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.

Breakfast Skipping, Weight, Cardiometabolic Risk, and Nutrition Quality in Children and Adolescents: A Systematic Review of Randomized Controlled and Intervention Longitudinal Trials

“…This division across all the studies suggests that well-rounded and prolonged efforts, involving educators, media, governments, policymakers, physicians, and peers, should be expected to have a significant impact on lifestyle habits. Economic discounts are useful but not enough, even where children from low-income families are concerned [ 48 , 49 ]. Furthermore, the wide variety of definitions of breakfast skipping could have affected the results of negative studies.…”

Leveraging water, sanitation and hygiene for nutrition in low‐ and middle‐income countries: A conceptual framework

“…It provides an encompassing view of all the pathways by which water and sanitation affect nutrition, highlighting the need to incorporate multilevel WASH measures in multisectoral nutrition planning and programming. Much like how the health and education sectors have important linkages to nutrition, improvements in WASH could accelerate nutrition gains in LMICs, while reducing disease more broadly (King et al, 2021;Xu et al, 2021). This framework brings together the various roles of policy makers, program implementors, engineers and researchers engaged in WASH and highlights gaps that need to be addressed to have a measurable effect on nutrition.…”

Assessing Parental Preferences Regarding a Plant-Based Game for Educating Children about More Sustainable and Healthier Diets

“…Low-and middle-income countries have a double burden characterized by the coexistence of undernutrition and overweight and obesity, which is more prevalent in high-income groups in urban areas [53]. The observed trend is worrying because a rapid transition is happening from underweight to overweight and obesity [53]; some authors have stated that the education sector is key in fighting against this rising problem [54]. Hence, one of the challenges of the future is to convince the governments of low-and middle-income countries to implement the most effective interventions regarding the environment and proper nutrition at school for children and adolescents.…”