Engaging Health Officials in the Philippines: Application of a Bottleneck Analysis Tool to Improve Health and Nutrition Program Implementation at the Local Government Level.

ABSTRACT

Objectives: For children in the Philippines, malnutrition remains a challenge, especially for the youngest and most vulnerable children. An innovative systems analysis tool with local government officials has been developed that uses existing data on IYCF practices and engages local public health workers to identify bottlenecks in service delivery and targeted interventions to improve effective coverage. Methods: A bottleneck analysis tool was developed based on the Tanahashi model. The tool requires the development of a determinants matrix and key indicators to reveal bottlenecks in key components of IYCF programs. The tool helps assess the current status of program delivery and engages local government officials and nutrition experts to identify bottlenecks and propose solutions. Results: The analysis revealed several critical bottlenecks to IYCF program implementation across LGUs in the Philippines. For example, there was a large discrepancy in mother's awareness and knowledge of breastfeeding. These localities proposed culturally appropriate breastfeeding campaigns in their localities or creating targeting educational materials. Conclusions: The results of this initiative demonstrate the utility of targeted bottleneck analysis at a local level to engage and empower local government officials and stakeholders to assess data and identify interventions in a timely manner for improving key IYCF programs in their communities. By creating a collaborative environment, an open discussion regarding data usage, analysis of available data, and positive program improvements can be achieved.