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Healthy Food Healthy Students: Healthy food choices for school food systems in peri-urban areas in Uganda

All children in Uganda learn about healthy eating in an enabling school environment that lays the foundation for healthy eating for life

Photo of Deborah Nabuuma
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Lead Applicant Organization Name

Alliance of Bioversity International and CIAT

Lead Applicant Organization Type

  • Researcher Institution

Website of Legally Registered Entity

https://www.bioversityinternational.org/

How long have you / your team been working on this Vision?

  • Under 1 year

Lead Applicant: In what city or town are you located?

Kampala

Lead Applicant: In what country are you located?

Uganda

Your Selected Place: what’s the name of the Place you’re developing a Vision for?

Government aided primary schools in peri-urban areas of Mukono and Wakiso districts that have a total area of 3,782 km2

What country is your selected Place located in?

Uganda

Describe your relationship to the place you’ve selected.

I was raised and currently live in Wakiso district, a peri-urban area near Kampala the capital city. Additionally, I have had the opportunity to work in peri-urban areas of the country like Mukono and Wakiso districts. These areas are close to the capital and are rapidly changing in population, culture and food environment. My training and experience in nutrition have illuminated by observations of the food environment in peri-urban areas. These include an increase in population and cost of living, an increase in the availability and access of a variety of foods as a result of trade of food produce from across the country. I have also witnessed an increase in availability, consumption and advertising of street food and highly processed foods, especially those high in sugar, salt and fats in the community and within the school environment

I would like to see the people in my community to be in a position to access and consume healthy diets. I have a particular interest in students because youth are the largest segment of the Ugandan population and are caught in between the changing food culture. They are consuming less of the local and indigenous foods that are nutritious and consuming more of the highly processed foods. Uganda has diverse cultures and customs with over 60 different ethnic groups. In the urban and peri-urban areas, the different cultures and way of living are integrating and this together with urbanisation has influenced the food consumption preference and patterns.

I believe various actors in the school food environment can be mobilised to ensure that students and the communities they come from having healthy food options and are aware and able to make healthy food choices.

Describe the People and Place: Provide information that would be helpful for an outsider who has never been there and may have no context about this Place to better understand the area.

The urban population of Uganda is growing with 9.4 million in 2017 (UBOS, 2019). This is attributed to gazetting of new urban areas, rural-urban migration and an increase in population. This is particularly pertinent to districts surrounding Kampala. For example, Wakiso district was the most populated district in 2014 with 1,997,418 people, followed by Kampala district at 1,507,080 people. Districts surrounding the capital continue to have both the urban and rural communities intersecting. In fact, Wakiso and Mukono districts were estimated to have urbanisation levels of 59% and 27% respectively (UBOS, 2016).

The majority of the population nationally (54%) and in peri-urban areas are below 18 years of age (UBOS, 2019). Employment is mainly in agriculture, construction, trade, and services other than trade. 73-76% of the population in the central region (excluding Kampala) are working (UBOS, 2017). The main crops produced in peri-urban areas include maize, sweet potatoes, bananas, cassava beans, groundnuts, soybean, fruit and vegetables. Livestock such as poultry, pigs, goats, and cattle are also reared in these areas (Ekesa et al., 2015).

Despite the wide variety of foods available in the central region, dietary diversity is low with 28-32% of households consuming less than five out of seven food groups (UBOS, 2017). Starchy staples like maize, bananas, sweet potatoes, cassava, and potatoes contribute 24-27% of the dietary energy consumption (UBOS, 2017). Indeed, malnutrition in this population has been reported, with 28% of children aged 6-59 months stunted, and 52-55% anaemic. Among those aged 6-24 months, only 13-20% consume minimum acceptable diets. Among adults, 10-14% and 28-32% of men and women respectively in the central region are anaemic while, 12-14% and 30-37% of men and women respectively are overweight or obese (UBOS and ICF, 2018).

The education system in Uganda is comprised of pre-primary education for children aged 3-5 years, seven years of primary education, four years of Ordinary Level secondary education, and two years of Advanced Level secondary education. This is followed by tertiary education of three to five years. Schools are either government or privately aided and can be day or boarding schools. There are 19,718 primary schools with 8.6 million pupils. Majority (61%) of the primary schools are government owned and located in the central region. On the other hand, there are 3,070 secondary schools of which 34% are government owned and 28% in peri-urban areas (MoES, 2017). 71-73% of people aged 6-24 years were in school in 2014 (UBOS, 2016). Wakiso district has a total of 717 primary schools with 209,257 students, and 110 secondary schools with 62,840 students. 34% of primary schools are government aided. Mukono district has 325 primary schools with 120,280 students, and 55 secondary schools with 35,620 students. 67% of primary schools are government aided (MoES, 2017). The school-going population spends 6-8 months in school a year.

