nutrition-friendly schools initiative (nfsi) · 12/7/2010 · 4 child and adolescent nutrition is...
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Nutrition-Friendly Schools Initiative
(NFSI)
A school-based programme to address
the double burden of malnutrition
Department of Nutrition for Health and Development
Originally developed as a follow-up to the
WHO Expert Meeting on Childhood Obesity in Kobe (2005)
� effectively addressing the increasing global public health problem of the
double burden of malnutrition requires common policy options
� school-based programmes offer opportunities to gain access to children
and promote healthy dietary and physical activity patters for children
Nutrition-Friendly Schools Initiative
A brainstorming meeting in Montreux, February 2006
among partners (EDC, FAO, SCN, WFP and WHO)
� reviewed ongoing school-based health and nutrition-related programmes
� reviewed evidence base
� developed the NFSI framework
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1. Provide a framework for school-based programmes which
address the double burden of nutrition-related ill health
2. Serve as a mechanism for inter-connecting on-going
school-based programmes
Objectives
Surveillance
Nutrition and HIV/AIDS
Advocacy
Partnership development
Hygiene and food safety
Food security
Obesity & diet-related NCDs
Undernutrition
Vitamin and mineral deficiency
Healthy lifestyle
NFSI is designed to
address all aspects of malnutrition according to
country situation
NFSI is addressing
underlying factors through multiple strategies that are part of multisectoral food and nutrition action plans
NFSI, a school-based initiative with potential to address the double-burden of nutrition problems throughout the lifecourse
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Expected outcomes
To increase the number of schools that:
1. Provide an enabling environment for promoting health
and nutritional well-being of children and in turn
contribute to their improved learning and academic
achievements
2. Have close links with parents, local community and health
services in order to promote health and nutritional well-
being of children
3. Are accredited Nutrition-Friendly Schools
Why should schools care for nutrition?
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Child and adolescent nutrition is at a crossway in the lifecourse – nutritional well-being is crucial for
- Maximising their own intellectual potential and school performance
- Preventing the development of malnutrition in all its forms (i.e. undernutrition, micronutrient
malnutrition, obesity and diet-related NCDs)
- Securing the health of future generations through ensuring nutrition of adolescent girls
Child
malnutrition
Adolescent malnutrition
Fetal & infant
malnutrition
Elderly
malnutrition
Adult
malnutrition
Pregnancy
Low weight gain
Higher maternal
mortality
Reduced capacity for care
RapidRapid
growthgrowth
Inappropriate food, health & care
Inadequatecatch up growth
Impaired mentaldevelopment
Higher mortality rateInappropriate feeding practices
Frequent infections
Inappropriate food, health & care (including untimely/inappropriate
complementary feeding)
Societal and
environmental
factors
Inadequatefetal
nutrition
Source: Darnton-Hill, Nishida & James, 2002 (adapted)
Low birth weight & compromised body compositionLifecourse:
causal links
Reduced intellectual potential & reduced school performance
Inappropriate food, health & care
Inappropriate food, health & care
Reduced intellectual potential & reduced school performance
ObesityAbdominal
obesity
Diabetes,
CVD
Advantages of the school setting
• School settings offer many opportunities to promote healthy diet and physical activity habits for children
• Schools act as access points for engaging parents and community members in the prevention of diseases associated with poor child nutrition
• Healthy nutrition and sufficient physical activity improves child well-being and learning ability, leading to better academic performance
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Concept and principles
NFSI builds on the WHO/UNICEF Baby-friendly Hospital Initiative (BHFI)
Global Award Global Award Global Award Global Award PlaquePlaquePlaquePlaque
A school will be accredited as
Nutrition-Friendly Schools
when fulfilling
26 essential criteria identified in
5 core components of the NFSI
framework
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NFSI core components
1. Having a written Nutrition-Friendly Schools policy
2. Enhancing awareness and capacity building of
the school community
3. Developing a nutrition and health-promoting
school curriculum
4. Creating a supportive school environment
5. Providing supportive school nutrition and health
services
(5)
(3)
(4)
(11)
(3)
1. Having a written Nutrition-Friendly Schools policy
Essential criteria:
1. Written “Nutrition-Friendly Schools” policy that
addresses all five key components, and includes:
2. Rationale that covers healthy diet and eating practices,
physical activity, prevention of all forms of malnutrition,
and contributory factors
3. Objectives with timelines and clear milestones.
4. Action plan that takes a "whole school" approach and
describes processes, organizational structure, roles
and responsibilities, rights/ equity/ non-discrimination,
and a strong commitment by all concerned
stakeholders, including family and community.
5. Monitoring and evaluation plan for the school policy.
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2. Enhancing awareness and capacity building
of the school community
Essential criteria:
1. Dissemination of the “Nutrition-Friendly Schools” Policy.
2. Activities for families and community, community
involvement and outreach in the area of nutrition and
health related issues.
3. School staff training in nutrition and health related
issues.
3. Developing a nutrition and health-promoting
school curriculum
Essential criteria:
1. Culturally appropriate and effective nutrition education.
2. Age, sex and culturally appropriate physical education
curriculum.
