Section One

OPERATION TIMBANG PLUS

(OPT PLUS) OVERVIEW
 OVERVIEW

1. describe the OPT Plus; its purposes,

The general objective of this and processes;
section is to provide information 2. identify who are involved in OPT Plus
on the basic concepts of the OPT and their roles;

Plus. 3. enumerate the forms used in OPT

Plus;

After this section, you should be 4. identify the common anthropometric

measurements used in OPT Plus; and
able to: 5. explain the mechanics in the OPT Plus
implementation.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 WORKSHOP 1
Ating Alamin ang OPT Plus Activities

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 WORKSHOP 1
Ating Alamin ang
OPT Plus
Activities

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 OPT PLUS
Operation Timbang Plus (OPT Plus) is the regular child
growth assessment for all 0-59-month-old children in the
barangays done by a trained team. OPT Plus also involves
planning, follow-up, and data quality check activities.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 GENERAL OBJECTIVES

Generate data on the Locate under or over- Guide local government

nutritional status of nourished children units (LGU) in nutrition
children in a barangay program management

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 SPECIFIC 1. assess the nutritional status of the 0-59-month-
old children;
OBJECTIVES
2. locate families with children who are
underweight, stunted, wasted, overweight, and
Community Level obese;
3. determine priority areas and individuals for
program planning;
4. serve as the basis for the preparation and
evaluation of the nutrition action plan;

5. monitor the nutrition trend and assess the

effects of nutrition interventions implemented

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 SPECIFIC 1. provide parents/caregivers information on
the nutritional status of their child/children to
OBJECTIVES prevent malnutrition;
2. early detection and immediate referral of
Family Level undernutrition to prevent severe
wasting/severe acute malnutrition (SW/SAM)
and moderate wasting/moderate acute
malnutrition (MW/MAM) cases;
3. guide the parents/caregivers on the growth
and development of their children.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 THE OPT PLUS TEAM
Suggested other members:
Composed of at least
7 members • Committee Chair on Health and
Nutrition
Headed by • Sangguniang Kabataan Officials
Rural Health Midwife
• Day Care Worker (DCW)
(RHM)/Barangay Nutrition
Action Officer (BNAO) • Teacher-in-Charge
• Purok/mother leaders
Assisted by • Representatives from civic
Barangay Nutrition Scholars organizations
(BNS) and Barangay Health
Workers (BHWs) • Other barangay officials and staff

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 TARGET GROUP VENUE SCHEDULE

OPT Plus
Either in the health preparation at the
All 0-59-month- facility, weighing post, municipality/city
old children barangay hall, level should start
daycare center, every August to
house-to-house or prepare for the OPT
other conducive Plus activities for the
areas following year.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 INSERT OPT TIMELINE

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ANTHROPOMETRIC MEASUREMENTS
USED FOR OPT PLUS

WEIGHT
measurement of body mass
or heaviness of a child

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ANTHROPOMETRIC MEASUREMENTS
USED FOR OPT PLUS

LENGTH
the stature measurement of a
child 0-23-month-old while in
a recumbent or lying position

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ANTHROPOMETRIC MEASUREMENTS
USED FOR OPT PLUS

HEIGHT
the stature measurement of a
child 24-59-month-old
collected while standing up

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ANTHROPOMETRIC MEASUREMENTS
USED FOR OPT PLUS

MID-UPPER ARM
CIRCUMFERENCE (MUAC)
the circumference of the left
arm taken between the elbow
and shoulder at the midpoint

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 1.2

RECOMMENDED
ANTHROPOMETRIC
TOOLS

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 RECOMMENDED TOOLS/EQUIPMENT FOR WEIGHING

Several weighing tools can be

purchased but only recommended
Weighing
weighing scales can be used in
Scales assessing nutritional status to get
accurate data.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Hanging Infant
Weighing Scale
For: Children age <5
Maximum Capacity: <25 kg

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Hanging Digital Scales
For: Children
Maximum Capacity: 25 kg

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Digital Platform Scale
For: Children
Maximum Capacity: 150 kg

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Digital
Taring Scale
For: Children
Maximum Capacity: 150 kg

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Mechanical
Column Scale
For: All age groups
Maximum Capacity: 200 kg

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 NOTE 2.2

Why are regular bathroom scales not

recommended?
Regular bathroom scales, especially the
mechanical or spring-type kind, may not
maintain accurate readings with repeated
use (UW, n.d.). Although cheaper in price,
these types of scales are not meant to last.
Recommended ones, on the other hand,
ensure accurate and precise readings and
are designed to last.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 RECOMMENDED TOOLS/EQUIPMENT FOR MEASURING HEIGHT

While there are many available length

Length/Height and height measurement tools in the
Measurement market, not all are recommended for
Tools nutritional status assessment due to
inaccuracies that may result during use.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Length/Height Board
Usage: Set up horizontally against a
flat surface for measuring the length
and vertically against a wall. A sliding
piece acts as a foot piece when
taking length or a headpiece when
taking height.

For: 130 cm maximum measurement

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Stadiometer
Usage: Can only be used vertically.
Place the tool perpendicular to the
floor. A sliding paddle that rests on
top of the head when taking height.

For: Children >23 months old

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Microtoise
Usage: Mounted to a flat wall, its
bottom part can be slid down to
the top of the child’s head and the
height measurement can be seen
through a window.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Mobile
Measuring Mat
Usage: Can only be used
horizontally. Unfold then measure
the infant/toddler’s length while lying
down using the fixed headpiece and
sliding food positioner.

For: Infant/toddler

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 RESOURCES NEEDED IN OPT PLUS
IMPLEMENTATION

● The OPT Plus Team ● Computer with Excel

● Appropriate weighing scale and software
length/height board ● OPT forms
● MUAC tape ● Pens/pencils
● Child Growth Standard (CGS) tables ● Clipboard
● Growth chart for male and female
Thus, the OPT Plus activities should have a budget appropriation in the
City/Municipal Nutrition Action Plan (C/MNAP), Barangay Nutrition Action Plan
(BNAP), and Annual Investment Program (AIP).

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 END OF SECTION 1

REFERENCES

FANTA (2018). Guide to Anthropometry: A Practical Tool for Program Planners, Managers, and
Implementers.

Inter-agency Technical Working Group on Child Growth Standards. (2012). Implementing Guidelines on
Operation Timbang Plus (OPT+). Retrieved from
https://www.nnc.gov.ph/phocadownloadpap/userupload/elavapie/OPT%20Plus%20Guidelines.pdf.

