Rio Fe G. del Valle, Joyce Ann A. Viar
Background: The First 1,000 Days (F1KD)—from pregnancy to a child’s second year—are critical for child’s health and development. In the Philippines, malnutrition persists due to weak local health and nutrition systems. To address this, the Zuellig Family Foundation (ZFF) created the F1KD Nutrition Systems Roadmap, a governance-based tool aligned with the World Health Organization’s health system building blocks, helping local government units (LGUs) strengthen systems and improve nutrition outcomes. The F1KD Nutrition Systems Roadmap aims to: (I) assess current gaps hindering positive health and nutrition outcomes; (II) guide LGU actions to improve local nutrition systems; and (III) monitor progress to sustain ongoing improvements.
Methods: In the preparatory phase, key LGU staff conduct self-assessment using documents and interviews to evaluate local system readiness and governance. During implementation, evaluators validate on-site and score indicators, producing color-coded results showing system functionality. Post-implementation involves analysis of findings to inform key actions to sustain or improve the LGU’s F1KD Nutrition System.
Results: The roadmap was implemented in five provinces, 36 cities/municipalities, and 16 barangays across ZFF program sites. Most areas showed improved assessment scores from baseline to endline. The project team validated results through document reviews and facility inspections, followed by mentoring to address gaps. This process also recognized local progress and supported better nutrition outcomes. To site, stunting and wasting rates generally declined across five provinces.
Conclusions: The F1KD Nutrition Systems Roadmap provides a clear framework that unifies local efforts into strategic actions to combat malnutrition. This governance-driven approach has led to systemic improvements and enhanced nutrition outcomes across various government levels. With its adaptable framework and demonstrated impact, the roadmap offers a scalable model for improving child nutrition systems across diverse contexts within the Philippines, and potentially in other low- and middle-income settings.