What is the approximate size of your Place, in square kilometers? (New question, not required)

3782

What is the estimated population (current 2020) in your Place?

3226900

Challenges: Describe the current (2020) and the future (2050) challenges that your food system faces.

The responsibility of the current school food system lies on the guardian of the child. The system is informed by the national school feeding guidelines, which give guidance on the aspects of food procurement, contribution by the guardian, food storage, food hygiene, food preparation, and school gardening (OES, 2015). However, the implementation and monitoring of adherence are limited. Schools are resource- and capacity-constrained, affecting the facilities, quantity, quality and safety of meals, which leads to three major challenges.

First, lack of awareness and knowledge on the role of healthy diets of the school administration. Diets within schools (where provided) are very monotonous, consisting mainly of maize and beans with limited consumption of fruit and vegetables. The diets lack sufficient protein, minerals and vitamin (Najjumba et al., 2013; OES, 2015; UBOS, 2016). Food handling, preparation, cooking and hygiene practices are very limited, due to inadequate kitchen structures, storage facilities, and sanitation practices.

Second, low capacity/awareness of healthy diets and appropriate food choices within children creates challenges. Children who are not informed will make poor food choices. For example, in several schools (mostly secondary schools) food vendors provide various foods and snacks during mid-morning break and lunch break. The foods sold to the students are increasingly highly processed foods such as various wheat products like bread and biscuits, soft drinks, natural and artificial juices, sweets and confectioneries or deep-fried cassava, bananas, potatoes, and maize (Najjumba et al., 2013). The foods bought by the students largely depend on what is available at home, the amount of money they have, and their tastes and preferences. In addition, there is a limited linkage between the vendors and schools, implying no quality or safety control measures and reinforced.

Third, the financial capacity of schools to support the school food system largely depends on the financial capacity and awareness of the guardian. Some guardians themselves are constrained by limited food and income, given the fact that 10 million (21.4%) people in Uganda live below the poverty line and 40% are considered as food poor households in rural areas (UBOS, 2016). Sixty-five percent of the school dropouts are due to cost-related issues. In addition, instability in payments/ contributions to the schools affects the planning and purchase of food, the capacity of schools to link with farmers, as well as the ability to handle price fluctuations of agricultural produce (UBOS, 2016). Whereas others refuse to contribute to the school food due to the perception that the government should pay for school meals in government aided schools.

 Furthermore, through the increase in population in peri-urban areas, schools are facing the challenge of higher numbers of students (UBOS, 2016). The current and future challenge is to create ownership and mobilisation of all actors within the food systems environment in schools to consistently and sustainably provide school meals of adequate quantity, quality, safety, and diversity.

Address the Challenges: Describe how your Vision will address the challenges described in the previous question.

The envisioned school food system in peri-urban areas is one where the school food environment offers healthy food options for students and where students make healthy food choices. The vision will seek to:

1. Assess the current school food system in government aided primary schools for gaps and opportunities to improve quantity, quality, safety, and diversity of food through: (a) desk review, (b) focus group discussions and key informant interviews, (c) stakeholder mapping, and (d) participatory review of school meals and foods sold to assess their status and potential of schools to provide balanced and diverse diets. This will involve school staff, parent-teacher associations, student representatives, and food processors and/or vendors.

2. Create awareness of the importance of nutrition, school feeding and traditional and indigenous foods especially nutritious, under-utilised foods, and biofortified foods through development and implementation of a school nutrition social behaviour change communication strategy that engages students, school administration, teachers, parents/ guardians, and food processors and/or vendors, using media and interactive avenues like food role models or champions, school clubs, and food fairs.

3. Increase diversity and quality of school meals served through facilitated production of plant protein source foods, fruits and vegetables within schools and participatory enrichment of school meals. This will involve tailored capacity building exercises and workshops and establishing feasibility and acceptability of meals.

4. Increase availability of affordable, acceptable, safe and nutritious snacks and foods sold within schools through a) modification to produce affordable, acceptable, safe and nutritious snacks and foods and incorporate nutritious and under-utilised foods and biofortified foods, and b) reduction of the sell and promotion of foods high in sugar and salt within schools through advocacy and policy development or enforcement.

5. Promotion of nutritious school meals and snacks and foods sold within schools and dissemination of actions that ensure good nutrition and healthy food choices. The school nutrition social behaviour change communication strategy will also be used to target school staff, parents, students, and food processors and/or vendors, policymakers, and local leaders.