NNC Governing Board Resolution, No. 2, S. 2008. Retrieved from

https://www.nnc.gov.ph/downloads/category/23-board-resolution?download=640:nnc-governing-board-
resolution-no-2-series-of-2008.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 REFERENCES

Nutrition Center of the Philippines (NCP). (n.d.). The Easy Weigh with Nutri Scale Digital. Retrieved from
http://www.ncp.org.ph/nutri-scale-digital.html.

SECA. (n.d.). SECA 878 Flat scales for mobile use. Retrieved from
https://www.seca.com/fileadmin/documents/product_sheet/seca_pst_878_en.pdf

Talavera, M.T.M., Gordoncillo, N.P., Tandang, N.A., and Domningo, D.G.C. (2021). Acceptability of Height
Measuring Equipment of Different Materials among Community Nutrition and Health Workers and Parents
in Laguna Province, Philippines. Acta Medica Philippina. https://doi.org/10.47895/amp.vi0.3100.

Tanita. (n.d.) HD-662 Digital Weight Scale. Retrieved from https://www.tanita.com/data/product-

brochures/HD-662.pdf?rev=9D9A.

UNICEF (2015). National Guidelines on the Management of Severe Acute Malnutrition for Children under
Five Years: Manual of Operations. 1st Ed.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 REFERENCES

USAID. (2017). Nutrition in Emergencies: Technical Guidance Brief.

World Health Organization (WHO). (2008a). Training Course on Child Growth Assessment: Introduction.
Geneva, WHO, 2008.

WHO. (2008b). Training Course on Child Growth Assessment: Interpreting Growth Indicators. Geneva,
WHO, 2008.

WHO. (2013). Guideline: Updates on the management of severe acute malnutrition in infants and children.
Geneva: World Health Organization; 2013.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
Section Two

PRE-OPT PLUS PROTOCOL

 OVERVIEW

This section aims to cover an in- • organizing the OPT Plus team;
• collection of household profile;
depth discussion of the pre-OPT • preparation and updating of spot
Plus protocol to instill integrity map;
• calibration and verification of
in conducting the OPT Plus.
weighing tools and equipment;
• verification of length and height
At the end of this section, one is
tools and equipment; and
expected to describe the process • accurately and precisely measure
of: the weight, length, height and
MUAC

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 2.1

ORGANIZING THE
OPT PLUS TEAM

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Through the help of the C/MNAO, two (2) OPT Plus Team will be organized:

OPT PLUS SUPERVISORS BARANGAY OPT PLUS TEAM

TEAM • RHM
• C/MNAO • BNAO
• Committee Chair on Health and Nutrition
• RHM
• Barangay Nutrition Scholars (BNS)
• Nurses
• Sangguniang Kabataan Officials
• D/C/MNPC • Other BHWs
• Human Resource for Health • Day Care Worker (DCW)
(HRH), i.e. Nutritionist-Dietitian • Teacher-in-Charge
Deployment Program (NDDP).
• Representatives from civic organizations
• Other barangay officials and staff

One per city/municipality One per barangay

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ROLES AND RESPONSIBILITIES OF OPT PLUS TEAM AND SUPERVISORS

ORGANIZATION/PERSONS
FUNCTION
INVOLVED
1. Disseminate the memorandum on the conduct of OPT Plus issued by
the RNPC
Provincial Nutrition Action Officer 2. Assist in the calibration/verification of tools and equipment.
(PNAO)
3. Provide technical support during the training of the OPT Plus team.
4. Allocate funds needed for OPT Plus

1. Assist in organizing the Training and Standardization and Refresher

Training on the OPT Plus.
2. Facilitate the organization of the OPT Plus Team in assigned cluster.
Supervisors
3. Check if the weighing scales are calibrated and if length/height boards
are verified. If not, initiate or lead the calibration or verification of
the tools and equipment.
Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ROLES AND RESPONSIBILITIES OF OPT PLUS TEAM AND SUPERVISORS

ORGANIZATION/PERSONS
FUNCTION
INVOLVED
1. Organize the OPT Plus Training and Standardization and Refresher
Training.
City/Municipal Nutrition Action 2. Remind the barangay OPT Plus Team of the scheduled conduct of
Officer (C/MNAO) the OPT Plus every January to March of the current year.
3. Oversee the conduct of family profiling and spot-mapping.
4. Allocate funds needed for OPT Plus

1. Attend the Training and Standardization and Refresher Training on

the OPT Plus.
2. Assist the supervisor in facilitating the organization of the OPT Plus
Team.
OPT Plus Team members 3. Check if the measuring equipment are calibrated and/or verified,
conduct calibration/verification of weighing scales and verification of
length/height board.
4. Conduct household profiling and spot-mapping of target
households.
Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ROLES AND RESPONSIBILITIES OF OPT PLUS TEAM AND SUPERVISORS

ORGANIZATION/PERSONS
FUNCTION
INVOLVED
1. Provide resources to the BNS to attend the Training and
Standardization or Refresher Training on the OPT Plus.
2. Organize the OPT Plus Team.
3. Assists the BNS in calibrating/verifying the weighing scales and
BNC
verifying the length/height board.
4. Assists in conducting household profiling and spot-mapping of target
households.
5. Allocate funds needed for the OPT Plus.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 2.3

HOUSEHOLD PROFILE

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 HOUSEHOLD

● social unit
● a person living alone or a group of persons who sleep in the same
housing unit
● have a common arrangement in the preparation and consumption of
food

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 HOUSEHOLD PROFILE

● A household profile records the health and nutrition information of

families in the barangay.
● Existing updated household profile from the C/M Health Office may be
used (i.e. FHSIS)
● This may be collected before or during the conduct of OPT Plus
Anthropometric Measurement

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 C1: Write the control number of each household that will be interviewed.
C2: Write the number of family/ies living within a household A family is composed of a mother, father and children
C3: Write the total number of household members
C4: Write the code that corresponds to the household’s inclusion in the NHTS list.
C5: Write the code that corresponds to the household’s membership to an IP group
C6 to C25: Write the number of family member by age and sex according to health risk group.
C26: Write the first name, middle name and last name of the father in row (Fa) and the mother in row (Mo); If both not available, write the name of
C27: Select the appropriate occupation in the list below and write the only the number
C28: Select the appropriate highest educational attainment in the list below and write the only the code
C29: Check the YES box if the couple is practising family planning and NO if not practising family planning. Leave it blank if not applicable i.e. the mother is beyond reproductive age.
C30: Write the code what is the type of toilet facility used Next Slide
C31: Write the code what is their source of water (Refer to Slide 18)Slide 18
C32: Write the code on what type of food production activity/ies the family are engaged
C33: Check the YES box if using salt fortified with iodine and NO if not using
C34: Check the YES box if using rice fortified with iron and NO if not using

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Household Profile
Toilet facility classification

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Household Profile
Source of water classification

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 2.4

SPOT MAPPING

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 SPOT
SPOTMAPPING
MAPPING

Spot Mapping

Helps the nutrition worker to

locate the target households
with under-five children for
OPT Plus.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 2.5

CALIBRATION AND
VERIFICATION OF
WEIGHING TOOLS
AND EQUIPMENT
Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Calibration
Calibration is the comparison of two instruments or measuring devices, one of
which is a standard test weight identified as accuracy.

