Why Schools should be on the Frontline in Combating Malnutrition
To celebrate International School Meals Day on the 5th March, schools from around the world share their experiences of school meals. It’s a fun way for school kids to learn what’s on their plates and on what children the other side of the world will be eating.
However given the depressing regularity of nutritional bad news focusing on obesity or malnutrition perhaps policy makers should be just as excited by school meals and the wider school health and nutrition movement which can provide countries with the tools to tackle this problem.
In fact, school feeding and school health programmes are present in almost every country in the world – low, middle and high income alike. However, the quality of these programmes is often the poorest where nutritional challenges are the greatest. Attention is needed to improve the quality of these programmes to reach children who have the most to gain.
The World Health Organisation estimates that 42million infants and young children under 5 are overweight or obese in 2013 and by current trends this figure was likely to top 70 million by 2025. At the same time, in low and middle income countries, over a fifth of children under five are affected by stunting due to poor diets. Often the same children are suffering from the double burden of malnutrition resulting in stunted due to poor diets followed by a higher propensity for obesity later in life.
The need for a coordinated response led to the WHO set up in 2014 the Commission on Ending Childhood Obesity.
This commission is sorely needed. According to a new six part series on obesity published by the Lancet, the global progress towards tackling obesity and its associated issues had been “unacceptably slow”, with only one in four countries implementing a policy on healthy eating by 2010.
According to Dr Lobstein from the World Obesity Federation and co-author of the series, "Undernutrition and overnutrition have many common drivers and solutions, so we need to see an integrated nutrition policy that tackles both these issues together to promote healthy growth for children."
In the drive to develop integrated health policies governments and international partners would be well set to look to the education sector, which has a long and successful track record in working collaboratively with sectors including health, agriculture, natural resources to develop school health and nutrition programmes focus on making children fit and able to learn.
School health and nutrition programmes provide the policies and skills based health education which will protect children as they grow up but also when combined with school feeding the means to deliver healthy nutritionally balanced food.
Skills for healthy living
Since 2003, Japan is one of the few countries to buck global trends and actually reduce year on year its obesity rates. This has been achieved by the government’s early adoption of food education in schools. Skill based education programmes such as the ones employed in Japan provide children with knowledge, attitudes and habits to live a healthy life is an incredibly effect means to cut down on obesity.
This skills-based health education is a core component of the globally recognised FRESH or Focusing Resources on Effective School Health framework which is used by Governments the world over to develop sustainable SHN programmes that work.
Balanced school meals
State of School Feeding, a World Food Programme publication written with the support of the Partnership for Child Development and the World Bank, found that virtually every country in the world provides school feeding at some level. This amounts to around 368 million children sitting down to a meal each school day.
This represents a prime opportunity to provide children with nutritious food and to educate them about the balanced diets. One such government-led movement which is seeking to do just that is Home Grown School Feeding. This seeks to provide school meals sourced from local smallholder providers. Rather than relying on imported heavily processed food this reconnects schools with a local and varied food basket.
This concept has been firmly adopted by the Ghana School Feeding Programme in which 1.6million of Ghana’s school children receive a hot nutritious meal made with ingredients grown locally. Instead of just filling the children up with carbs the programme is seeking to improve the nutritional intake of children through the use of an innovative online schools meals planner which enables caters to accurately calibrate the nutritional value of their cooked meals.
The initiative also encompasses community and school based skilled based education programmes to educate both school children and their families about healthy diets.
Using schools as a platform to tackle both under and over nutrition is even more effective when these programmes are integrated with WASH and deworming interventions.
Governments and their partners are increasingly taking on the nutritional crisis head on by using schools as a platform for the delivery of school health nutrition programmes. If that isn’t worth celebrating with a global day then I don’t know what is.
Francis Peel, Bachir Sarr and Meena Fernandes
Imperial College London - Partnership for Child Development
@HGSFglobal