wasted children 0-59 mos. old
Other families
c. Establish own home garden
d. Assist in establishing
community food garden

2. Livelihood assistance
a. Refer to programs and projects
Page 5 of 45
 1) Providing credit assistance Families with pregnant women
or seed capital
Families with children 0-23 months
Families with wasted children 0-59 months old
Families with stunted children 0-59 months old
Others, specify

Annual Duration/ Schedule of Activities

Activity Target Group Target No. Frequency J F M A M J J A S O N D
2) Providing material support Families with pregnant women
for income generating projects
Families with children 0-23 months
Families with wasted children 0-59 months old
Families with stunted children 0-59 months old
Others, specify
3) Providing training support Families with pregnant women
for income generating projects
Families with children 0-23 months
Families with wasted children 0-59 months old
Families with stunted children 0-59 months old
Others, specify
3. Water, Sanitation and Hygiene

a. Refer to programs and projects on

1) Distribution of sanitary Families with pregnant women
toilets
Families with children 0-23 months
Families with wasted children 0-59 months old
Families with stunted children 0-59 months old
Others, specify
2) Improving access to safe Families with pregnant women
drinking water
Families with children 0-23 months
Families with wasted children 0-59 months old
Families with stunted children 0-59 months old
Page 6 of 45
 2) Improving access to safe
drinking water

Others, specify
b. Campaign for zero open Community
defecation

c. Others, specify

Annual Duration/ Schedule of Activities

Activity Target Group Target No. Frequency J F M A M J J A S O N D
4. Population management
a. Assist in the promotion of
responsible parenthood, including
family planning

b. Assist in activities to prevent

teen-age pregnancy
D. ENABLING PROGRAMS
1. Assist in resource generation/fund
raising of nutrition projects of the
barangay

2. Attend meetings
a. BNC meetings
b. BNS-D/CNPC meetings
3. Assist in organizing/ reorganizing
barangay nutrition committee

E. OTHER ACTIVITIES (Please specify)

Remarks by supervisor (D/CNPC or C/MNAO

Page 7 of 45
 ___________________________________________________________
Name and Signature Date

Prepared by: _______________________________________ Noted: ___________________________________

Date: _____________________ Date: _____________________

Page 8 of 45
0.10714 target

Page 9 of 45
BNSP FORM No. 4
Philippine Plan of Action for Nutrition

BNS ACCOMPLISHMENT REPORT

2nd Semester, 2020

Province: BATANGAS City: STO. TOMAS

Name of BNS: ________________________________________________

Activity and target group Target July August September October November December Total
A. GROWTH MONITORING ACTIVITIES
1. Full Weighing (OPT plus)
All children, 0-59 months old (Total population (TP) x 13.5%)
2. Monthly reweighing and height monitoring
All children, 0-23 months old (Total population (TP) x 5.4%)
Underweight children 0-59 months old (based on OPT data)
Severely underweight children 0-59 months old (based on OPT data)
Wasted children 0-59 months old (based on OPT data)
Severely wasted children 0-59 months old (based on OPT data)
Overweight children 0-59 months old (based on OPT data)
Obese children 0-59 months old (based on OPT data)
Stunted children 0-59 months old (based on OPT data)
Severely stunted children 0-59 months old (based on OPT data)
3. Semestral reweighing and height monitoring
Children, 24-59 months old (TP x 8.1%)
B. NUTRITION SPECIFIC PROGRAMS
1. Infant and Young Child Feeding (IYCF)
a. Refer for breastfeeding or lactation counseling
Pregnant women
Lactating mothers
b. Counseling on breastfeeding and complimentary feeding
Page 10 of 45
 Pregnant
Lactating
Mothers with acutely malnourished children 0-59 months old
c. Assist in organizing IYCF community support groups
d. Other activities, specify

2. Integrated Management of Acute Malnutrition

a. Assist in case finding
b. Refer cases to in-patient therapeutic care (ITC)
Severe acute malnutrition (SAM) cases with medical complication
c. Refer cases to out-patient therapeutic care (OTC)
Severe acute malnutrition (SAM) cases without medical complication
d. Refer cases to supplementary feeding
Moderate acute malnutrition (MAM) cases
e. Assist in operations of outpatient therapeutic care (OTC) and supplementary
feeding MAM & SAM cases without medical complication

3. Dietary Supplementation
a. Refer cases
Underweight pregnant women
Other pregnant women
Infants 6-23 months old
Other groups, specify
b. Assist in dietary supplementation activities
Underweight pregnant women
Other pregnant women
Infants 6-23 months old
Other groups, specify
4. National Promotion Program for Behavior Change

Page 11 of 45
 a. Conduct nutrition education classes (Idol ko si Nanay, Pabasa sa Nutrisyon,
cooking demonstrations, others)
Mothers or caregivers of children 0-23 months old
Mothers or caregivers of children 24-59 months old
Other mothers
Pregnant women
Fathers or other male members of the family
Other groups, specify
b. Do home visits for nutrition counseling and follow-up
Mothers or caregivers of children 0-23 months old
Mothers or caregivers of wasted (SAM or MAM) children 0-59 months old
Mothers or caregivers of moderately or severely underweight children 0-59
months old

