Healthy food in school canteens, policy directions and deviations: A cross sectional study from Sri Lanka

Abstract

Introduction: Sri Lanka introduced school canteen guidelines in 2007 to promote healthy food choices and eating habits among school children. This initiative intended to combat malnutrition among school children through provision of nutritious, culturally acceptable food at affordable prices within the school premises. A formal assessment has not been done on the implementation of those guidelines for last seven years. The objective of this study was to assess the availability of healthy food items in school canteens and explore perceptions of providers on adherence to the guidelines. Materials and Methods: A cross sectional study was conducted in government schools in two districts. A mix methodology was employed. An observational check list was used to quantitatively assess the availability of healthy food items according to stipulated guidelines. This was followed by a qualitative inquiry to explore perceptions of school principals and canteen operators on adherence to the guidelines using in-depth interviews. Results: Only two out of ten food items encouraged in the guidelines were available in 50 % of the school canteens. In contrast, five out of nine items prohibited or discouraged were available in half of the canteens. Also 25% of canteens sold carbonated drinks that are totally prohibited. Differential understanding of healthy versus unhealthy, current food habits of students, present method of selecting canteen operators and other external factors contributed negatively. Conclusion: The rigor of implementation was sub optimal at present due to many reasons. Those obstacles can be addressed through coordinated efforts to transform canteen towards a nutrition promoting setting. Keywords: School health, Child and adolescent nutrition, Health promotion, Health policy, Food habits.