3. Healthy living and life-skills education curriculum.
4. Regular monitoring of school curriculum relevant to the
NFSI, and evaluation of the impact of the education
against the objectives.
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4. Creating a supportive school environment
Essential criteria:
1. School meals, food vendors, snack bars promote healthy eating
2. Positive messaging towards nutrition and physical activity
3. Absence of marketing of unhealthy foods and beverages
4. Access to an adequate eating place
5. Adequate school cooking facilities.
6. Access to safe drinking water.
7. Promotion of safe hygiene and sanitary behaviour.
8. Availability of clean and separate toilets, for boys and girls.
9. Opportunity to access space and school sporting facilities
10. Affirmative action against bullying, stigmatization, discrimination.
11. School staff as role-models in encouraging healthy eating, physical activity and a healthy lifestyle.
5. Providing supportive school nutrition and health
services
Essential criteria:
1. Regular monitoring of children’s growth development.
2. Effective feedback system for parents and children of
findings of the regular monitoring.
3. A supportive school health service, including a referral
system.
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How to implement the NFSI?
Establish NFSI National Coordinating Committee
Country level implementation
Identify existing programmes and tools relevant to NFSI
Form NFSI National Designation Authority
Develop a NFSI dissemination plan
Coordinate and perform external school assessments and designations
Step 1:
Step 2:
Step 3:
Step 4:
Step 5:
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Form a Core Action Group
Implementation in schools
Conduct 1st Self-Appraisal
Develop School Action Plan
Report results of 1st appraisal to NFSI-NCC
Implement School Action Plan
Conduct 2nd Self-Appraisal
Request NFSI-NCC for external assessment
After 2 years, request external assessment
Maintain NFSI accreditation
Global Award
Plaque
Certificate of
commitment
Step 1:
Step 2:
Step 3:
Step 4:
Step 5:
Step 6:
Step 7:
Step 9:
Step 10:
AccreditationStep 8:
Progress to date
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Brazil Hungary
Canada India
Croatia Italy
Denmark Latvia
Finland Lithuania
Georgia Slovenia
Greece Switzerland
Grenada Uganda
Countries undertaken pilot-testing
of NFSI framework
Developments in EURO
• Capacity building workshop in Durham University
March 2009
• An official Member States Action Network on NFSI
was launched in March 2010
• First meeting was held 10 November 2010
• After finalization of the NFSI Modules (early 2011),
WHO EURO will scale up implementation and follow
up of NFSI
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Developments in EMRO
• NFSI utilised as a tool to implement the WHO Global
Strategy on Diet, Physical Activity and Health
• United Arab Emirates has taken the lead in the region,
requested and held series of advocacy and information
meetings plus a national workshop 29 Nov - 2 Dec
2010
How does NFSI link to other
school health initiatives?
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Nutrition-Friendly Schools Initiative
4 basic components
1. Health-related school policies 2. W&S, healthyschool environment3. Skills-based health
education 4. Health and nutrition services
3 strategies:1. Partnerships between teachers and health workers2. Community
partnerships3. Pupil participation
Improve learning outcomes through
health
2000
UNESCO, UNICEF, WHO, World Bank ,others
FRESH (Focusing Resources on Effective School Health)
Content
Goal
Year
Partners
5 key components with
22 essential criteria regarding nutrition-friendly schools policy, awareness and capacity building of the school
community, nutrition and health-promoting school curriculum, supportive school environment, and
school nutrition and health services
12 cost-effective
interventions to improve the health and nutrition of school-age children, including basic
education, food for education, W&S, health education, deworming, MN
supplementation, etc.
13 characteristic:
1. Children's rights2. Whole child3. Child centered4. Gender-sensitive5. Quality learning
6. Reality education7. Flexibility, diversity8. Inclusion 9. Mental and
physical health10. Affordable and accessible11. Teacher capacity12. Family focused
13. Community based
6 strategies regarding
1. Engagement of staff, students, parents and communities2. Safe and healthy environment
3. Skills-based health education4. Health services 5. Health-promoting
policies and practices6. Focus on community health concerns
Address the double burden of nutrition-
related ill health
Improve learning through health (focus
on undernutrition)
Rights-based, quality basic education in a
healthy environment
Health promotion according to context
200620021995 1995
EDC, FAO, SCN ,UNESCO, UNICEF, World Bank, WFP,WHO, others
UNICEF-WFPUNICEFWHO
NFSIEssential package (EP)
Child-Friendly Schools (CFS)
Health-Promoting Schools (HPS)
• psycho-social support
• Skills-based health/nutrition education
• Tri-partite
3. Strategies
• Nutrition education
• Health education
• School feeding/nutrition services
• Health and nutrition interventions*
• Healthy and secure school buildings and grounds
• Sanitation
• Water
• School policies
2. Core Components
• rights
• learning/education
• nutrition
• health
1. Main focus
NFSIEPCFSHPSFRESH
none / negligible
little
some
considerably
primarily / predominantly* Deworming; supplementation, screening)
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NFSI addresses all forms of malnutrition
What is specific to NFSI?
NFSI uses a global standardized evaluation and accreditation scheme
NFSI has a strong focus on developing supportive school environment which promotes nutritional well-being and
physical activity
Thank you!
For further information, please contact: NFSI@who.int
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