The Reality of School Nutrition Programs as Perceived by Teachers: A Case Study of Primary Schools in Khotang, Nepal

Background: The school environment is crucial in the formulation of healthy eating habits, promoting healthy action and nutrition education. School Health and Nutrition (SHN) Programs conducted globally have resulted in improved nutrition knowledge, attitude and behavior of students. Such programs aim to improve school attendance and nutrition outcomes mainly through food or cash transfer, depending on the situation. The Government of Nepal prioritizes SHNs for primary school students through the support of various national and international organizations. However, SHN Programs carried throughout the country are neither similar nor widespread. Nutrition education includes curriculum enhancement, parental involvement, hands-on activities, gardening and physical activities. In this regard, teachers may influence the feasibility of nutrition education and improve dietary behavior among students of poor households. Sustainable SHN Programs envision long term operation/functioning and local development by reducing external dependency with better program activities. The sustainability of such programs depends on parents' participation, resource availability and the conduction of various activities. Sustainability of the SHN Program is crucial not only to improve student's diet quality and academic performance, but also to enhance their physical and social functioning. Objective: Aim of this study is to assess teachers' perception towards different nutrition modalities implemented at four different primary schools in Khotang district of Nepal. Methodology: The study was conducted at four schools in Eastern Nepal running different SHN Programs. Data was collected from extensive Focus Group Discussion (FGD) with the school Principals, nutrition focal persons and other teachers at each school. A total of four FGDs were conducted in early months of 2022 with a total of 20 participants (teachers). The obtained data was analyzed qualitatively to gain an in-depth understanding of school nutrition modality in practice. Results: The surveyed schools followed their own nutrition modality based on their most suitability and effectiveness for implementation. Nutrition modalities, namely i) Home-based meal, ii) Direct parents' participation, iii) Government program and iv.) Catered-based programs were implemented in four different schools. Home based nutrition with direct parents' participation tends to reduce the need for extra financial resources. Cash and catering based mo