key: cord-0828946-3qxnlewm
authors: Burkhart, Sarah; Singh, Pragya; Raneri, Jessica E.; Hayman, Ann; Katz, Sefano; Matairakula, Ulamila; Mackay, Clarissa; Horsey, Bridget; Underhill, Steven; Kama, Ateca; Maelaua, Josephine; Demei, Brynn; Mitchell, Arlene; Nyangmi, Mamta Gurung; Taawetia, Tebwaatoki; Tekatu, Tabera; Hunter, Danny
title: Growing our future: Introducing the Pacific School Food Network to support healthy school food and nutrition environments for better nourished children in the Pacific Islands
date: 2021-12-13
journal: Lancet Reg Health West Pac
DOI: 10.1016/j.lanwpc.2021.100338
sha: 6f96ebe3ad29837c4227de02013f3b9da02033df
doc_id: 828946
cord_uid: 3qxnlewm

nan

Food systems in the Pacific Islands (P.I.) are transitioning from local, traditional diets to those with low fruit and vegetable intake and largely based on ultra-processed foods that are often, but not always, imported. Alongside changes in diet and health outcomes, there is a loss of traditional and sociocultural dimensions of food, resulting in poor quality diets in many P.I. populations, including children. Besides high rates of overweight and obesity, in some areas stunting rates are up to 48.4%, 1 and prevalence of anaemia (5-14 years) as high as 45%. 2 After many years of limited multisectoral action and effort to enact sustainable change across policy and practice, there is growing interest in improving school food and nutrition environments (SFE) in the region.

SFE offer an entry point to reach children, parents, school staff and the wider community to improve food consumption behaviours and can include relevant policy and standards, provision of nutritious food in and near schools, nutrition education and complementary activities, for example integrated curriculum using school gardens for practical learning experiences. 3 A dearth of research and evidence, due to geographical location, constrained human, financial and physical resources, and lack of coordination, is a critical barrier to the development of regional policies and practice conducive to healthier SFE. 4 Where policies exist at a national or local level, they are not well monitored, often leading to poor compliance. 4−5 Additionally, limited standards are used to ensure that food provided in and near schools is nutritious and safe.

Schools can support nutritious food choice, through provision of healthy food in school meals and in canteens/ tuckshops. School feeding programmes, like those in Palau, Nauru and planned for Kiribati, act as a crucial social safety net, ensuring children have access to at least one nutritious meal a day, and incentivise attendance, especially for girls. Given global evidence of the impact of similar programs, 6 these could improve food intake and health, and enhance educational outcomes for generations to come. Expanding these programs could enhance social protection and support local livelihoods, by better linking school food provision from local smallholder farmers 7 as recommended in the Global Action Programme (GAP) for 

Food Security and Nutrition in Small Island Developing States (SIDS). 8 Currently, limited healthy food options are available within many schools, particularly in canteens/ tuckshops, while unhealthy foods are often directly marketed by vendors and readily accessible to students within and outside school grounds. 4 As nutrition transition continues in P.I, developing food literacy; the skills, knowledge and behaviours required for healthy food choice, 9 through well-developed and delivered, and contextually appropriate curriculum, can support children to navigate food environments as they grow and increase awareness of the link between nutrition and health. This may foster stronger connections between communities and food systems, through promotion of healthy, including organic, food production and preparation activities. This may assist with preservation of traditional elements. For example Vanua in Fiji is the land, sea, resources, people and spiritual connectedness, demonstrated through dependence on and sustainable use of natural resources with traditional knowledge for food security. Enhanced education, and engaging teaching tools such as school gardens can encourage youth to choose agriculture as a preferred profession, reducing rates of maritime/rural emigration.

While global evidence shows healthy SFE have a positive, multi-layered impact on children and their local communities, there is no evidence for what model would work best for the P.I. 4 The region's unique and often challenging contexts 4 mean no one school-based strategy is likely to significantly change the health of P.I. children − country context specific solutions are required.

Against this backdrop of limited capacity, coordination, effort, research and evidence, the Pacific School Food Network (PSFN) was formed (panel). Through a regional coordinated and multisectoral approach, the PSFN focuses on policy, practice, and action, and addresses recommended actions in the GAP 8 that aim to foster healthier school food environments. This will accelerate action on food and nutrition security, a key pillar of the SAMOA pathway. 8 The PSFN also supports P.I. on a key recommendation of the SIDS Summit for Health, held in June 2021, that member states implement appropriate policies and actions to create healthy, safe and sustainable food environments with a focus on healthy, safe and sustainable school food environments. 10 Further, the PSFN provides a regional platform for collaborative action in the aftermath of the UN Food Systems Summit, where improving school food is the focus of a new School Meals Coalition. The establishment of the PSFN is timely. We call on relevant government and agency staff, researchers, and school staff to consider joining the PSFN to help transform school food systems and the health and wellbeing of P.I children, now and for generations to come. The PSFN is growing with members from government, UN agencies, academia, and NGO's representing the areas/sectors of agriculture, biodiversity, education, health, natural resource management, school nutrition and sustainable development involved. However, while there is now a concerted effort to focus on this important area and an opportunity as we move on from the COVID-19 pandemic to transform food systems, there is still an urgent need to address a lack of awareness, capacity, operational budgets and other constraints that can currently limit the provision of healthy food options, and the need for standards to guide food production and provision in and near schools in our Pacific Islands region.

From our knowledge, the PSFN is the only cross-country regional mechanism in the Pacific specifically focused on the issue of school food and nutrition environments. We expect that the PSFN, partnering with and alongside ongoing relevant initiatives including on NCD and diets, will help define future entry points, identify research/evidence gaps and priority areas of future investment in our region. Members of the PSFN are planning a situational analysis to explore the current state and work of regional forums, and how we can best complement these. An outcome of this situational analysis will be a deeper understanding of all relevant regional forums/initiatives that pertain to the PSFN, and a decision on how we best collaborate/interact with these and coordinate this activity. 

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School nutrition education programmes in the Pacific Islands scoping review and capacity needs assessment -Final report. FAO

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