An Assessment of the Implementation of Guidelines in ... Nutritional Status of Students and...

A Joint Publication by the Institute of Policy Studies of Sri Lankaand the Ministry of Education Services

An Assessment of the Implementation of GuidelinesAn Assessment of the Implementation of GuidelinesAn Assessment of the Implementation of GuidelinesAn Assessment of the Implementation of GuidelinesAn Assessment of the Implementation of Guidelinesin School Canteensin School Canteensin School Canteensin School Canteensin School Canteens

MANUJ C WEERASINGHESAMANTHI BANDARA

MUNSIF SANOON

A Case Study from the Western Province of Sri Lanka

An Assessment of the Implementation of Guidelines in School Canteens

ii

LIST OF TABLES IILIST OF FIGURES IILIST OF ABBREVIATIONS IIIACKNOWLEDGEMENTS IVEXECUTIVE SUMMARY V

1. Introduction 01

1.1 Background 011.2 Objectives of the Study 02

2. Methodology 022.1 Study Setting 022.2 Data Collecting Methods 03

3. Results 043.1 Main Canteen 053.2 Unhealthy Advertisements 153.3 Availability of H800 Form for Ranking of Food Establishments 15

4. Perceptions on Implementation of School Canteen Guideline 164.1 Nutritional Status of Students and Education 164.2 Guidelines on Bringing Food to Schools by Students 164.3 Awareness on School Canteen Guidelines 174.4 Food Habits and Guidelines 174.5 Feasibility of Operating School Canteen According to the Guidelines 184.6 Present System of Selecting Canteen Operators 194.7 Future of School Canteens 19

5. Discussion and Conclusions 205.1 Directive for Healthy Canteen 205.2 Facilities in the Schools to Operate a Canteen 215.3 Food Items and Food Behaviour 225.4 Prices of Selected Food Items 235.5 Food Stalls Located in Close Proximity to the School 235.6 Suggestions 24

References 25

Annexures 26

Table of Contents

ii


List of Tables

Table 2. 1 - Selection of Schools 3

Table 3. 1 - Distribution of Schools According to District, Zone and

Type of School 4

Table 3. 2 - Availability of a Canteen in the School 5

Table 3. 3 - Characteristics of Housing in the Food Preparation Area 6

Table 3. 4 - Facilities for Proper Disposal of Waste in the Food Preparation Area 7

Table 3. 5 - Facilities for Maintaining Food Safety in the Food Preparation Area 7

Table 3. 6 - Availability of Refrigeration Facilities and Proper Maintenance 8

Table 3. 7 - Facilities Available in the Food Serving Area in the Canteen 9

Table 3. 8 - Availability of Different Food Items in the Canteen 10

Table 3. 9 - Availability of Different Kinds of Protein Source for Rice and

Curry Menu 11

Table 3. 10 - Availability of Beverages in the Canteen 11

Table 3. 11 - Availability of Food Products with High Sugar Content 12

Table 3. 12 - Availability of Food Products with Fatty Content 12

Table 3. 13 - Availability of Other Junk Food 12

Table 3. 14 - Availability of Safe Drinking Water 13

Table 3. 15 - Characteristics of Housing in the Dining Area 13

Table 3. 16 - Facilities for Maintaining Food Safety and Other Needs

in the Dining Area 13

Table 3. 17 - Prices of Selected Food Items 14

Table 3. 18 - Information on Food Stalls and Food Advertisements

in the School Perimeter of 200m 15

List of Figures

Figure 3. 1 - Cleanliness of the Outside Environment of the Canteen 5

Figure 3. 2 - Food Preparation and Facilities for Dining in the Canteen 6

Figure 3. 3 - Type of Food Items Prepared in the Canteen Premises 6

Figure 3. 4 - Status of the Food Storage Area in the Canteen 8

Figure 3. 5 - Practices of the Food Handlers in the Canteen 9

Figure 3. 6 - Availability of Different Kinds of Vegetables for Rice and Curry Menu 10

List of Abbreviations

CMC - Colombo Municipal Council

DCS - Department of Census and Statistics

KII - Key Informant Interview

PHI - Public Health Inspector

MOE - Ministry of Education

SMI - School Medical Inspection

UNICEF - United Nations Children's Fund


iii

AcknowledgementsWe wish to use this opportunity to appreciate the generous support given bynumerous persons and institutions to conduct this survey. First, we would like tothank the UNICEF for granting financial support to conduct this project, andespecially to its representative Dr. Indra Tudawe.