Mothers or caregivers of stunted children 0-59 months old

Mothers or caregivers of overweight or obese children 0-59 months old
Pregnant women
5. Micronutrient Supplementation
a. Assist in administration of vitamin A supplements
Children 6-59 months old
Post-partum mothers
Measles cases
b. Assist in iron-folic acid supplementation, including follow-up home visits to
check on actual use

Pregnant women
c. Assist in distribution of multiple micronutrient powder, including follow-up
home visits to check on actual use

Children 6-23 months old

d. Assist in distribution of iodized oil capsules (if available)
Women of reproductive age
Page 12 of 45
 Pregnant women
6. Mandatory food fortification
a. Promotion on the use of iodized salt
General population
b. Assist in monitoring the sale of iodized salt where salt is sold
Market
Grocery/Supermarket
Sari-sari store
Eating places
7. Nutrition in Emergencies
a. Assist in rapid assessment
Evacuees with children 0-59 months old
b. Assist in distribution of vitamin A capsules
Children 6-59 months old
c. Refer cases of SAM and MAM
As identified
d. Assist in OTC
As needed
e. Assist in supplementary feeding of MAM cases
As needed
f. Assist in following up SAM and MAM cases
As needed
g. Conduct counseling on infant and young child feeding
As needed
h. Conduct nutriion education
As needed
i. Others, specify
As needed

Page 13 of 45
 8. Overweight and Obesity Management and Prevention Program
a. Refer cases to service provider
Overweight and obese children 0-59 months old
b. Assist in weight management intervention
Overweight and obese children 6-59 months old
c. Assist in promoting healthy environment
d. Others, specify
C. NUTRITION SENSITIVE PROGRAMS
1. Home, school and community food production
a. Refer to programs and projects that distritbute seeds, seedlings, other planting
materials, and small animals

Families with pregnant women

Families with children 0-23 months old
Families with wasted and severely wasted children 0-59 months old
Other families
b. Assist in distributing seeds, seedlings, other planting materials and small
animals

Families with pregnant women

Families with children 0-23 months old
Families with wasted and severely wasted children 0-59 months old
Other families
c. Establish own home garden
d. Assist in establishing community food garden
2. Livelihood assistance
a. Refer to programs and projects
1) Providing credit assistance or seed capital
Families with pregnant women
Families with children 0-23 months old

Page 14 of 45
 Families with wasted children 0-59 months old
Families with stunted children 0-59 months old
Others, specify
2) Providing material support for income generating projects
Families with pregnant women
Families with children 0-23 months old
Families with wasted children 0-59 months old
Families with stunted children 0-59 months old
Others, specify

3) Providing training support for income generating projects

Families with pregnant women
Families with children 0-23 months old
Families with wasted children 0-59 months old
Families with stunted children 0-59 months old
Others, specify

3. Water, Sanitation and Hygiene

a. Refer to programs and projects on
1) Distribution of sanitary toilets
Families with pregnant women
Families with children 0-23 months old
Families with wasted children 0-59 months old
Families with stunted children 0-59 months old
Others, specify
2) Improving access to safe drinking water
Families with pregnant women
Families with children 0-23 months old

Page 15 of 45
 Families with wasted children 0-59 months old
Families with stunted children 0-59 months old
Others, specify
b. Campaign for zero open defecation
Community
c. Others, specify
4. Population management

a. Assist in the promotion of responsible parenthood, including family planning

b. Assist in activities to prevent teen-age pregnancy

D. ENABLING PROGRAMS

1. Assist in reource generation/fund raising for nutrition projects of the barangay

2. Attend meetings
a. BNC meetings
b. BNS-D/CNPC meetings
3. Assist in organizing/reorganizing barangay nutrition committee
F. OTHER ACTIVITIES (Please specify)

Remarks by supervisor (D/CNPC or C/MNAO)

Name and Signature Date

Prepared by: __________________________________________

Date: ______________________

Page 16 of 45
BNS Form No. 2, Revised January 2018
BARANGAY NUTRITION SCHOLAR ACTION PLAN CY 2019

Name of BNS:_______________________________________________________ City: STO. TOMAS

Barangay: __________________________________________________________ Province: BATANGAS

Annual Duration/ Schedule of Activities

Activity Target Group
Target No. Frequency J F M A M J J A S O N D
A. WEIGHING ACTIVITIES
1. Full Weighing (OPT+) All children, 0-59 months old (Total population (TP) x 0.10714)
2. Monthly reweighing and height Children, 0-23 months old (based on OPT data)
monitoring
Underweight children 0-59 months (based on OPT data)
Severely underweight children 0-59 months old (based on OPT
data)

Wasted children 0-59 months old (based on OPT data)

Severely wasted children 0-59 months old (based on OPT data)
Overweight children 0-59 months old (based on OPT data)
Obese children 0-59 months old (based on OPT data)
Stunted children 0-59 months old (based on OPT data)
Severely stunted children 0-59 months old (based on OPT data)
3. Semestral weighing and height Children, 24-59 mos. Old (TP x 8.1%)
monitoring