A weighing scale’s performance eventually degrades as it ages and undergoes

mechanical stress

For OPT Plus, calibration is recommended every three years to ensure

that the weighing scale remains functional and reliable.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 HOW TO CALIBRATE WEIGHING SCALES?

1. Departure from Nominal Value Test. Tests

whether the weighing scale reading is consistent and
accurate at different points (i.e., 5, 10, 15, 20, 25kg).
2. Repeatability Test. Ensures that the weighing scale
Tests for the provides consistent and accurate readings after
Calibration of repeated measures.
Weighing 3. Effect of Off-Center Loading/Eccentricity Test.
Scales Determines if the weighing scale reading is consistent
and accurate if standard weight is placed on different
points in the weighing scale. This test is only
applicable with platform scales and not with
hanging scales.
Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Verification
Verification or intermediate check is done in between regular calibration and
is done more frequently to ensure that operational stability and calibration
status is maintained at tolerable limits.

To perform verification, calibration records and information of the weighing

scale should be available. If none is available, an initial calibration should first
be conducted.

For OPT Plus, verification of weighing scales is recommended every

year in between calibration schedule.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 2.6

VERIFICATION OF
LENGTH/HEIGHT
TOOLS AND
EQUIPMENT
Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Verification
Verification or intermediate check is done in between regular calibration and
is done more frequently to ensure that operational stability and calibration
status is maintained at tolerable limits.

To perform verification, calibration records and information of the weighing

scale should be available. If none is available, an initial calibration should first
be conducted.

For OPT Plus, verification of length/height boards is recommended

every year in between calibration schedule.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Verification of
Length/Height
Verification
Tools and
Procedure
Equipment
for
Before Length/
a length/height board can be

Height Board
used, verification should be done by
trained personnel (passed the
Competency Training on
Verification).

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
Section Three

OPT PLUS PROTOCOL ON

ANTHROPOMETRIC MEASUREMENT
 OVERVIEW

1. properly measure the weight of 0-59-month-old children

The general objective of this using the appropriate weighing scale;

section is to provide information 2. properly measure the recumbent length of 0-23-month-

old children;
on the proper measurement of 3. properly measure the height of 24-59-month-old
weight, length, height and MUAC children;

measurement and weighing 4. properly measure the MUAC of 6-59-month-old children;

protocol. 5. properly check for and classify severity of bilateral pitting

edema; and

At the end of this section, you 6. properly record the weight, length, height, and MUAC
measurements.
should be able to: 7. provide immediate feedback to parents/caregivers and
refer malnourished children to relevant rural health
Section One: Operation Timbang Plus (OPT Plus) Overview offices for appropriate interventions. July 2022
 Section 3.1

Roles and Responsibilities

of OPT Plus Team and
Supervisors
Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ROLES AND RESPONSIBILITIES OF OPT PLUS TEAM AND SUPERVISORS

ORGANIZATION/PERSONS
FUNCTION
INVOLVED

NATIONAL NUTRITION COUNCIL Monitor the status of the OPT Plus activity at the national level
CENTRAL OFFICE

1. Monitor the status of the OPT Plus activity

Regional Nutrition Program 2. Provide mentoring and supportive supervision visits to
Coordinator (RNPC) LGUs/barangays needing assistance

1. Monitor the status of the OPT Plus activity

Provincial Nutrition Action Officer 2. Provide mentoring and supportive supervision visits to barangays
(PNAO) needing assistance

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ROLES AND RESPONSIBILITIES OF OPT PLUS TEAM AND SUPERVISORS

ORGANIZATION/PERSONS
FUNCTION
INVOLVED
1. Check the master list of 0-59-month-old children
2. Oversee the actual collection of length/height measurement and
weighing
3. Review the recording of the sex, date of birth, date of weighing,
length/height, and weight
Supervisors
4. Refer to the Barangay Health Centers (BHC)/Rural Health Unit (RHU)
the children with edema and obviously manifesting malnutrition (i.e.
extreme thinness, hollow cheeks, edematous feet, and hands, etc.)
5. Feedback the child's nutritional status immediately after
measurement using the weight-for-length/height index

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ROLES AND RESPONSIBILITIES OF OPT PLUS TEAM AND SUPERVISORS

ORGANIZATION/PERSONS
FUNCTION
INVOLVED
Monitor the status of the conduct of the OPT in each Barangay Health
City/Municipal Nutrition Action Station (BHS)
Officer (C/MNAO)

1. Conduct monthly OPT Plus monitoring of MW/MAM, SW/SAM,

underweight, and 0-23-month-old children, and quarterly monitoring
of 24-59-month old children.
2. Participate in the bi-annual review of the BNAP and present BNAP
OPT Plus Team Members accomplishments during the Barangay General Assembly/BNC
meetings.
3. Prepare the master list of 0-59-month-old children.
4. Conduct the actual collection of length/height measurement and
weighing with the supervisor, if feasible.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ROLES AND RESPONSIBILITIES OF OPT PLUS TEAM AND SUPERVISORS

ORGANIZATION/PERSONS
FUNCTION
INVOLVED
5. Record the sex, date of birth, date of weighing, length/height, and
weight.
6. Refer to the BHC/ RHU the children with edema and obviously manifest
malnutrition if the supervisor is unavailable.
OPT Plus Team Members 7. Feedback the child's nutritional status immediately after measuring
using the weight-for-length/height index in the CGS tables if the
supervisor is unavailable.
8. Coordinate with the DCW to measure the children who were not
covered during the center-based OPT Plus or home visit.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ROLES AND RESPONSIBILITIES OF OPT PLUS TEAM AND SUPERVISORS

ORGANIZATION/PERSONS
FUNCTION
INVOLVED
1. Assist in the preparation of the master list of 0- to 59-month-old
children.
2. Mobilize the under-five children to the weighing post.
3. Provide logistic support, i.e., transportation and food allowance to the
Barangay Nutrition Committee OPT Plus Team.
4. Provide transportation and other services to the family with
malnourished children to visit the BHC/RHU.
5. Assist coordination with the DCW for the children who have not been
measured at home or center-based.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 3.2

OVERVIEW OF
ANTHROPOMETRIC
MEASUREMENTS

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 What is Anthropometric Measurement?