We highly appreciate the support of Mrs. Kanthi Perera (Secretary, Ministry ofEducation Services) and Mrs. Renuka Peiris (Director/Education-School Healthand Nutrition) for granting permission to conduct this survey in the schools and fortheir constructive and valuable inputs. We kindly acknowledge the timelyassistance of the Provincial Director of Education (Western Province), the zonalDirectors of Education (Colombo, Homagama, Kelaniya and Negombo zones),and the Divisional Directors of Education.

Our special thanks go to the Retired Officers of the Department of Census andStatistics namely Mr. D. A. Gunarathne (Deputy Director), Mr. J. Asky (SeniorStatistician), Mr. M. A. Gunapala (Senior Statistician), Mr. W. Gunasiri (SeniorStatistician), Mr. R. A. P. Kumarasinghe (Statistician), Mrs. W. S. J. Botheju(Statistical Officer), Ms. Soma Athukoralage (Statistical Officer), and Mr. B. A. H.Premarathna (Statistical Officer) who took the role of data collection in this studyand made this survey a success. We also thank Mr. W. D. P. Wickramaratne (PHI,CMC) who trained our enumerators regarding the canteen inspection.

We deeply acknowledge the generous support of the Principals, Vice Principals,teachers and the canteen owners during the data collection period.

We owe a great debt of gratitude to Dr. Saman Kelegama (Executive Director,Institute of Policy Studies of Sri Lanka) and to the staff members of the Institute ofPolicy Studies of Sri Lanka for their continuous support throughout the projectperiod.

iv


Executive SummarySri Lanka is enjoying the

benefits of free education policy

for the last 70 years.

Successive governments have

introduced many incentives to

the student population in the

way of free text books, free

school uniforms and free

mid-day meals. Although the

initiatives of providing text

books and uniforms were

sustained, the provision of free

mid-day meals could not be

sustained in the prescribed

manner due to many issues.

Efforts to transform the school

canteen as a healthy setting is

one of the initiatives

undertaken. Over seven years

have passed since introducing

healthy canteen guidelines.

This study was undertaken to

assess the implementation of

those guidelines in two districts.

A total of 71 school canteens

were studied in the districts of

Colombo and Gampaha in the

Western Province. A check list

and a data recording sheet

were used to record the

observations done in the school

canteens. In addition, we

conducted Key Informant

Interviews with Principals of

participating schools and

persons operating the school

canteens to obtain their

perception of implementing the

school canteen guidelines. The

data collectors and the

investigators also recorded

their additional observations in

field note books.

A majority of the schools (95

per cent) had a canteen in the

school. Of them, 94 per cent

had a permanent place to

maintain the canteen. Even

when the canteen is given a

permanent place, the suitability

of the location and the

cleanliness of the outside

environment were questionable

in one fifth of the cases.

Although most of the canteens

(79 per cent) prepared some

kind of food within the

premises, space and facilities

were grossly inadequate to

maintain the standards of

hygiene in food preparation

and storage. It was found that

canteens continued to sell

unhealthy food items despite

the restrictions. The demands

for alternative healthy food

items were extremely low

among students. Affordability of

most students using the

canteens was below Rs. 25 per

day. Hence, most of the food

items were priced at or around

Rs. 25. This lead to reduction of

quality and quantity of the food

offered. No major differences

were observed in the

implementation of guidelines

among the three types of

schools.

Food establishments outside

the school were a major source

of unhealthy foods for school

children making the canteen

guidelines less effective in

changing food habits. Many

barriers were identified that

hinder the effective

implementation of school

canteen guidelines. Lack of

support from the students, and

parents, absence of alternative

healthy food items, lack of

resources in schools,

inappropriateness of the

present system of selecting

canteen operators and

prevailing trade and fiscal

policies in the country

negatively affect the

implementation of canteen

guidelines.


v

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.ek .eg¿jla mj;S.

wdmk Yd,d fndfyduhl

^ishhg 79& tu ia:dkfhau

iuyr wdydr j¾. ilia lsÍu

isÿ jqjo tajdfha bvlv yd

myiqlï wdydr ilia lsÍu iy

;nd .ekSu ms<sn| fi!LH

m%ñ;Ska mj;ajd .ekSu i|yd

lsisfia;au m%udKj;a ke;.iSud mkjd ;snqK o fuu

wdmk Yd,dj, fi!LH

;;ajhg fkd.e,fmk wdydr

úlsKSu È.gu isÿjk nj

olakg ,eìK. fi!LH

;;ajfhka Wiia wdydr i|yd

we;s b,a¨u YsIHhka w;r

b;du;a wvqh. wdmkYd,d u.ska

wdydr ,nd .kakd isiqka tA

i|yd úhoï lrkafka Èklg

re. 25 g;a wvq m%udKhla fõ.tA ksid fndfyda wdydr re. 25la fyda Bg wdikak ñ<lg

wf,ú lrhs. tA ksid ,nd fok

wdydrj, .=Kd;aul Ndjh iy

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fj<| iy nÿ m%;sm;a;sh wdmk

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lsÍug ksfIaOd;aulj n,mdhs.