B. NUTRITION SPECIFIC PROGRAMS

1. Infant and Young Child Feeding (IYCF)
a. Refer for breastfeeding or Pregnant women
lactation counseling
Lactating mothers
b. Counseling on breastfeeding Pregnant women
and complementary feeding
Lactating mothers
Mothers with acutely malnourished children 0-59 months old
Page 17 of 45
 Annual Duration/ Schedule of Activities
Activity Target Group Target No. Frequency J F M A M J J A S O N D
c. Assist in organizing IYCF
community support groups

d. Other activities, specify

2. Integrated Management of Acute Malnutrition

a. Assist in case finding
b. Refer cases to In-patient Severe acute malnutrition (SAM)cases with medical complication
therapeutic care (ITC)

c. Refer cases to out-patient SAM cases without medical complication

therapeutic care (OTC)

d. Refer cases to supplementary Moderate acute malnutrition (MAM) cases

feeding

e. Assist in operations of OTC and SAM cases without medical complication and/or MAM cases
supplementary feeding of MAM
cases

3. Dietary Supplementation
a. Refer cases Underweight pregnant women
Other pregnant women
Infants 6-23 months old
Other groups, specify

b. Assist in dietary Underweight pregnant women

supplementation activities
Other pregnant women
Infants 6-23 months old

Page 18 of 45
 b. Assist in dietary
supplementation activities

Other groups, specify

Annual Duration/ Schedule of Activities

Activity Target Group Target No. Frequency J F M A M J J A S O N D
4. National Promotion Program for Behavior Change
a. Conduct nutrition education Mothers or caregivers of children 0-23 months old
classes (Idol ko si Nanay, Pabasa
sa Nutrisyon, cooking Mothers or caregivers of children 24-59 months old
demonstrations, others Other mothers
Pregnant women
Fathers or other male members of the family
Other groups, specify

b. Do home visits for nutrition Mothers or caregivers of children 0-23 months old
counseling and follow-up
Mothers or caregivers of wasted (SAM or MAM) children 0-59
months old

Mothers or caregivers of moderately or severely underweight

children 0-59 months old

Mothers or caregivers of stunted children 0-59 months old

Mothers or caregivers of overweight or obese children 0-59 months
old

Pregnant women
5. Micronutrient Supplementation
a. Assist in administration of Children 6-59 months old
vitamin A supplements
Post-partum mothers
Measles cases
b. Assist in iron-folic acid Pregnant women
supplementation, including
follow-up home visits to check on
actual use Page 19 of 45
 b. Assist in iron-folic acid
supplementation, including
follow-up home visits to check on
actual use

Annual Duration/ Schedule of Activities

Activity Target Group Target No. Frequency J F M A M J J A S O N D
c. Assist in distribution of multiple Children 6-23 months old
micronutrient powder, including
follow-up home visits to check on
actual use

d. Assist in distribution of iodized Women of reproductive age

oil capsules (if available)
Pregnant women

6. Mandatory food fortification

a. Promotion on the use of iodized General population
salt

b. Assist in monitoring the sale of Market

iodized salt where salt is sold
Grocery/supermarket
Sari-sari store
Eating places
7. Nutrition in Emergencies
a. Assist in rapid assesssment Evacuees with children 0-59 months old
b. Assist in distribution of vitamin Children 6-59 months old
A capsules

c. Refer cases of SAM and MAM As identified

d. Assist in OTC As needed
e. Assist in supplementary feeding As needed
of MAM cases

f. Assist in following up SAM and As needed

MAM cases

Page 20 of 45
 g. Conduct counseling on infant As needed
and young child feeding

h. Conduct nutrition education As needed

i. Other, specify As needed

Annual Duration/ Schedule of Activities

Activity Target Group Target No. Frequency J F M A M J J A S O N D
8. Overweight and Obesity Management And Prevention Program
a. Refer cases to service provider Overweight and obese children 0-59 months old
b. Assist in weight management Overweight and obese children 0-59 months old
intervention

c. Assist in promoting healthy

environment

d. Others, specify
C. NUTRITION SENSITIVE PROGRAMS
1. Home, school and community food production
a. Refer to programs and projects Families with pregnant women
that distribute seeds, seedlings,
other planting materials, and Families with children 0-23 months old
small animals Families with wasted & severely wasted children 0-59 mos. old
Other families
b. Assist in distributing seeds, Families with pregnant women
seedlings, other planting
materials, and small animals Families with children 0-23 months old
Families with wasted & severely wasted children 0-59 mos. old
Other families
c. Establish own home garden
d. Assist in establishing
community food garden

2. Livelihood assistance
a. Refer to programs and projects
Page 21 of 45
 1) Providing credit assistance Families with pregnant women
or seed capital
Families with children 0-23 months
Families with wasted children 0-59 months old
Families with stunted children 0-59 months old
Others, specify

