School characteristics
All six schools reached out to agreed to participate in this study. Two schools were found in an area with high socioeconomic status. Two of them were at the top level, while the other two were at a moderate level. In Jakarta’s low socioeconomic areas, there is no school. The school had between 111 and 541 students. The schools generally had one teacher who was trained in nutrition and education. This was usually either the PE teacher, or the teacher responsible for the school’s health post. Two schools in the moderate socioeconomic level (SES) have one teacher who is trained in nutrition education and health education. However, one of the two schools in the very high and very low SES has such a teacher. Two of the four schools in this study shared canteens, sports fields, and buildings with other schools. Another school shared the area with an orphanage. Table1These are the characteristics of the schools.
Access to and availability of food
Table 2Based on components 2 and 3, the PSEA tool shows the food availability and access of each school. All schools have a school cafeteria within their school premises. It is open during school operating hours. There were no guidelines for healthy canteens in any of the schools. All canteens offered a breakfast menu. The most popular foods were rice-based meals like fried rice, coconut, turmeric rice, instant noodles/vermicellis, sweet breads/buns and spaghetti. One school canteen served vegetable soup. All schools had students who loved sugar-sweetened beverages and instant (sachet), drink options.
Nearly all canteens offered fruits and vegetables. All schools had canteen staff who noted that fruits and vegetables were not very popular with students. A private school’s canteen did not offer healthy meals because they thought no one would buy them. Two canteens from the four public schools were asked about healthy diet promotion. They said that they offer a healthy meal on a special menu that is available occasionally. Two private schools could not promote a healthy diet. Two schools with moderate SES areas admitted to promoting healthy meals on a daily basis, while the schools with higher SES levels only occasionally or never received promotion.
Every day there are vegetables, such as beans sprouts, mustard greens, tofu and sometimes spinach. The favorite meal of the children is crispy chicken
Canteen staff (school 5).
Staff at the canteen deemed healthy food to be those that are low in sugar and salt but still loved by children. This would be difficult, as children love sweet and savory food. We found that sugar-sweetened beverages were extremely popular, as well as fried foods.
Take into account that the snacks sold at the canteen must be healthy. They must not contain too much sugar or salt. Children love them. However, they should also consider the spices and the containers.
Canteen staff (school 6).
This study reports the food prices in US dollars and cents. Rice-based meals are usually less expensive than one dollar. However, snacks (e.g. chips, crackers and variety of deep-fried snacks like sweets and chocolate) cost even less (15 cents). Fruit costs about 7 cents. Juices with added sugar cost more (approximately 70%). The 600mL bottled mineral water costs just 15 cents. Instant drinks and sugar-sweetened drinks cost approximately 20 cents.
Regular inspections of school canteens by local public health centres (Puskesmas), were done regularly. Some (2/6) were also checked by the Indonesian Food and Drug Agency. Inspections also included street food vendors from the immediate vicinity. All canteen staff believed that routine inspections by the Puskesmas were sufficient to maintain the hygiene of the canteen. As their primary concern was food hygiene and cleanliness, none of the inspections noticed any food variation or nutrition quality. In some schools, catering services from outside sources were an option (3/6), especially in private schools. These services were usually organized and managed by parents or a former teacher. The students were charged an additional fee for the use of this external food source. The catering service provided a complete meal box that included rice, meat/chicken as well as vegetables, fruits, and dessert (e.g., icecream/probiotic drinks).
Nearly all schools had easy accessibility to street vendors. One school was the only one that did not have street vendors access because it is located in narrow alleys, which restricted vendors’ access to schools. Most schools (5/6) didn’t have strict regulations that prohibited students from buying food from street vendors. However, one private school banned students from eating street vendors.
We don’t know if the food outside the school is safe or not. “We only know what the food is inside the fence.
The most common street vendors’ foods were deep-fried foods and ice cream. These foods were also cheaper than food sold in schools canteens. Street vendors often sell food on bicycles or in carts, so they are easily accessible and can avoid inspection by authorities.
Healthy eating and school policies
This document presents school policies and the environment for healthy eating. Table 3Based on components 4-8 of the PSEA tool. All school heads claimed to have a written policy which promotes healthy eating to students. This policy mainly included healthy eating topics in the national school curriculum such as in a natural sciences lesson. Two public schools and one private school had an additional program. These included a weekly fruit day, weekly healthy breakfast, and sharing breakfast with all students and teachers. Some schools (3/6) also claimed that they could regulate the types of food that were allowed in the canteens or in students’ lunch boxes, and gave information about healthy food. The messages were relayed by teachers to the class through announcements. However, most schools admit that they don’t strictly monitor the implementation.
The number of students bringing a lunch box from home was used by the PE teachers and headmasters to determine the effectiveness of the nutrition policy. Five schools claimed that the policy was effective. One headmaster of a public school admitted that the regulations were not effective because the canteen is often full with parents who wait for their kids. Therefore, the children eat street food. He stated however that the schools had already made plans to implement a new strategy for the next school year.
“The next school year, children will have to bring food home. They learn to be calm and clean, and they won’t want to eat from street vendors as often.”
The headmasters of the four public schools in the moderate and high SES areas claimed that they place a high or very high importance on healthy eating. These priorities were evident in the presence of healthy diet posters throughout the school and the implementation at certain events of healthy eating habits. In collaboration with the local health center, two other schools also offered health education. Both schools were in a high-sector area and assumed that healthy eating was not a priority.
All PE teachers and headmasters viewed teachers as role models in healthy eating for students. Teachers would often bring their own lunchbox, choose healthier food from the canteen menu, encourage students to have healthy lunchboxes, and remind them not to buy food from street vendors. They also agreed that parents are important in promoting healthy eating and were supportive of students bringing lunch from home.
Environment and policy on physical activities
PE was included in the national school curriculum as a compulsory subject. Only two schools (1 private and 1 public) had a written regulation on physical activity.Table 3). The duration of physical education in public schools was much longer than that in private schools. All schools had a sports field and provided equipment for students. Some schools (2/6) recognized that students needed a field because the schools are located in an area with many cars passing by.
The play area outside of the school or building is very poor because it is full traders selling.
They encouraged students to take part in physical and sports competitions. One school encouraged its students to use bikes or walk to school. All PE teachers stated that the school’s policy on physical activity was effective. This was demonstrated by students walking from their homes to school and receiving awards in competitions. Five schools rated their PE teachers as a role model for physical activity through their involvement in students’ physical activities. One private school held monthly events for teacher-student physical activities.