vi


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1


1. Introduction

Sri Lanka is enjoying the benefitsof free education policy for thelast 70 years. It is estimated thatthere are over 4 million studentsenrolled in schools across thecountry. Successive governmentshave introduced many incentivesto the student population in theway of free text books, freeschool uniforms and free mid-daymeals. Although initiatives ofproviding text books and uniformswere sustained, the provision offree mid-day meals could not besustained in the prescribedmanner due to many issues.Different programmes were testedfrom time to time in the provisionof mid-day meals. Within the lastdecade many circulars wereissued by the Ministry ofEducation on school nutritionprogrammes ranging from theprovision of mid-day meals to aglass of milk for primary schoolchildren. Acceptability of fooditems, sustainability of supplychains, financial difficulties andissues of accountabilitynegatively influenced the mid-daymeal programmes. However, theconstant attempts to provide ameal at school highlighted thefact that nutrition of schoolchildren is a national priority(Ministry of Healthcare andNutrition, 2010; National NutritionCouncil, 2013).

Although there have beenimprovements in the overallnutritional status in the Sri Lankanpopulation during the last threedecades, there is enough room forimprovement (National NutritionCouncil, 2013). Nutrition of school

children is a priority for bothhealth as well as for theeducation sector. Apart from theissues related to protein caloriemalnutrition, micronutrientdeficiencies and childhoodobesity are also becoming publichealth problems (Jayatissa,Gunathilaka, & Fernando, 2012).Discussions started on a schoolcanteen policy is one initiativetaken by the government in 2006to combat malnutrition amongschool children through provisionof nutritious, culturally acceptablefood at affordable prices withinthe school premises. In addition,food hygiene, promoting healthydietary habits, child friendlyservice provision and improvingfacilities of school canteens wereexpected through the policy.Based on the draft policydocument, a circular was issuedin 2007 (MOE circular 2007/2) toformalize the functioning ofschool canteens. A follow upcircular was issued in 2011 (MOEcircular 2011/3) to strengthen theschool canteens. In addition, adirection was issued to schools(MOE circular 2007/21) toestablish Health PromotionCommittees that could engage inenhancing and monitoring ofhealthy activities in schoolsincluding nutrition of students.

The circular issued in 2007focused on seven points thatneed to be considered inmaintaining a school canteen.They were;

1. To maintain a canteen in allschools

2.To ascertain provision ofhygienic food andmaintaining utensils used toprepare food in a hygienicmanner

3.To ascertain food safety andappropriate nutritional value

4.To improve opportunities tobuy "healthy foods" in schoolcanteen

5.To enhance "healthyfood habits"

6.To prohibit "unhealthy food"in school canteen

7. To keep the indoor andoutdoor environment of thecanteen clean

The circular issued in 2011 addedthree more aspects to thedirections. They were;

1. To maintain the indoor andoutdoor environment of thecanteen in a systematicmanner and provision ofsafe drinking water

2. Proper storage of food itemsand maintaining oftemperature in coolingdevices

3. To ascertain use ofapproved preservatives andadditives that does notcause allergy.

The directions sent to the schoolauthorities did not specificallydefine the food categories as"healthy" and "unhealthy" or thedetails of maintaining differentfunctions of the canteens.Broadly, it mentioned those fooditems with high fat, salt and sugarcontent and wheat basedproducts to be restricted. Further,

1.1 Background

2


the circulars stressed to makefruits, vegetables and cerealbased food items available as faras possible. Examples ofindividual food items that shouldbe prohibited/ restricted and thosethat need to be promoted werementioned as an aid to schoolauthorities. School authoritieswere instructed to solicit the helpof Public Health Inspectors (PHIs)from the health department tomaintain food safety.

Seven years have passed sincethe preparation of guidelines tostrengthen school canteens. Asystematic assessment of theimplementation of the differentelements in the proposed policyand the circular would providevaluable evidence forimprovement of the status ofschool canteens. This study in

1.2 Objectives ofthe Study

2. Methodology2.1 Study Setting

Gampaha district and the restfrom Kalutara district.

The schools are categorized into 4different types.