Anthropometric measurement is a non-invasive quantitative measurement of the body

useful in assessing the nutritional status of both adults and children.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ANTHROPOMETRIC MEASUREMENTS
USED FOR OPT PLUS

WEIGHT LENGTH HEIGHT MID-UPPER EDEMA

ARM
CIRCUMFEREN
CE (MUAC)

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 3.3

GENERAL REMINDERS
IN TAKING
ANTHROPOMETRIC
MEASUREMENTS
Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 SOME CONSIDERATIONS WHEN PLANNING TO TAKE
ANTHROPOMETRIC MEASUREMENTS (FAO, 2021)

1. Placement of 2. Safety and 3. Dealing with

tools and precaution a distressed
equipment child

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 SOME CONSIDERATIONS WHEN PLANNING TO TAKE
ANTHROPOMETRIC MEASUREMENTS (FAO, 2021)

4. Children with This will include those suffering

from chronic diseases, deformities,
special disfigurement and disabilities
conditions/needs (Alberta Health Services, 2015)

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 SOME CONSIDERATIONS WHEN PLANNING TO TAKE
ANTHROPOMETRIC MEASUREMENTS (FAO, 2021)

● If the child’s height cannot be measured, get the

length instead
● If a child cannot form a vertical plane where the
head, shoulders, buttocks, and heels are aligned, a
4. Children with minimum of two contact points (i.e. back of the
head and buttocks or heels and buttocks) should
special touch the surface of the measuring tool.
conditions/needs

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 SOME CONSIDERATIONS WHEN PLANNING TO TAKE
ANTHROPOMETRIC MEASUREMENTS (FAO, 2021)

● If a child has leg length asymmetry, have the

child stand on the longer leg and place a block
or wedge on the shorter leg to align the hips
before taking the height measurement. To get
the length, hold the legs together and get the
measurement to the heel of the longer leg.
4. Children with ● In case weight and length/height cannot be
measured, note the child’s information (i.e.
special name of the child, name of parent/caregiver,
conditions/needs address) in the recording form and note that
the measurements cannot be taken due to the
child’s special condition.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 SOME CONSIDERATIONS WHEN PLANNING TO TAKE
ANTHROPOMETRIC MEASUREMENTS (FAO, 2021)

a. Clean and check the anthropometric tools regularly.

For there are signs of damage, report them
immediately to your supervisor for replacement.
b. Regularly calibration and verification
5. Taking care of
c. Follow the guidelines in tool care.
anthropometric
d. When using digital scales, make sure that batteries are
Tools replaced and that extras are available.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 SOME CONSIDERATIONS WHEN PLANNING TO TAKE
ANTHROPOMETRIC MEASUREMENTS (FAO, 2021)

a. Use pencils
b. Record all relevant information for one child before moving
on with the next.
c. Record weight in the nearest 0.1kg
6. Recording d. Record length, height and MUAC in the nearest 0.1cm.
measurements e. Always validate and confirm the recorded anthropometric
data after the assistant writes them down.
f. Record anthropometric data legibly in the OPT Plus Form A
Recording Sheet.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 NOTE 3.1

Reminders on Recording Data

• Use OPT Plus Form A Recording Sheet

• Get all the measurements on the same day. The weight and
length/height taken at different days will result in inaccurate data.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CORRECT WAY OF WRITING NUMBERS WHEN RECORDING
ANTHROPOMETRIC MEASUREMENTS

In recording anthropometric
measurements the following
guidelines are to be followed to
minimize errors.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 GETTING READY TO MEASURE
Before you proceed to weigh and measure the child, make sure to :

Introduce yourself and briefly explain the purpose of your visit

to the mother/caregiver.

Provide the mother/caregiver with an overview of what will be

done to the child during weighing and length/height measurement.

After explaining, get the consent of the mother/caregiver by using

the Annex Form 3.2. Signature in the OPT Form A signifies the
consent of the mother/caregiver
Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 3.4

INSTRUCTIONS ON
HOW TO WEIGH THE
0-59-MONTH-OLD
CHILDREN
Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON WEIGHT EQUIPMENT: HANGING SCALE

The scale is calibrated within The pointer of the scale is

the past 3 years and verified moving freely
within 1 year with signed
sticker in the equipment
The pointer of the scale is at
“0” when the pants were hung
The scale has complete
and goes back to “0” after
components
removing the child and the
pant was rehung.
The scale has no broken parts

The weighing pants used The unit of measurement is at

were clean and not damaged. 0.1 kg.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON WEIGHING USING HANGING WEIGHING SCALE

1 The weighing scale hung from a stable and sturdy branch, ceiling beam, or
pole and the ropes used for hanging the scale was sturdy.

2 The weighing scale dial is at eye level of the measurer.

3 The measurer assured that the child is wearing light clothes or ask the
mother/caregiver to remove unnecessary clothing including shoes,
slippers, socks, extra clothes and diaper; the child's pockets were checked
and emptied.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON WEIGHING USING HANGING WEIGHING SCALE

4 The measurer was assisted by another person while putting the child in
the weighing pants to be measured.

5 The measurer used one hand to carry the child while the other hand was
used to hang the straps to the scale.

6 The strap of the pants were placed in front of the child and the child’s feet
were not touching the ground during weight measurement.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON WEIGHING USING HANGING WEIGHING SCALE

7 The weight measurement was recorded/written correctly and in the

nearest 0.1 kg.