Annual Duration/ Schedule of Activities

Activity Target Group Target No. Frequency J F M A M J J A S O N D
2) Providing material support Families with pregnant women
for income generating projects
Families with children 0-23 months
Families with wasted children 0-59 months old
Families with stunted children 0-59 months old
Others, specify
3) Providing training support Families with pregnant women
for income generating projects
Families with children 0-23 months
Families with wasted children 0-59 months old
Families with stunted children 0-59 months old
Others, specify
3. Water, Sanitation and Hygiene

a. Refer to programs and projects on

1) Distribution of sanitary Families with pregnant women
toilets
Families with children 0-23 months
Families with wasted children 0-59 months old
Families with stunted children 0-59 months old
Others, specify
2) Improving access to safe Families with pregnant women
drinking water
Families with children 0-23 months
Families with wasted children 0-59 months old
Families with stunted children 0-59 months old
Page 22 of 45
 2) Improving access to safe
drinking water

Others, specify
b. Campaign for zero open Community
defecation

c. Others, specify

Annual Duration/ Schedule of Activities

Activity Target Group Target No. Frequency J F M A M J J A S O N D
4. Population management
a. Assist in the promotion of
responsible parenthood, including
family planning

b. Assist in activities to prevent

teen-age pregnancy
D. ENABLING PROGRAMS
1. Assist in resource generation/fund
raising of nutrition projects of the
barangay

2. Attend meetings
a. BNC meetings
b. BNS-D/CNPC meetings
3. Assist in organizing/ reorganizing
barangay nutrition committee

E. OTHER ACTIVITIES (Please specify)

Remarks by supervisor (D/CNPC or C/MNAO

Page 23 of 45
 ___________________________________________________________
Name and Signature Date

Prepared by: _______________________________________ Noted: ___________________________________

Date: _____________________ Date: _____________________

Page 24 of 45
BNS Form No. 1A
Philippine Plan of Action for Nutrition

FAMILY PROFILE
Purok/Sitio: City: STO. TOMAS
Barangay: Province: BATANGAS
No. of Children Check if: Check if: Fill in: Check if:
No. of HH Educational Couple Breastfeeding < 6 mos. child Toilet Water Food HH HH
HH No. Members 0-5 mos. 6-23 mos. 24-59 ≥60 mos. Name of Household Head/Spouse Occupation Attainment Mother Practice Type Production using
old old mos. old old Pregnant Family
Mixed Bottle (WS, OP, Source Activity (VG, Iodized using
Planning EBF Milk Feeding (P, W, S) P/L, FP) IFR
Feeding O, N) Salt
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19)

(F)

(M)

(F)

(M)

(F)

(M)

(F)

(M)

(F)

(M)

(F)

(M)

(F)

(M)

(F)

(M)

(F)

(M)

(F)

(M)
Abbreviations
CF - Complementary Feeding IFR - Iron Fortified Rice Educational Attainment Water Source Toilet Type Food Production Activity
EBF - Exclusive Breastfeeding (F) - Father EU - Elementary Undergraduate CU - College Undergraduate P - Pipe WS - Water Sealed VG - Vegetable Garden
HH - Household (M) - Mother EG - Elementary Graduate CG - College Graduate W - Well OP - Open Pit P/L - Poultry/Livestock
HU - Highschool Undergraduate V - Vocational S - Spring O - Others FP - Fishpond
HG - Highschool Graduate O - Others N - None
BNS Form No. 1B
Philippine Plan of Action for Nutrition

NUTRITIONAL STATUS, FEEDING AND MICRONUTRIENT SUPPLEMENTATION RECORD

Purok/Sitio: ________________________
Barangay:
Nutritional Status Practicing EBF if
Date of Birth
child is <6 mos. old
HH (mm/dd/yyyy) Age in Weight Height (Y/N)
Name of HH Head Name of Children Weight
# months (kg) (cm) Weight Height for
Date of OPT Plus for age for age Height
(mm/dd/yyyy) Y N

1 (F) (DOB)

(M) (DOOPlus)

2 (F) (DOB)

(M) (DOOPlus)

3 (F) (DOB)

(M) (DOOPlus)

4 (F) (DOB)

(M) (DOOPlus)

5 (F) (DOB)

(M) (DOOPlus)

6 (F) (DOB)

(M) (DOOPlus)

7 (F) (DOB)

(M) (DOOPlus)

9 (F) (DOB)

(M) (DOOPlus)

10 (F) (DOB)

(M) (DOOPlus)

Abbreviations
HH - Household EBF - Exclusive Breastfeeding SF - Supplementary Feeding
CF - Complimentary Feeding MNP - Micronutrient Powde

Weight for age Height for age

SUW - Severely underweight SSt - Severely stunted
UW - Underweight St - Stunted
N - Normal N - Normal
OW - Overweight T - Tall
CORD OF PRESCHOOL CHILDREN
City: STO. TOMAS
Province: BATANGAS
Solid Food Feeding Micronutrient Supplementation
Practicing CF if Practicing CF if
child is 6-23 Age in child is 6-23 Vitamin Iron drops/syrup
months old (Y/N) months months old (Y/N) A last received (Y/N) Using MNP (Y/N)
started date
CF received
Y N Y N Y N Y N

Feeding DOB - Date of Birth

t Powder DOOPlus - Date of OPT Plus

Weight for Height

ed SUW - Severely underweight
UW - Underweight
N - Normal
OW - Overweight
Ob - Obese
BNS Form No. 1C
Barangay Nutrition Profile