7. Ensure a safe food environment in schools through a) development and/or enhancement and implementation of school food policies that promote quality and safety of food purchased and prepared by schools and foods sold within schools, and food waste management, b) improvement of facilities and adoption of methods that support food quality, food safety, clean water and adequate and sustainable food waste management, and c) awareness creation of food quality, food safety and food waste management using social behaviour change communication methods.

High Level Vision: With these challenges addressed, now provide a high level description of how the Place and the lives of its People will be different than they are now.

The envisioned school food system will have students, school administration and teachers with sufficient access to balanced meals and diverse foods, increased consumption of micro-nutrients due to focus on animal and plant protein source foods, fruits, and vegetables as part of the school meals and foods sold within schools.

The vision is for students aged 6 to 12 years, to be empowered to make healthy food choices now and for the rest of their lives, igniting a sustained behaviour change toward healthier food choices for Ugandans. Changes in food preferences and consumption patterns will extend to school staff and guardians. Surrounding communities including women and youth will also benefit from availability of affordable, acceptable, safe and nutritious snacks and foods as processors/ retailers and consumers of nutritious snacks and foods. Guardians especially smallholder farmers will have increased capacity in production as they work to produce nutritious foods for the schools. The school food system will enhance agrobiodiversity in the communities due to utilisation of nutritious and under-utilised food by the schools.

The school food system will have guardians and schools playing the central role in providing balanced and diverse school meal choices for students. With increased access and consumption of these foods within schools, the businesses of the food processors or retailers, many of whom are locals from surrounding communities, will be supported. Schools will prioritise processors and retailers that provide affordable, tasty nutritious snacks and foods.

Following efforts that ensure a safe food environment, the envisioned school food system will have schools that have functioning food policies with clear, sustainable and eco-friendly actions to ensure adequate food quality, food safety and food waste management.

Full Vision: How do you describe your Vision for a regenerative and nourishing food future for your Place and People for 2050?

The regenerative and nourishing food future envisioned for schools in peri-urban areas of Uganda is one where the school food environment offers healthy food options for students and where students make healthy food choices. The vision seeks to: 1) Assess current school food system in government aided primary schools for gaps and opportunities to improve the quantity, quality, safety, and diversity of food available. 2) Create awareness of the importance of nutrition, school feeding, and traditional and indigenous foods especially nutritious, under-utilised foods, and biofortified foods. 3) Increase diversity and quality of school meals served to the students. 4) Increase availability of affordable, acceptable, safe and nutritious snacks and foods sold within schools. 5) Promotion of nutritious school meals and affordable, acceptable, safe and nutritious snacks and foods sold within schools and dissemination of actions that ensure good nutrition and healthy food choices. 6) Ensure a safe food environment in schools.

Objective 1. Assessment of current school food systems for gaps and opportunities to improve the quantity, quality, safety, and diversity of food available will include (a) desk review, (b) focus group discussions, key informant interviews, (c) stakeholder mapping, and (d) participatory review of school meals and foods sold to assess status and potential of schools to provide balanced and diverse diets. The participatory review will be conducted in selected schools that are willing to participate and have land or areas that can support agriculture. It will involve school staff, parent-teacher associations, student representatives, and food processors and/or vendors to i) identify nutritious foods that can be incorporated in school meals to sustainably achieve diverse and balanced diets, and ii) assess the quality and safety snacks and foods sold and identify those that can be improved.

Objective 2. Create awareness of the importance of nutrition, school feeding, and traditional and indigenous foods especially nutritious, under-utilised foods, and biofortified foods. It will involve development and implementation of a school nutrition social behaviour change communication strategy. Various learning and practice approaches will be explored like healthy food role models, school clubs, food fairs, competitions and awards and media like leaflets, circulars, posters, and radio. The strategy will engage students, school staff, guardians, food processors and/or vendors, and other actors.

Awareness creation will increase demand for nutritious school meals and snacks, reduce consumption of foods high in sugar and salt, support cultural and agrobiodiversity and strengthen community linkages.

Objective 3. Increasing diversity and quality of school meals served to students through facilitated production of nutritious foods and enrichment of school meals. A) Given limited land in peri-urban areas, urban farming techniques will be used to increase availability of the plant protein source foods, fruits and vegetables. For example, fruit trees and vegetable gardens planted around schools require limited management. Guardians will be mobilised to manage production of the foods. The presence of these crops on school property will provide a learning avenue for students and emphasise their importance. B) Identification and linkage of producers and suppliers of foods identified to enrich school meals that cannot be produced by the schools especially animal source foods, supplied by traders and farmers/ farmer groups within the districts and neighbouring areas. Farmer groups that include women and youth producing various protein source foods, fruits and vegetables will be of interest. C) Participatory enrichment of school meals to provide balanced and diverse diets by including animal and plant protein sourced foods, fruits and vegetables. Enriched school meals will cater to the nutrient needs of students, consider cost of meals including time and labour, food preferences and acceptability, and incorporate nutritious and under-utilised foods. This will involve capacity building of actors’ workshops and establishing feasibility and acceptability of meals.