8 The child was measured twice and if the replicate measurement had a
difference greater than or equal to 0.3 kg, a third weight measurement
was obtained.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON WEIGHT EQUIPMENT: USING DIGITAL WEIGHT
SCALE/MODEL/ OR DIGITAL FLAT SCALE

The scale was at “0.0” once set-

The scale has no broken parts
up for weighing

The battery is in good condition

The scale reading changed when
as indicated in the scale
a child was weighed and goes
back to “0” after removing the
The digital window is clean and
child/the mother and child
the numbers are clear enough
to read. The scale is calibrated within
the past 3 years and verified
The unit of measurement is at within 1 year with signed
0.1 kg. sticker in the equipment

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON WEIGHT EQUIPMENT: USING DIGITAL WEIGHT
SCALE/MODEL/ OR DIGITAL FLAT SCALE

1 The scale is placed on a flat surface.

2 The measurer assured that the child is wearing light clothes or ask the
mother/caregiver to remove unnecessary clothing including shoes,
slippers, socks, extra clothes and diaper; the child's pockets were checked
and emptied.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON WEIGHT EQUIPMENT: USING DIGITAL WEIGHT
SCALE/MODEL/ OR DIGITAL FLAT SCALE

3 For scale without taring: the mother/caregiver was measured and her
weight was recorded then the child was given to the mother/caregiver on
the weighing scale and their weight was taken. The weight of the mother
was deducted from the total weight of mother/caregiver and child.

For scale with taring: the mother/caregiver was asked to be on the weighing
scale before taring the scale; the child was given to the mother/caregiver
on the weighing scale and the child's weight was taken.

A weighing scale with the taring function allows the user to adjust/reset the equipment’s display to zero.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 NOTE 3.2 1. Make sure that the scale is at “0.0”

Manual Taring 2. Have the parent/caregiver stand on the

scale, then write down the weight.

If the digital scale has no 3. Place the child on the parent’s/caregiver’s

taring function, you may arms, then write down the combined weight.
follow these steps: 4. Subtract the parent’s/caregiver’s weight from
the combined weight to get the child’s weight:
Child’s Weight = Combined Weight -
Parent’s/Caregiver’s Weight
5. Verify and record.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON WEIGHT EQUIPMENT: USING DIGITAL WEIGHT
SCALE/MODEL/ OR DIGITAL FLAT SCALE

4 The weight measurement was recorded/written correctly and in the

nearest 0.1 kg.

5 The child was measured twice and if the replicate measurement had a
difference greater than or equal to 0.3 kg, a third weight measurement
was obtained.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 3.5

INSTRUCTIONS ON
MEASURING THE LENGTH
OF THE 0-23-MONTH-
OLD CHILDREN
Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON LENGTH BOARD/INFANTOMETER

The length board/infantometer is The foot piece was straight

available and owned by the and slides smoothly.
barangay
The number is legible and easy
to read and the unit is at 0.1 cm.
The headboard was secure
and in place. The equipment is calibrated
within the past 3 years and
verified within 1 year with
signed sticker

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON LENGTH MEASUREMENT

1 The measuring length board was placed on a hard flat surface on the
floor or on the table.

2 If placed on the floor, the assistant was kneeling beside the headboard.
If placed on the table, the assistant was standing beside the
headboard.

3 The measurer requested the mother/caregiver to remove headgear,

braids, etc. and shoes, slippers, and socks, etc. prior to measurement.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON LENGTH MEASUREMENT

4 The measurer was on the right side of the child while holding the foot
piece using the right hand.

5 The measurer was helped by the mother/caregiver in placing the child

on the board and instructed the mother/caregiver to position at the
opposite end of the board to help calm the child.

6 The assistant cupped his/her hands over the child’s ear to position the
child’s head ensuring that the child’s sight was perpendicular to the
ground and the the assistant was at eye level with the child.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON LENGTH MEASUREMENT

7 The measurer made sure that the child was lying flat in the center of the
board and checked the position of the child before getting the
measurement.

8 The measurer pressed the child’s shins or knees against the board using
his/her left hand while maneuvering the foot piece firmly on the child’s
heels using their right hand.

9 The length was read and called out by the measurer to the nearest 0.1 cm.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON LENGTH MEASUREMENT

10 The length was recorded by the assistant in the nearest 0.1 cm and
showed to the measurer who checked the accuracy and legibility.

11 The child was measured twice and in case the replicate measurements
had a difference greater than or equal to 0.5 cm, a third length
measurement was obtained; the two closest measurements was used.

12 The measurer used the appropriate procedure for length measurement

(0-23 months - RECUMBENT) and if height was measured (due to any
reason) it was documented under remarks.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 3.6

INSTRUCTIONS ON
MEASURING THE HEIGHT
OF THE 24-59-MONTH-
OLD CHILDREN
Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON HEIGHT BOARD

The stadiometer/height board The head piece was straight

is available and owned by the and slides smoothly.
barangay
The number is legible and easy
to read and the unit is at 0.1 cm.
The height board is stable
and not moving except for The equipment is calibrated
movable parts; the footboard within the past 3 years and
was secure and in place. verified within 1 year with
signed sticker

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON HEIGHT MEASUREMENT

1 The measuring board was placed on a hard flat surface against a wall,
table, tree, staircase, etc. ensuring that the board was not moving.

2 The measurer or assistant asked the mother/caregiver to remove the child’s

shoes and/or unbraid any hair that would interfere with the height
measurement and asked the mother/caregiver to walk the child to the board.

3 The measurer knelt with his/her right knee on the right side of the child
while the assistant placed the OPT Plus Form A and pencil on the ground
and knelt on both knees on the right side of the child.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON HEIGHT MEASUREMENT

4 The assistant placed the child’s feet flat and together at the center and
against the back and base of the board/wall.

5 The assistant placed his/her hand right above the child’s ankles, his/her
left hand on the child’s knees and pushed it against the board/wall; the
assistant then informed the measurer that he/she has already positioned
the child’s feet and legs accordingly.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON HEIGHT MEASUREMENT

6 The measurer instructed the mother/caregiver to stand in front of the

child and for the child to look straight ahead to the mother/caregiver
so that the child’s line of sight was level with the ground when the
height was being measured.

7 The measurer’s left hand was placed under the child’s chin and gradually
close his/her hand.

8 The child’s shoulders are level and the measurer pushed the child's
tummy a little bit before measuring.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON HEIGHT MEASUREMENT

9 The measurer ensures that the headpiece is pushed through the

child’s hair.

10 The height was read and called out by the measurer to the nearest 0.1 cm.

11 The height was recorded by the assistant in the nearest 0.1 cm and
showed to the measurer who checked the accuracy and legibility.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKLIST ON HEIGHT MEASUREMENT

12 The child was measured twice and in case the replicate measurements
had a difference greater than or equal to 0.5 cm, a third height
measurement was obtained; the two closest measurements were used.