BARANGAY SITUATIONAL ANALYSIS, CY 2022

Barangay Santiago

Region: IV-A City: STO. TOMAS Province: BATANGAS

Total Numb
mber of purok. 7

INDICATORS Number
1 Total of population. 7
2 Total number of Households 7505
3 Household surveyed during Family Profile Survey 7505
4 Total number of women who are:
a. Pregnant
b. Lactating
5 Total number of households with preschool children aged 0-59 months old 401
6 Actual population of preschool children 0-59 months old 453
7 Total number of preschool children 0-59 months old measured during OPT Plus 65.70%
a. Percent (%) measured coverage (OPT Plus)
b. Number and Percent (%) of preschool children according to Nutritional Status No. %
1) Severe underweight 0 0.00%
2) Underweight 0 0.00%
3) Normal weight 387 100.00%
4) Severely wasted 1 1.52%
5) Wasted 0 0.00%
6) Overweight** 1 1.52%
7) Obese 3 4.55%
8) Severely Stunted 0 0.00%
9) Stunted 0 0.00%
8 Total number of infants 0-5 months old 0 0.00%
9 Total number of infants 6-11 months old 36
10 Total number of preschoolers 0-23 months old 142
11 Total number of preschool children aged 12-59 months old 331
12 Total number of preschoolers 24-59 months old
13 Total number of families with severely wasted and wasted preschool children
14 Total number of families with stunted and severely stunted preschool children
15 Total number of Educational Institutions Public Private
a. Number of Child Development Centers
b. Number of Elementary Schools
16 Total number of children enrolled in Kindergarten (DepEd-Supervised)
17 Total number of school children (Grades 1-6)
18 Total number of school children weighed at the start of the school year (Kinder-Gr.6)
19 Percent (%) coverage of school children measured
20 Number and Percent (%) of school children according to Nutritional Status No. %
a. Severely wasted
b. Wasted
c. Normal
d. Overweight
e. Obese
*Referred as "Barangay Nutrition Profile" in the BNS Handbook
**Refers to weight-for-length/height

INDICATORS Number
21 0-5 month old infants who are exclusively breastfeed
22 Households with severely wasted and wasted school children
23 School children dewormed at the start of the school year
24 Fully immunized children (FIC)
25 Households, by type of toilet facility: No. %
a. Water-sealed toilet
b. Other types, specify: ________________________
c. No toilet
26 Households, by type of garbage disposal: No. %
a. Barangay or municipal garbage collection
b. Own compost pit
c. Others, specify: ________________________
27 Households, by source of drinking water: No. %
a. Piped water system (level III)
b. Communal source piped water system
c. Mineral water/water dispensing stores
c. Others, specify: ________________________
28 Households with: No. %
a. Vegetable garden
b. Livestock/poultry
c. Fishpond
29 Households according to type of dwelling unit: No. %
a. Concrete
b. Semi-concrete
c. Wood
d. Makeshift/barong-barong
30 Total number of households using iodized salt
31 Total number of eateries/carinderia
32 Total number of sari-sari stores
33 Total number of Botika sa Barangay
34 Number of health and nutrition workers:
a. Barangay Nutrition Scholar
b. Barangay Health Worker
35 Total number of household beneficiaries of Pantawid Pamilya Pilipino Program
BNS Form no. 3A
Philippine Plan of Action for Nutrition