As a result, the school food system envisioned in 2050 will have guardians and schools playing a central role in providing balanced and diverse school meals options. Schools will coordinate with guardians, students, policymakers, food suppliers and traders to ensure consistent and sustainable availability of balanced and diverse school meals. Guardians and school administration will be part of the development process and own the envisioned school food system thus promoting its sustainability. Actors in the food system will be equipped to adapt to general changes in food availability, such as price fluctuations, climate change, pest & diseases, etc thus supporting its adaptability.

The school food system will utilise a wide range of nutritious foods available across different agricultural seasons. Uganda has a great diversity of plants and animals with an estimated 1,400 indigenous plant species (NEMA, 2016) and two seasons a year. Inclusion of diverse nutrient-dense and under-utilised foods and biofortified foods available in communities will ensure school meals are continually balanced and diverse. For example, having a variety of fruit trees in the school increases availability and access of fruits in different seasons and has ecological importance (Kehlenbeck et al., 2013). The community including women and youth will be engaged as producers and traders of the food consumed by the schools.

Objective 4. Increasing the availability of affordable, acceptable, safe and nutritious snacks and foods sold within schools through: A) Facilitated modification of snacks and foods sold within schools that focuses on production of affordable, acceptable, safe and nutritious snacks and foods and incorporation of nutritious and under-utilised foods and biofortified foods available in communities. This will involve capacity building workshops with food processors and/or vendors and school actors, establishing feasibility and acceptability of modified snacks and foods, and their sell in schools. B) Reduction of sell and promotion of foods high in sugar and salt within schools. Through advocacy and policy development or enforcement of existing policies, schools will be equipped on securing a nutritious food environment by limiting the consumption, sale, and promotion of foods high in sugar and salt.

With increased access and consumption of affordable, acceptable, safe and nutritious snacks and foods sold within schools, the capacity and business of food processors or vendors will increase. Several snacks are currently locally produced in surrounding communities therefore, demand for nutritious snacks in schools and involvement of local food processors will directly benefit these communities. The demand for and consumption of nutritious snacks by school staff and students will also act as a catalyst for their demand outside schools.

Schools will have several healthy food options available for students and staff in addition to the balanced and diverse school meals thus contributing to their nutrient needs, both macro- and micro-nutrients.

Objective 5. Promotion of nutritious school meals and affordable, acceptable, safe and nutritious snacks and foods sold and dissemination of actions that ensure good nutrition and healthy food choices. The developed school nutrition social behaviour change communication strategy will be used to promote the modified school meals, nutritious snacks and foods and good nutrition and healthy food choice actions. School staff, guardians, students, and food vendors, policymakers, local leaders, and food processors will be involved. In addition to media, interactive avenues like food fairs, competitions, sales, and cooking classes will be used. This will increase consumption of the modified school meals and purchase of nutritious snacks and foods and reduce purchase of foods high in sugar and salt.

Objective 6. Ensuring a safe food environment in schools will involve: A) Development and/or enhancement and implementation of school food policies that promote the quality and safety of food purchased and prepared by the school and of food sold within, and food waste management. Various stakeholders such as guardians, students, policymakers, food suppliers, waste management actors will be involved. A review of school food policies and their implementation (if present) and development or enhancement of school food policies will be conducted. Reference will be made to national food policies and regulations, school feeding guidelines and respective school contexts. B) Awareness creation about food quality, food safety and food waste management using social behaviour change communication methods. C) Improvement of facilities and adoption of methods that support food quality, food safety, clean water and adequate and sustainable food waste management. This will include food storage, preparation, and serving facilities, water facilities and waste management processes and facilities. Sustainable and eco-friendly methods and facilities will be of focus.

Following efforts that ensure a safe food environment, the envisioned school food system will have schools with functioning food policies with clear, sustainable and eco-friendly actions to ensure adequate food quality, safety and waste management. These actions require involvement of all actors.

Awareness of the importance of and adherence to food quality and safety will increase the confidence that consumers (primarily students, school staff, and guardians) have in food suppliers, processors and retailers. This will serve to increase the consumption of food and snacks within the school and snacks in the community that are produced and/or sold by reliable parties.

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