13 The measurer used the appropriate procedure for height measurement

(23-59 mos - standing) and if length was measured due to any reason,
this was documented under remarks

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 NOTE 3.3

Reminder on Length and

Height Measurement
In case of child’s inability to stand or refusal to lie If a 0-23-month-old child was measured
down, the measurer will have to adjust the standing up, add 0.7cm to the obtained
measurement accordingly: measurement.
If a 24-59-month-old child was measured
lying down, subtract 0.7cm to the obtained
measurement.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 3.7

INSTRUCTIONS ON
HOW TO MEASURE MUAC
OF 6-59-MONTH-OLD
CHILDREN
Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 The use of mid-upper arm circumference
(MUAC) tape detects the possible problem of
malnutrition among children immediately,
especially during emergencies.

The following are the instructions on how you are going to use the
MUAC.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 An unstretchable MUAC tape is
Checklist on available in the barangay.
MUAC Tape The MUAC tape is not folded, torn or
damaged and the numbers are clear.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 The measurer informed the mother/caregiver that
the Child's MUAC will be measured and asked
him/her to position the child such that the left arm is
exposed.
Checklist on Midpoint between the elbow and the tips of the
MUAC shoulder was properly located.

Measurement The arm was at a right angle and MUAC was

measured at the midpoint.

The MUAC was measured not too loose or too tight.

The MUAC was measured in the left arm.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 3.8

IDENTIFICATION OF
BILATERAL
PITTING EDEMA

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Bilateral pitting Edema is characterized by the
puffiness or swelling of feet,
edema, or edema, is hands, and/or face. An
the presence of excess edematous child is considered
fluid in muscle tissues as severely wasted or SW/SAM,
at higher risk of mortality, and
caused by severe in need of urgent medical
muscle wasting. attention.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKING FOR PRESENCE OF EDEMA

2 Check for edema.

a. Hold the child’s feet with your
thumb on top of the foot.
b. Gently press your thumbs down
and slowly count to three
before lifting your thumb.
c. Check if there are pits or dents
left by your thumb.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 CHECKING FOR PRESENCE OF EDEMA

d. Record the results Edema Bilateral Pitting Edema

based on severity.
+1 Both feet
You may refer to the
following table for Both feet, legs, and may
the grades of +2
include hands, lower arms
bilateral pitting
edema. Both feet, legs, hands,
+3 lower arms, upper arms,
face

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 3.9

REFERRAL OF
MALNOURISHED
CHILDREN

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 REFERRAL
Referral is the process of linking identified
malnourished children to appropriate interventions
and services in the community and is one of the main
objectives of the OPT Plus at the individual level.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 A normal nutritional status suggests that
For Child Who the child is growing well. Parents/
is Growing Well caregivers of these children should be
commended by the OPT Plus Team
during counseling.

Normal growth should be sustained. This may be achieved by educating the parents/
caregivers on the importance of proper nutrition and by giving feeding advice appropriate
for the age of the child.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 If there is a growth problem, the
For parent/caregiver should be interviewed
and counseled to identify possible
Malnourished
causes of the problem and to provide
Children nutritional advice to improve the
nutritional status of the child.

It is very important to keep the discussion positive and to avoid accusing or judging the
parent/caregiver. The parent’s/caregiver’s trust should be built to clearly communicate
that he/she can help the child.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 However, if you observed any of the following
severe undernutrition problems, refer them
immediately for specialized care:

Referral for • Moderate wasting (MW/MAM)

Specialized • Severe wasting (SW/SAM)
Care • Edema of both feet

Whenever you refer a child, explain to the

mother the reasons for the referral and stress
its importance.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 1 Explain to the mother the child’s nutritional
status is MW/MAM or SW/SAM.

Steps on
how to
2 Tell her the consequences if her child will not
explain the be referred immediately to the health center.
reasons for
the referral:
3 Inform her what are the possible interventions
that will be given to the child.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 NOTE 3.4

Assistance for Families of

Malnourished Children
Sometimes the parents or caregivers refuse to bring their child to the health center because
it is far, or they lack the financial resources. The barangay can give a certification of
indigency and ask financial support from the Municipal Social Welfare and Development
(MSWD) while the barangay can help facilitate or arrange for transportation.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 NOTE 3.5

MUAC vs WFL/H in Assessing Wasting

in 6-59-month-old Children
MUAC and WFL/H can both be used to identify wasting or acute
malnutrition in children 6-59-month-old. However, the same method
should be used during monitoring. For example, a child that was initially
classified as SW/SAM using MUAC should be monitored using MUAC
until discharge from the PIMAM program.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 4

ELECTRONIC OPT (eOPT)

PLUS TOOL

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 e-OPT PLUS TOOL

The e-OPT Plus Tool helps

• record,
• consolidate, and
• summarize the results of
OPT Plus among 0-59-month-
old children.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 OVERVIEW OF THE E-OPT PLUS TOOL

The e-OPT Plus tool is a

nutritional status calculator.
It calculates a child's age in months and
automatically generates the nutritional
status using World Health Organization
Child Growth Standards (WHO-CGS) as
basis.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 After all the children’s measurements are taken and recorded,
an encoder puts in the data to the e-OPT Plus Tool.

With e-OPT’s automatic feature:

Easier collection and Less chances of errors compared

interpretation of measurements to manual approach.
of many children in the community.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 How to encode the OPT Plus data in
the e-OPT Plus Tool?

1 Fill up the necessary information in the ‘Nut_Statustool’ headings such as the year, region,
province, municipality, and barangay. The entry worksheet will not appear if the information
is blank.
○ Type in the YEAR (cell M1). Choose first the PROVINCE/LGU, then the
CITY/MUNICIPALITY, and lastly the name of the BARANGAY from the dropdown lists
in each corresponding cell. Please fill these up in sequence.
○ If the message "Note: Large Barangay" appears in Cell C3, you should use this file
for a Purok or smaller part of the barangay. In Cell A3, choose the
"Purok/Area/Block" option. Please then type in the name of the Purok or sub-part
of the barangay in Cell C6.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 How to encode the OPT Plus data in
the e-OPT Plus Tool?

