TY - JOUR
T1 - Integrating nutrition into the education sector in low- and middle-income countries
T2 - A framework for a win–win collaboration
AU - Xu, Yvonne Yiru
AU - Sawadogo-Lewis, Talata
AU - King, Shannon E.
AU - Mitchell, Arlene
AU - Roberton, Timothy
N1 - Funding Information:
We thank Global Affairs Canada who funds the Real Accountability: Data Analysis for Results project (Johns Hopkins University grant 90067950) under which this work was undertaken. We also thank Tricia Aung for her feedback on a draft version of this manuscript, Laura Caulfield for reviewing the conceptual framework, and Eleonor Zavala for the consistent support throughout the literature review and framework development process.
Publisher Copyright:
© 2021 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.
PY - 2021/7
Y1 - 2021/7
N2 - 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.
AB - 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.
KW - conceptual frameworks
KW - education
KW - low- and middle-income
KW - nutrition
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U2 - 10.1111/mcn.13156
DO - 10.1111/mcn.13156
M3 - Article
C2 - 33590645
AN - SCOPUS:85100893156
SN - 1740-8695
VL - 17
JO - Maternal and Child Nutrition
JF - Maternal and Child Nutrition
IS - 3
M1 - e13156
ER -