Here is an interesting paper for our network… Integrating nutrition into the education sector in low‐ and middle‐income countries: A framework for a win–win collaboration
Abstract
Malnutrition—both undernutrition and overnutrition—is a public health concern worldwide and particularly in low‐ and middle‐income countries (LMICs). The education sector has high potential to improve immediate nutrition outcomes by providing food in schools and to have more long‐term impact through education. We developed a conceptual framework to show how the education sector can be leveraged for nutrition. We reviewed the literature to identify existing frameworks outlining how nutrition programs can be delivered by and through the education sector and used these to build a comprehensive framework.
We first organized nutrition programs in the education sector into (1) school food, meals, and food environment; (2) nutrition and health education; (3) physical activity and education; (4) school health services; and (5) water, sanitation, and hygiene (WASH) sector.
We then discuss how each one can be successfully implemented. We found high potential in improving nutrition standards and quality of school foods, meals and food environment, especially through collaboration with the agriculture sector. There is a need for well‐integrated, culturally appropriate nutrition and health education into the existing school curriculum. This must be supported by a skilled workforce—including nutrition and public health professionals and school staff. Parental and community engagement is cornerstone for program sustainability and success. Current monitoring and evaluation of nutrition programming in schools is weak, and effectiveness, including cost‐effectiveness, of interventions is not yet adequately quantified.
Finally, we note that opportunities for leveraging the education sector in the fight against rising overweight and obesity rates are under‐researched and likely underutilized in LMICs.
We woud like to highlight the following two sections fron the paper – the blue font highlighting what we do at Children for Health…
4.3 Key factors requiring attention for program success
Our review also illuminated some key factors identified from nutrition programs in various countries that were either program bottlenecks or enabling factors for success. These can serve as valuable lessons and also warrant further attention in research and program evaluation.
- First, national level commitments to capacity building of experts in public health and nutrition enables the establishment school health policies that address context‐specific nutrition concerns and allows for national funding and implementation guidance. It is therefore necessary to ensure that a pipeline for training these professionals is created and maintained.
- Second, school meal and feeding programs must move beyond solely providing adequate calories, but also ensure nutritional quality of foods. This means adequate nutrients and diversity, guided by clear school nutrition standards and food purchasing and sourcing criteria. It also means investment in the identification and/or production of affordably priced nutritious food items. Lack of focus on hygienic food preparation and food safety practices in schools prompt increased the need for in‐service training for food handling staff. Ensuring a streamlined food supply chain and distribution system is tied with parental confidence in school meal programs, which can be a particular challenge for rural schools most in need.
- Third, nutrition and health curricula must be developed using a collaborative process and integration of nutrition and health topics into other basic subject matters. Qualified nutrition and health professionals provide relevant content, which is then packaged by education experts into culturally relevant and digestible teaching materials and plans to ensure engagement and effective learning among the targeted age group. This also includes adequate pre‐ or in‐service training for education staff responsible teaching the material.
- Fourth, community engagement—particularly the engagement of parents—must be fostered at all levels of implementation, both to reflect the needs of the community in children’s education and health and to extend impact and benefits of the program to the community while holding the implementing agency or office accountable.
- Finally, several studies discuss the importance of a coordinating body or committee consisting of stakeholders from both the education sector and the nutrition and health sector that can articulate responsibilities of each player to ensure accountability and commitment—perhaps even share costs—at the national level.
…And key messages from the review include:
- Well‐adapted national policies and guidelines, adequate training of workforce at all levels, and community and parental engagement are paramount to the success of school nutrition programs.
- More research is needed to evaluate the multi‐generational and broader societal impact, of school nutrition programs, including on indirect beneficiaries (i.e., food and agriculture workers, women).
- A globally accepted monitoring framework with standard indicators for all program areas is needed to strengthen monitoring and evaluation efforts.
- The education sector is particularly well placed but so far underutilized to play a major role in the mitigation—and ultimately, prevention—of obesity and overweight.
Have a look at the PCAAN programme we did in Mozambique to improve nutrition education.