MONTHLY RECORD OF WEIGHT AND WEIGHT STATUS

INFANTS 0-23 Months

Province: BATANGAS City/Municipality: STO. TOMAS Barangay:Santiago

Date of Birth Date of Weighing
January 02/2021 February 08 /2021 March 21/2021 April 12/2021 May 12 /2021 June. 14/2021
No. Name of Child
Year Month Day Age in Weight Weight Age in Weight Weight Age in Weight Weight Age in Weight Weight Age in Weight Weight Age in Weight Weight
months (kilos) Status months (kilos) Status months (kilos) Status months (kilos) Status months (kilos) Status months (kilos) Status
1 Villar Princess kiarra marie 2020 10 21 2 4.2 N 3 4.4 N 4 4.6 N 5 4.8 N 6 5.1 N 7 5.4 N
2 Debelen Charles Stanley 2020 11 6 2 4.7 N 3 4.9 N 4 5.2 N 5 5.6 N 6 6 N 7 6.4 N
3 Medel Adysson 2020 11 10 2 6.2 N 3 6.4 N 4 6.7 N 5 6.9 N 6 7 N 7 7.1 N
4 Gomez Ranzel 2020 11 13 2 5 N 3 5.1 N 4 5.3 N 5 5.7 N 6 6 N 7 5.9 N
5 Itziana Quarra marie 2020 11 18 2 5.6 N 3 5.9 N 4 6 N 5 6.4 N 6 6.7 N 7 7 N
6 Bautista Janelle 2020 9 27 3 5.9 N 4 6 N 5 6.2 N 6 6.5 N 7 6.9 N 8 7.3 N
7 Ordonez Elizze 2020 9 11 3 7.5 N 4 7.7 N 5 7.9 N 6 8 N 7 7.4 N 8 7.9 N
8 Tayong Akiro Michael 2020 9 30 3 6.3 N 4 6.5 N 5 6.8 N 6 7 N 7 8.2 N 8 8.5 N
9 Rapada Reingmark 2020 9 16 3 6.7 N 4 7 N 5 7.3 N 6 7.5 N 7 7.9 N 8 8 N
10 Meera Kirstein nash 2020 9 21 3 6.6 N 4 6.8 N 5 7 N 6 7.3 N 7 7.6 N 8 8 N
11 Zacarias Skyller Kian 2020 10 3 3 6.1 N 4 6.4 N 5 6.7 N 6 7 N 7 7.4 N 8 7.9 N
12 Ybanez Mikaela 2020 10 21 3 6.6 N 4 6.8 N 5 6.9 N 6 7 N 7 7.2 N 8 7,5 N
13 Almocera Zib ziro 2020 8 31 4 7.4 N 5 7.7 N 6 7.9 N 7 8.1 N 8 8.4 N 9 8.7 N
14 Deguzman Carl aiden 2020 12 12 1 4.8 N 2 5.0 N 3 5.4 N 4 5.7 N 5 6 N 6 6.3 N
15 Anemias Genesis neon 2020 12 21 1 3.1 N 2 3.9 N 3 4.2 N 4 4.5 N 5 5 N 6 5.6 N
16 Apolong Denise Carla 2020 12 25 1 4.5 N 2 4.7 N 3 4.9 N 4 5 N 5 5.4 N 6 5.8 N
17 Talamayan Yael 2020 10 8 2 4.0 N 3 4.6 N 4 4.8 N 5 5 N 6 5.4 N 7 5.8 N
18 Bantillan Flyn lorcan 2020 10 12 2 6.0 N 3 6.2 N 4 6.5 N 5 6.7 N 6 6 N 7 6.3 N
19 Vicencio Rihanna 2020 10 28 2 5.2 N 3 5.5 N 4 5.8 N 5 6.1 N 6 6.4 N 7 6.8 N
20 Orbino Arjiel 2020 10 23 2 4.8 N 3 5 N 4 5.4 N 5 6 N 6 6.2 N 7 6.5 N
21 Tenoya Kilua 2020 10 30 2 4.5 N 3 4.6 N 4 4.8 N 5 5.1 N 6 5.5 N 7 6 N
22 Sebastian Aidan 2020 10 31 2 6.1 N 3 6.3 N 4 6.6 N 5 6.8 N 6 7 N 7 7.3 N
No. Severely undeweight. 0 Date Accomplished:01/06/2021
No. Underweight. 0 Accomplished by:Maricris F, Odiongan

Submitted to: MARIA CRISTINA GIRLIE M. SOLLEZA, RND

Municipal Nutrition Action Officer
 Date of Weighing
July 12/2021 August 06/2021 September/5/2021 October/8/2021 November/5/2021 December/06/2021
Age in Weight Weight Age in Weight Weight Age in Weight Weight Age in Weight Weight Age in Weight Weight Age in Weight Weight
months (kilos) Status months (kilos) Status months (kilos) Status months (kilos) Status months (kilos) Status months (kilos) Status
8 6.3 N 9 6.5 N 10 6.9 N 11 7.4 N 12 7.5 N 13 8.3 N
8 6.7 N 9 7 N 10 7.3 N 11 7.6 N 12 7.8 N 13 8.6 N
8 7.4 N 9 7.8 N 10 8.2 N 11 8.5 N 12 8.9 N 13 9.3 N
8 6.2 N 9 6.6 N 10 7 N 11 7.5 N 12 7.8 N 13 8.5 N
8 7.5 N 9 7.8 N 10 8 N 11 8.4 N 12 8.6 N 13 9.1 N
9 7.8 N 10 8.2 N 11 8.5 N 12 8.9 N 13 9.5 N 14 9.7 N
9 8.2 N 10 8.5 N 11 8.8 N 12 9.1 N 13 9.5 N 14 9.7 N
9 8.8 N 10 9 N 11 9,4 N 12 9.5 N 13 9.7 N 14 10 N
9 8.3 N 10 8.5 N 11 8.8 N 12 9 N 13 9.4 N 14 9.8 N
9 8.2 N 10 8.5 N 11 9 N 12 9.5 N 13 9.7 N 14 10.4 N
9 8.2 N 10 8.7 N 11 9 N 12 9.4 N 13 9.9 N 14 10.2 N
9 7.5 N 10 7.9 N 11 8 N 12 8.2 N 13 8.5 N 14 8.9 N
10 9 N 11 9.3 N 12 9.6 N 13 10 N 14 10.4 N 15 10.7 N
7 6.7 N 8 7.1 N 9 7.6 N 10 7.9 N 11 8.2 N 12 8.6 N
7 6.4 N 8 6.9 N 9 7.3 N 10 7.8 N 11 8.3 N 12 8.8 N
7 6 N 8 6.5 N 9 7 N 10 7.3 N 11 7.8 N 12 8.4 N
8 6.2 N 9 6.7 N 10 7.1 N 11 7.5 N 12 7.9 N 13 8.5 N
8 7.4 N 9 7.8 N 10 8.1 N 11 8.5 N 12 8.8 N 13 9.2 N
8 7.1 N 9 7.4 N 10 7.8 N 11 8 N 12 8.4 N 13 8.9 N
8 6.9 N 9 7.1 N 10 7.3 N 11 7.6 N 12 8 N 13 8.3 N
8 6.7 N 9 7 N 10 7.3 N 11 7.6 N 12 8 N 13 8.5 N
8 7.5 N 9 7.8 N 10 8 N 11 8.6 N 12 8.8 N 13 9.1 N
No. of Severely Underweight: 0 Date Accomplished:12/06/2021
No. of Underweight: 0 Date Accomplished.Maricris F.Odiongan.
 2019 MONTHLY RECORD OF WEIGHT AND HEIGHT STATUS

