Pascua, H. G. (2018). Oplan anemia reduction: Optimizing iron supplementation using a strategic multi-stakeholder approach in Lidlidda, Ilocos Sur (Unpublished master's thesis). Graduate School of Public and Development Management, Development Academy of the Philippines.

Graduate School of Public and Development Management Health Systems and Development Batch 1 - Regular Thesis (MPM-HSD)--Development Academy of the Philippines.

Iron deficiency anemia is recognized as the most common form of micronutrient malnutrition worldwide. This was noted to be highly prevalent in the Municipality of Lidlidda particularly among pre-school children with an average prevalence rate from 2012-2016 of 30.05% falling under the moderate burden of public health significance based on WHO criteria. With the children being at stake in the situation, this aroused the passion of the researcher to validate high prevalence of anemia and further establish a more accurate data on anemia prioritizing the identified vulnerable populations and further conduct a research study on the challenges in the management of anemia using participative Problem Tree and SWOT Analysis which guided to the development of as strategic plan to reduce if not totally resolve the problem. The Theory U conceptual framework was used in the study to show the changes brought about by the implementation of the adapted multi-stakeholder collaboration approach generated during the Multi-stakeholder Anemia Meeting in 2013 and presented by USAID Anemia Task Force. The creation of Anemia Task Force in the Municipality as recommended by Global Action for Nutrition Report was also adapted as a strategy to scale-up anemia reduction in the municipality. The action plan project was started by conducting a baseline study of the prevalence of anemia from July to December 2017 among all health service clienteles in all age groups prioritizing the anemia vulnerable physiologic age groups particularly 6.24 mos., adolescent females, pregnant women and women of the reproductive age by conducting hemoglobin determination, among all patients screened for anemia using WHO standards for normal hemoglobin per age group, to diagnose anemia. Inter-agency linkage was done with the Department of Health to generate support for human resource particularly the Medical Technologist and supplies like iron to enable the implementation of he project. Analysis of anemia prevalence data pre- and post- iron supplementation showed a reduction of cases in July 2018 from baseline data gathered from July to December 2017. Other stakeholders with related programs in nutrition in the locality were identified and involved in the project which include the Department of Education, Department of Social Welfare and Development, Department of Agriculture, Municipal Planning and Development Office, Department of Budget and Finance and other Private civic organizations like the Southern Ilocos Sur Medical Society, an accredited component of the Philippine Medical Association and the Lingkod Medisina Foundation. The multi-stakeholder collaboration was finally strengthened thru Executive Order No. 32-2018 creating the Anemia Task Force and SB Resolution No. 60-2018 adopting the Local Nutrition Action Plan with Anemia Prevention and Control Program integrated, in the Municipality last August 6,2018. Key Informant Interview and Focus Group discussion were conducted among program implementors and managers, Pre-test and Post-test were done among Barangay Health Workers (BHWs) and Barangay Nutrition Scholars (BNS), Purposive sampling interview was done among anemic patients and their caregivers and documents review were employed to assess for other factors related to program implementation that contributed to anemia prevalence in the municipality. The findings and analysis include 1) among stakeholders - poor collaboration resulting to poor policy and budget support for anemia 2) among health service providers- poor knowledge on anemia management that resulted to poor rehabilitation of anemic patients, inadequacy of human resource to implement and monitor the program and lack of incentives resulting to poor health service delivery impacting to poor access to services related to anemia and unreliable data to steer program support and 3) among patients- poverty and poor knowledge and behavior on anemia prevention and control to poor dietary intake of iron. The project was able to show successful anemia reduction thru the implementation of optimized iron supplementation and anemia control advocacy integrated in the regular services and activities of stakeholders. With the success of this project, the sustainment of newly-institutionalized Anemia Task Force and the initiated multi-stakeholder collaboration in nutrition program particularly in anemia prevention and control are highly recommended to facilitate anemia reduction to be able to keep track in the attainment of the sustainable goals of ending all forms of malnutrition by 2030.