Author of submission (name, surname, position, organization)
Igor Spiroski, MD, PhD, Head of Department of Physiology and Monitoring of Nutrition, Institute of Public Health of the Republic of Macedonia
Title of your example
Regulation of kindergartens and school meals
Theme
School food and nutrition programs
Date, location and geographic scope of your example (regional, sub-regional, national, local)
National program started in 2014
Main responsible entity(ies) for the implementation of your example
Ministry of Social Policy, Ministry of Education, Ministry of Health
Key objectives and implementation approach of your example
In the last few years, few important documents and legal provisions related to nutrition have been adopted in Macedonia. Ministry of Health (MoH) and the Institute of Public Health have prepared and adopted first ever Food based dietary guidelines in the country. Ministry of Social Policy in cooperation with MoH has put in place The standards for nutrition in kindergartens, in the form of a bylaw. Ministry of education in cooperation with MoH has adopted the Standards for nutrition of primary school children, in 2014, in the form of bylaw. Comprehensive media campaign has been launched in the country that aimed to raise awareness about acceptance of healthy nutrition and to stress the importance of healthy lifestyles in prevention of early occurrence of NCDs. The overall objective of the process was to reduce dietary health risk factors for in school settings.
Funding and technical assistance of your example.
No particular funding related to the legal provisions adopted. The funding from the ministries to the schools and kindergartens that subsidize the price of school meal remained unchanged.
Key stakeholders involved. Describe the cross-sectoral coordination mechanism of your example, if any.
The standards were prepared by the working group consisting participants from Ministry of Health (Institute of Public Health), Food and Veterinary Agency, Ministry of Education and Ministry of Social Policy, as well as the participant from the National Inspection Council. The commission for monitoring and evaluation was established and it is also cross-sectoral.
How your example addresses food security and nutrition challenges. Describe linkages to social protection policies / school food programs / sustainable food systems.
This process addresses nutrition challenges related to malnutrition in children. Data from Childhood Obesity Surveillance Initiative show that prevalence of obesity in school children in Macedonia is increasing, so this process is only one piece in the puzzle of integrated food policy that has to be implemented.
What are the elements needed for the practice to be institutionally, socially, economically and environmentally resilient and/or sustainable?
Beside this measure there should be integrated food policy in the country. Food and nutrition action plan is in its final draft and the Government should adopt it and start more comprehensive approach by providing healthier school food environment. This needs commitment and resources allocated for the process. This measure will be success, only if it is a part of a wider food and nutrition policy process in the country.
The impact of your example on national policies and people’s lives. What indicators have been used to measure it?
The evaluation process is in progress. Two indicators are principal ones and that is the adherence of the macro and micronutrient content of the meals to the bylaws regulating them and the nutritional status of the children covered by this regulations.
Key lessons (positive and negative) that can be learned from your example and how gaps, obstacles and any other adverse conditions were addressed.
The dominant obstacle in implementation is the communication with food caterers that provide meals in schools since. In the case of kindergartens the school kitchens are owned by the kindergartens, so the process of reformulation of the meals was much smoother and the results were better. In schools, the meals are prepared by the catering companies and there is no sufficient knowledge as well as willingness in them to implement reformulation. Other obstacle is divided responsibilities for school procurement and school environment shaping by the local and central governments. The ongoing process of communication will include counseling with food caterers provided by the health, education and agriculture ministries as well as separate communication with local governments.
Sources and/ or additional background material
Igor Spiroski