Abstract
Introduction: Childhood obesity is increasing in the Southeast Asian region, including in the nation of Brunei Darussalam. Within the public health focus on obesity prevention, specific settings, including primary schools, have been singled out as suitable sites for action. Recognizing that stakeholders are, in their various roles, producers of policy or implementers of practice, the purpose of this study in Brunei was to establish a baseline for interventions as well as to establish strengths and limitations in the current practice.
 Methods: Semi-structured interview with government and school community stakeholders was conducted, and transcriptions were thematically analyzed.
 Results: Three themes emerged from the data. The first theme was “children’s eating habits today = healthy adult population tomorrow;” many of the stakeholders believed that, if healthy eating is not practiced from an early stage, this can lead to the development of harmful diet-related diseases in the future. The second theme was “barriers to effectively addressing the issue of childhood obesity;” all were able to identify barriers such as workforce issues to address obesity prevention and health promotion activities. The third theme was “parental responsibility for children’s diet and physical activity habits.” The majority of respondents believed that parents are responsible for the rise in childhood obesity in Brunei.
 Conclusions: The widespread ethos of personal responsibility for health behaviors has resulted in policies having a heavy emphasis on individual health behavior management and blame for the problem being directed primarily at parents. This individualization of the problem of childhood obesity is a barrier to the planning and implementation of ecological interventions.
Highlights
Childhood obesity is increasing in the Southeast Asian region, including in the nation of Brunei Darussalam
Individual interviews were conducted with 17 stakeholders: 6 of these were from various health and education government agencies and 11 were school community members (5 principals and 6 teachers)
Stakeholder responsible for setting policy: Members of the section under the Ministry of Health (MOH) dealing with organizing the promotion of physical activity and healthy eating programs Government officer holding a senior position
Summary
Childhood obesity is increasing in the Southeast Asian region, including in the nation of Brunei Darussalam. Within the public health focus on obesity prevention, specific settings, including primary schools, have been singled out as suitable sites for action. Countries in the Southeast Asian (SEA) region, including Brunei, are recording an upward trajectory in childhood obesity rates [4]. Within the SEA region, the number of children who are obese had recorded an increase from 1.2 million in 1990 to 2.5 million in 2010 [5]. The prevalence of childhood obesity in the Brunei primary schools shows an increasing trend from 11.8% in 2005 to 17.3% in 2013 [6]. Without proper obesity prevention policies and programs, health problems caused by childhood obesity are likely to persist into adulthood [7]. The consequences of obesity are detrimental to the country’s economic development, not the least of which is the increased need to provide medical specialists and other hospital services [8,9]
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