Assessment of Preschool Preparedness Intervention Package on Adoption of Nutrition Friendly School Initiative in Rural Sindh, Pakistan: An Exploratory Sequential Mixed Method Design

Abstract

Background Early years of life are crucial for growth and development; any adverse events (such as nutrition deficiencies) during this period significantly influence children’s life-course developmental trajectories to maturity. In 1995, the World Health Organization launched its Global School Health Initiative with the aim of expanding the Health Promoting School (HPS) approach globally. Therefore the primary objective of this study is to assess the preschool preparedness intervention package in adoption of Nutrition Friendly School Initiative. Methodology: An exploratory sequential mixed method study design was carried out in three campuses of Aga Khan School (Mirpur Sakro, Junior Campus Vur, community-based school Sujawal) in the Sindh province of Pakistan. Study participants (children & parents) were selected using purposive sampling. Data collection includes in-depth interviews with the school community, pre & post assessment of knowledge of parents, baseline and end-line nutrition status of preschool children of age 24-59 months and beyond, and baseline & end line assessment of Preschool preparedness using checklist Results/outcomes: The qualitative findings has informed additional measures (setting up nutrition theme corner, including parenting package in manual, aligning school nutrition policy with school handbook, launch of special campaign for engagement and awareness purpose with parents) that were adapted within the intervention package. Preschool preparedness also improved from 10 points to 22 points out of 26 indicators (with some indicators labeled at not applicable). The knowledge of parents on nutrition and health promoting manual has been enhanced with mean improvement of 7.17 points (out of 25 points). Also the mean increase in MUAC, height and weight of preschool children are 0.27cm, 0.6cm and 0.26kg respectively. Discussion and conclusion: This initiative has improved preschools preparedness in creating an enabling environment in addressing health and nutritional problems within and beyond the classroom. Program implementers should not ignore this nexus of health, nutrition, and early child development by utilizing school platforms to improve the nutrition status and prevent all forms of malnutrition. Policy takeaway include initiating a school accreditation program to certify schools as Nutrition friendly and utilized the developed school nutrition policy developed to feed the development of National Nutrition Friendly school policy