Date: Nutritional Status Date: Nutritional Status Date: Nutritional Status

Name of Child Sex Date of Birth
Age in Weight Height Weight Height Weight Age in Weight Height Weight Height Weight Age in Weight Height Weight Height Weight
months (kilos) (cm) for Age for Age for Ht. months (kilos) (cm) for Age for Age for Ht. months (kilos) (cm) for Age for Age for Ht.

Date Accomplished:

Accomplished by:

Summary (Accomplished after 3 months):

No. of Identified Severely Underweight: No. of Improved in Weight Status: No. of Dead: No. of Moved Out:
 SUMMARY OF SEVERELY UNDERWEIGHT AND UNDERWEIGHT CASES FOR THE YEAR 2019

January February March April May June

UW = UW = UW = UW = UW = UW =

SUW = SUW = SUW = SUW = SUW = SUW =

Total = Total = Total = Total = Total = Total =

No. Improved in No. Improved in No. Improved in No. Improved in No. Improved in
Nutritional Status: Nutritional Status: Nutritional Status: Nutritional Status: Nutritional Status:

UW > N = UW > N = UW > N = UW > N = UW > N =

SUW > UW = SUW > UW = SUW > UW = SUW > UW = SUW > UW =

SUW > N = SUW > N = SUW > N = SUW > N = SUW > N =

Total = Total = Total = Total = Total =

No. of New Cases = No. of New Cases = No. of New Cases = No. of New Cases = No. of New Cases =
No. of Overage = No. of Overage = No. of Overage = No. of Overage = No. of Overage =
No. of Moved Out = No. of Moved Out = No. of Moved Out = No. of Moved Out = No. of Moved Out =

July August September October November December

UW = UW = UW = UW = UW = UW =

SUW = SUW = SUW = SUW = SUW = SUW =

Total = Total = Total = Total = Total = Total =

No. Improved in No. Improved in No. Improved in No. Improved in No. Improved in No. Improved in
Nutritional Status: Nutritional Status: Nutritional Status: Nutritional Status: Nutritional Status: Nutritional Status:

UW > N = UW > N = UW > N = UW > N = UW > N = UW > N =

SUW > UW = SUW > UW = SUW > UW = SUW > UW = SUW > UW = SUW > UW =

SUW > N = SUW > N = SUW > N = SUW > N = SUW > N = SUW > N =

Total = Total = Total = Total = Total = Total =

No. of New Cases = No. of New Cases = No. of New Cases = No. of New Cases = No. of New Cases = No. of New Cases =
No. of Overage = No. of Overage = No. of Overage = No. of Overage = No. of Overage = No. of Overage =
No. of Moved Out = No. of Moved Out = No. of Moved Out = No. of Moved Out = No. of Moved Out = No. of Moved Out =
 SUMMARY OF 0-23 MONTHS WEIGHED FOR THE YEAR 2019

January February March April May June

Normal = Normal = Normal = Normal = Normal = Normal =

UW = UW = UW = UW = UW = UW =

SUW = SUW = SUW = SUW = SUW = SUW =

OW = OW = OW = OW = OW = OW =

Total = Total = Total = Total = Total = Total =

No. of New Cases = No. of New Cases = No. of New Cases = No. of New Cases = No. of New Cases =
No. of Overage = No. of Overage = No. of Overage = No. of Overage = No. of Overage =
No. of Moved Out = No. of Moved Out = No. of Moved Out = No. of Moved Out = No. of Moved Out =

July August September October November December

Normal = Normal = Normal = Normal = Normal = Normal =

UW = UW = UW = UW = UW = UW =

SUW = SUW = SUW = SUW = SUW = SUW =

OW = OW = OW = OW = OW = OW =

Total = Total = Total = Total = Total = Total =

No. of New Cases = No. of New Cases = No. of New Cases = No. of New Cases = No. of New Cases = No. of New Cases =
No. of Overage = No. of Overage = No. of Overage = No. of Overage = No. of Overage = No. of Overage =
No. of Moved Out = No. of Moved Out = No. of Moved Out = No. of Moved Out = No. of Moved Out = No. of Moved Out =
 SUMMARY OF SEMESTRAL WEIGHING RESULT FOR
24-59 MONTHS PRESCHOOL CHILDREN CY _________