2 Choose from the dropdown list in Cell KU6 which Nutritional Assessment Method
(Weight+Length/Height or MUAC) will be used during the OPT Plus. If Weight+Length/Height
was chosen as a method, the MUAC cell will be automatically blocked, vice versa.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ENCODING OPT PLUS DATA IN THE E-OPT PLUS TOOL

3 Refer to the paper forms (i.e. NNC Form 1A) that you used to record details of preschool
children from your last OPT Plus activity. Type in all the required data for each child into
the 'Nut_StatusTool' worksheet one at a time. One child, one row. Enter all the
information for each child in the table. Do not skip rows - it will cause your OPT Plus
Form A to not work properly.
○ You can then begin entering information for each child in the main table -- one child
at a time -- starting from the first blank row (Row # 10). Do not skip rows or leave
any rows blank - this will cause your OPT Plus Form A recording sheet to not work
properly.
○ If there was no edema identified in the child, choose ‘NO’ in Column KT and if yes,
indicate its severity (+1, +2 or +3).
○ Identify whether the child has a disability or not. Choose ‘YES’ or ‘NO’ from the
dropdown.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ENCODING OPT PLUS DATA IN THE E-OPT PLUS TOOL

4 For the 'Address or Location': make sure to specify the house street, purok/sitio or landmarks

For the 'Name of Mother or Caregiver': make sure to follow the format SURNAME, FIRST NAME
5 SUFFIX (e.g. DELA CRUZ, JUAN or DELA CRUZ, JUAN JR.)

For the 'Full Name of Child': make sure to follow the format SURNAME, FIRST NAME SUFFIX
6 (e.g. DELA CRUZ, JUANITO or DELA CRUZ, JUANITO JR

For the 'Belongs to the IP Group?': from the dropdown list, choose YES if the child belongs to
7 an indigenous tribe/group; otherwise, choose NO

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 ENCODING OPT PLUS DATA IN THE E-OPT PLUS TOOL

8 For the 'Sex': from the dropdown list, choose M if the child is a male; otherwise, choose F.

9 For the 'Date of Birth' AND 'Date Measured': first determine the date format settings on your
computer at the bottom right corner of your screen on your taskbar (or you can look at the
date format in cell K1 in 'Nut_StatusTool'). For example, if your computer's date format is MM-
DD-YYYY, "January 21, 2021" would appear as "01/21/2021"; if it is set as DD-MM-YYYY, it
would appear as "21-01-2021".

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 NOTE 4.1 Date Format
The way you type in the date format into the After you have typed in the numeric date, it
tool for the child's date of birth and the date will appear in the cell as MM-DD-YYYY (for
of measurement must be the same as the example, Jan-21-2021), regardless of your
way the date format in your computer's computer's date format settings. This is to
operating system appears (e.g., help users read the correct dates after the
MM/DD/YYYY or DD/MM/YYYY). Always type date has been typed in. Please check that
in any date using the format consistent with your computer's date and time settings are
your computer's settings. When you type in always correct.
the numeric date, make sure that the month
and the date are not interchanged.
Otherwise, this will lead to incorrect
calculation of the child's age in months.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 NOTE 4.2 To auto-generate each child's nutritional
status for all three indices, the following
Data Entry information must be complete:

• The name of the mother/caregiver,

ENSURE ALL CELLS OR
• The child's name,
INFORMATION ARE FILLED IN
• IP status (whether the child belongs to
FOR EACH CHILD.
an indigenous group),
• Child's sex,
• Date of birth,
• Date measured,
• Weight (in kg), and
• Height (in cm).

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 NOTE 4.2

Data Entry
If the child is missing any essential Note:
information (e.g., name of mother/ • If a child has no weight or height entered
caregiver): in the Nut_StatusTool, the cell for the
• Type in "TBD," and make sure to obtain corresponding missing measurement will
the needed information during the next be highlighted in yellow.
house visit. • If other child information is missing, the
• Otherwise, if any details are left blank in cell opposite the child's name in Column
the tool, one or all nutritional status A will be highlighted with a gray color.
indices for that child might not appear.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 How to update the eOPT Plus tool in the next OPT
Plus?
Suppose there is an encoded worksheet
already with e-OPT data from previous tool
used. In that case, the encoder can batch
copy the list of multiple children's names and
details into a blank Nut_StatusTool using the When copying from another worksheet
"Copy>>Paste>>Values" function of MS Excel. into the e-OPT Tool, always use the
option "Paste>>Values". Doing this
Please just note that the children's names avoids errors as underlying formulas,
and other information from the source and formats in cells from the source will
worksheet should be arranged in the same also be copied if just "Paste" is used.
way the columns in the tool are set up. Also,
make sure that the source data are pasted
into the blank tool starting from Row #10
downwards.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 What are the tables and reports generated
in the e-OPT Plus Tool?

a. ‘Instructions’ tab guides the users on how to encode the OPT data and key
features of the tool

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 What are the tables and reports generated
in the e-OPT Plus Tool?
b. Nut_Status Tool’ is the main data entry worksheet. The encoder can enter
information of one child at a time into each row, or through can do a batch
entry for many children.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 What are the tables and reports generated
in the e-OPT Plus Tool?
c. ‘Summary’ is the consolidation of the results of the nutrition assessment

1. Number of children 0-59 months old children who are Wasted and/or Stunted
2. Number of children 24-59 months who are Wasted and/or Stunted
3. Number of children 0-59 months old children who are overweight/obese
4. Total number of children 0-23 months old
5. Number of children 0-23 months old who are Wasted and/or Stunted
6. Total number of children 0-29 months old
7. Total number of children 30-59 months old
8. Total number of children 24-49 months old
9. Number of children 0-59 months old with Edema
10. Number of children 0-59 months old with disability
11. Total Number of mothers/caregivers of children 0-59 months old
12. Number of M/Cs of 0-59 months old children affected by wasting and/or stunting
13. Number of M/Cs of 0-59 months old children who are overweight/obese
14. Total number of M/Cs of children 0-23 months old
15. Number of M/Cs of 0-23 months old children affected by Wasting and/or Stunting

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 What are the tables and reports generated
in the e-OPT Plus Tool?
c. ‘Summary’ is the consolidation of the results of the nutrition assessment

16. Number of Children with names and birthdate repeated

17. Number of Children with missing information
18. Number of Children with no name of parents/address
19. Number of Children with no sex data
20. Number of Children with no date of birth data
21. Number of children whose names are repeated more than once; Number of children older than
59 months
22. Number of children with length/height but no weight
23. Number of children with weight but no length/height
24. Number of children with no MUAC

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 What are the tables and reports generated
in the e-OPT Plus Tool?

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Section 4.3

MANUAL: USING THE

WHO-CGS TABLE

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 STEPS IN DETERMINING NUTRITIONAL STATUS USING
THE WEIGHT-FOR-AGE AND HEIGHT-FOR-AGE

Step 1. Calculate Age in Months

Age in months is another important information needed in

determining the nutritional status of children when using indicators
such as WFA and L/HFA. There are automated tools and software that
you can use to calculate. In cases where these tools or software may
be unavailable and inaccessible, this section will discuss to you the
simple steps in calculating a child’s age in months manually.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 1 Make sure that the child’s date of birth is correct.
The date of birth may be counter-checked with
the information in the child’s birth certificate, the
newborn infant's record book of the RHM, or with
the records of local nutrition and health workers
such as midwives, BNS, or BHW.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 2 To compute the child’s age in months, subtract
the date of birth from the date of measurement.
The formula and format are shown below:

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 3 Write down the dates in yyyy-mm-dd format. Note
that the Date of Measurement is always the more
recent date compared to the date of birth.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 4 Start subtracting the days (dd).
Note: If the value of days (dd) cannot be subtracted, get 1
month from the mm which is equivalent to 30 days.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 5 Subtract the months (mm).
Note: If the value of months (mm) cannot be subtracted, get 1
year from the yy which is equivalent to 12 months.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 6 Subtract the year (yyyy).

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 7 Convert years (yyyy) into months by multiplying by 12,
then add to the month (mm). Disregard days (dd).

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 NOTE 4.3

Age in Months

The child's age is computed to the nearest month as of the last birth date.
Disregard the number of days in the computation of age in months.
If you do not have access to computers, you can use the WHO-CGS Reference
Tables for weight-for-age, weight-for-length/height, and length/height-for-age.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Example. Date of Measurement: January 13, 2021
Date of Birth: August 26, 2019

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 NOTE 4.4

Nutritional Status
The nutritional status classification of children may differ when using the e-
OPT Plus Tool and when using the manual method through WHO-CGS
Tables. As mentioned in Section 1, the e-OPT Plus Tool calculates the exact z-
score to determine nutritional status while the WHO-CGS Table is used only to
estimate the z-score nutritional status. The WHO-CGS Tables simplify the
determination of nutritional status and are used during field works or when
electronic tools are not available.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 STEPS IN DETERMINING NUTRITIONAL STATUS USING
THE WEIGHT-FOR-AGE AND HEIGHT-FOR-AGE

Step 2. Determine the nutritional status

You can easily determine the nutritional status of children using the
WHO Child Growth Standards (CGS) Tables. The next section will guide
you on using the WHO CGS Table:

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 1. Once you have computed the correct
age in months of the child, refer to
the sex-specific LFA/HFA table.
Length/Height- 2. Locate the child’s age in months at
for-Age (LFA/HFA) the first column of the table.

3. Once located, look through the

corresponding row to identify the
classification where the child’s
length/height-for-age falls.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Example. Juan is a 9-month-old boy whose measured length
is 66.3cm.

Using the CGS table for LFA/HFA for boys, we

first locate Juan’s age in months is 9 then
locate where his length falls.

Section Four:
One: Operation
OPT Plus Protocol
Timbangon
Plus
Encoding
(OPT Plus)
andOverview
Report Generation July 2022
April 2022
 Example. Juan is a 9-month-old boy whose measured length
is 66.3cm.

Since his length falls between 65.2cm and 67.4cm,

Juan is classified as STUNTED.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 1. Once you have computed the correct
age in months of the child, refer to
the sex-specific WFA table.
2. Locate the child’s age in months at
Weight-for-Age
the first column of the table.
(WFA)
3. Once located, look through the
corresponding row to identify the
classification where the child’s weight-
for-age falls.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Example. Maria is an 18-month-old baby girl who weighs 9.6kg.

Using the CGS table for WFA for girls, we first

locate Maria’s age in months is 18, then locate
where her weight falls.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Example. Maria is an 18-month-old baby girl who weighs 9.6kg.

Since her weight falls between 8.1kg and 13.2kg,

MARIA is classified as NORMAL.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 1. Once you have taken the
length/height of the child, round off
the actual measurement to the
nearest 0.5cm.
Weight-for-
2. Locate the rounded-off length/height
Length/Height at the first column of the table.
(WFL/WFH) 3. At the corresponding row, locate the
child’s weight at corresponding row to
identify the weight-for-length/height
classification.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Example. Pedro is a 33-month-old boy who weighs 7.4kg
and height is 72.2cm.

First, round off Pedro’s weight to the nearest

0.5cm, making the height 72.0cm. Using the WFH
table, locate 72.0cm on the first column.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Example. Pedro is a 33-month-old boy who weighs 7.4kg
and height is 72.2cm.

Since Pedro’s weight falls between 7.1kg and 7.6kg, he is

classified as MODERATELY WASTED.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Workshop 7

Age in months calculation & Determination

of NS using CGS table

1. Prepare copy of CGS tables (L/H for Age, Weight for Age, Weight for Height,
and Weight for Length) and scratch paper.
2. Compute for the age in months based on the date of birth and date
measured and write the answer in the exercise sheet.
3. Look for the L/H for Age, Weight for Age, Weight for Height, and Weight for
Length on the CGS tables and write the answer in the exercise sheet.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Workshop 8

Plotting in the ECCD Growth Chart

1. Prepare copy of CGS tables (L/H for Age, Weight for Age, Weight for Height, and
Weight for Length).
2. Look for the Wt/Length, Wt/Height and NS based on the CGS tables
3. Look for the L/H for Age, Weight for Age, Weight for Height, and Weight for
Length on the CGS tables and write the answer in the exercise sheet.

Weight-for-age
1. Look at the age-in-months and weight on the 1st page of the activity sheet.
2. Put a dot where the age in months and weight meets. Note that the age in
months is in the x-axis and weight is in the y-axis.
3. Plot it based on the available data
Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Workshop 8

Plotting in the ECCD Growth Chart

Length-for-age
1. Look at the length and age in months on the 1st page of the activity sheet.
2. Put a dot where the length and age-in-months meets. Note that the age-in-
months is in the x-axis and length is in the y-axis.
3. Plot it based on the available data

Height-for-age
1. Look at the height and age-in-months on the 1st page of the activity sheet.
2. Put a dot where the height and age-in-months meets. Note that the age in
months is in the x-axis and height is in the y-axis.
3. Plot it based on the available data
Section One: Operation Timbang Plus (OPT Plus) Overview July 2022
 Workshop 8

Plotting in the ECCD Growth Chart

Weight-for-Height
1. Look at the weight and height on the 1st page of the activity sheet.
2. Put a dot where the weight and height meets. Note that the height is in the x-
axis and weight is in the y-axis.
3. Plot it based on the available data.

Section One: Operation Timbang Plus (OPT Plus) Overview July 2022