January July

Normal = Normal =

UW = UW =

SUW = SUW =

OW = OW =

Total Weighed = Total Weighed =

No. of New Cases =

No. of Overage =

No. of Moved Out =

BNS Form no. 3C

SEMESTRAL RECORD OF WEIGHT AND HEIGHT STATUS

24-59 Months Preschoolers
Province: BATANGAS City/Municipality: STO. TOMAS Barangay:
Date of Birth Date of Weighing
January July
Name
Year Month Day Age in Weight Height Weight for Height for Weight for Age in Weight Height Weight for Height for Weight
months (kilos) (cm) Age Age Height months (kilos) (cm) Age Age for Height

Date Accomplished:
Accomplished by:
Summary of No. Identified:
Normal: Underweight: Severely underweight:

Submitted to: MARIA CRISTINA GIRLIE M. SOLLEZA, RND

Municipal Nutrition Action Officer
BNS Form No. 1B Barangay:
Philippine Plan of Action for Nutrition Municipality: STO. TOMAS
Province: BATANGAS

BASELINE WEIGHT AND IMMUNIZATION RECORDS OF PRESCHOOL CHILDREN

Date of Immunization NBS Weighing
HH # Name of HH Head Name of Children Date of Birth Hepa B done? Date of Age in Weight Weight
BCG Penta 1 Penta 2 Penta 3 PCV 1 PCV 2 PCV 3 OPV 1 OPV 2 OPV 3 IPV MCV 1 MCV 2 (Y/N)
BD weighing months (kg) Status
OPT Plus Form 1B. List of Affected/At-risk Preschoolers 0-59 Months old
Philippine Plan of Action for Nutrition

Barangay: ___________________________________ Province: BATANGAS

City/Municipality: STO. TOMAS Year/Period of Measure

Instructions:
In column 1, copy the household number from the Family Profile. In column 5, write "NA" if not applic
In column 2, write the family name first, followed by name of the household head. In column 6, indicate the age in mon
In column 3, write the first name of the preschool child only. In column 7-14, check the appropriat
In column 4, write "B" for boy and "G" for girl.

Household Name of Household Head/ Name of Preschooler Sex Indigenous Age in N

Number Mother/Caregiver Group months UW SUW St
(1) (2) (3) (4) (5) (6) (7) (8) (9)

Prepared by: ______________________________________ Checked: ___________________________________________ Approved: _________

Name & Signature of Barangay Nutrition Scholar Name & Signature of Midwife/Nurse/District/City Nutrition Program Coordinator Name & Signat

Date _______________________________________ Date ____________________________________ Date _______

Province: BATANGAS
Year/Period of Measurement: 2019

In column 5, write "NA" if not applicable, specify specific indegenous group/tribe.

In column 6, indicate the age in months based on last completed month.
In column 7-14, check the appropriate nutritional status.

Nutritional Status
SSt W SW OW Ob
(10) (11) (12) (13) (14)

Approved: _________________________________
Name & Signature of Barangay Captain, BNC Chairperson

Date _____________________________

Page 41 of 45
BNS Form No. 7
Philippine Plan of Action for Nutrition
BARANGAY NUTRITION SCHOLAR
FULL WEIGHING REPORT

Name of BNS: ____________________________________________

Purok/Barangay:_________________________________________
City: STO. TOMAS
Province: BATANGAS
Inclusive Date of Weighing: ________________________________
Total Preschool Population: _______________________________
Total Preschool Children Weighed:___________________________

Household Date of Birth

Name of Father/Mother Name of Child
Number (yyyy-mm-dd)
R

% OPT Coverage:____________________________
Consolidated OPT Data
No. of Normal: ______________________________
No. of Underweight: __________________________
-Severely Underweight:_______________________
-Underweight:______________________________
No. of Overweight: ___________________________

Date of Weighing Age in Weight in Nutritional Remarks

(yyyy-mm-dd) Months kilograms Status
OPT Plus Form 1. List of preschoolers with weight and height measurement and identified Nutritional Status
Philippine Plan of Action for Nutrition
Barangay: _______________________ City/Municipality: STO. TOMAS Province: BATANGAS
Purok Household Name of Household Head/ Date of (Yr-Mo-Day)
Number Mother/Caregiver Name of Preschooler Sex Measurement
Birthday
Weight
(1) (2) (3) (4) (5) (6) (7)

* Codes: for nutritional status: Weight-for-Age: N- Normal UW- Underweight SUW- Severely Underweight OW- Overweight
Length/Height-for-Age: N- Normal St - Stunting SSt - Severely Stunting T- Tall
Weight-for-Length/Height: N- Normal W- Wasted SW- Severely Wasted OW- Overweight Ob- Obese
"Age-in-months" always refers to completed number of months, i.e. 34 months and 30 days is considered 34 months only.
1/

Prepared By: _____________________________________________

Name & Signature of Barangay Nutrition Scholar
Date: __________________________
AS Year: 2019 Date of OPT Plus: __________
Day) Age in Weight Length/ Nutritional Status*
Measurement Months (kg) Height Weight for Length/ Weight for
Length/Height (cm) Age Ht for Age Length/Height
(8) (9) (10) (11) (12) (13) (14)

Checked: MARIA CRISTINA GIRLIE M. SOLLEZA

Name & Signature of MNAO
Date: __________________________