They are:

Type 1AB:Schools havingAdvanced LevelScience streamclasses

Type 1C: Schools havingAdvanced Level Artsand/or Commercestreams but noScience stream

Type 2: Schools having classesonly up to Grade 11

Type 3: Schools having classesonly up to Grade 08

This categorization of schools isused in the Ministry of Educationas well as the Ministry ofEducational Services for alladministrative functions includingresource allocation. Hence, datacollection for applied research witha focus on improving the systemsneed to use this categorization tobe meaningful for educationalauthorities.

In the sampling frame we includedall the government schools in thetwo districts except for the Type 3schools. Type 3 schools only havea primary section and with lessernumber of students. As this is apilot project to evaluate theimplementation of School canteen

The main objective of the studywas to evaluate selected aspectsof implementation of theguidelines in strengthening schoolcanteens in two districts. Theproposed school canteen policy in2006 and the circulars issued in2007 and 2011 included severalaspects of improving nutritionalstatus among school children. Thisstudy concentrated on thefollowing aspects of the guidelinesthat could help to assess thecurrent level of implementation;

o To identify existing facilitiesin the schools to operate acanteen maintainingappropriate standards

o To identify food items sold inthe school canteen

o To record prices of selectedfood items in schoolcanteens

o To assess the availability ofsafe drinking water in schoolpremises

o To describe the availability ofselected food items in foodstalls located in closeproximity to the school

o To assess providerperspective ofimplementation of healthyschool canteens.

The study was conducted in thegovernment controlled schools inColombo and Gampaha districts inthe Western Province of Sri Lanka.According to a recent report(Ministry of Education, Sri Lanka,2012), there are 1337 governmentcontrolled functioning schools inthe Western Province. Of those,402 schools are in Colombodistrict, 531 are from Gampahadistrict and the rest are fromKalutara district. Approximatelythere are nine hundred and thirtyeight thousand (938,340) studentsstudying in government schools ofthe Western Province. Amongthose, 370,000 students are fromColombo district, 350,000 are from

two districts of the country isintended to at least partly fulfillthis need.

3


policy in two districts in theWestern Province, sample sizeand the sampling method wasdevised considering the availableresources, field logistics and theshort time period available tocomplete the study. Multi-stagestratified sampling method wasemployed to achieve adequaterepresentation of schools in thetwo districts.

In the first step of sampling, twoeducational zones of each districtwere selected by simple randomsampling. Then, two educationaldivisions from each of theeducational zones were selectedusing simple random sampling.Therefore, in total eighteducational divisions from bothdistricts was selected.

The type of school wasconsidered as the "stratum' for thethird step of sampling. From eachstratum three schools wereselected. Hence, the final sampleconsisted of 72 schools (Table2.1). Same weightage was givento all the types of schools in theanalysis as the school canteen isexpected to have the samestandards in all schools. Inschools with more than onecanteen, the canteen used by the

most number of students wasselected for the assessment.

In addition to the observationsdone in the school canteens,in-depth interviews wereconducted with Key informants onthe implementation of guidelinesto strengthen school canteens.Participants were Principals or ateacher in charge of schoolcanteens and the person operatingthe school canteens. SixPrincipals and 6 canteen operatorswere selected for the interviewsconsidering the type of school,number of students, medium ofinstruction and the educationaldivision. From a given school,either the Principal or the canteenoperator was selected.

2.2 Data CollectingMethodsA check list and a data recordingsheet were used to record theobservations done in the schoolcanteens. The check listconsisted of four sections.(1) Physical facilities of thecanteen premises (2) Section onavailable food items (3) Availabilityof safe drinking water (4)

Information on food stalls close tothe school.

Section 1 of the observation listwas based on information providedin the canteen circular issued on2011 and the Food Act of 1980.Section 2 was based on theinformation provided in thecanteen circular issued on 2011and the preliminary observationsdone in the school canteens. Thecanteen circular containedinformation on the manner theMinistry of Education classified"healthy" versus "unhealthy" fooditems sold in canteens. Thecircular or the backgrounddocuments in the Ministry ofEducation did not refer to nutritionprofiling of food items before thisclassification. Further, no widelyaccepted classification based onnutrition profiling is available forSri Lankan food. Hence, thisassessment was solely based onthe directions provided in thecanteen circular of 2011.

Interview guide

A brief interview guide was usedto conduct Key InformantInterviews (KII) with Principals ofparticipating schools and owner/ incharge person of the schoolcanteen to obtain perception of

District No: Educational No: Educational Type of School Number ofZone Division Schools

Colombo 2 4 1AB 12

1C 12

Type 2 12

Gampaha 2 4 1AB 12

1C 12

Type 2 12

Total 72

Table 2.1Selection of Schools

4


3. ResultsTotally, 71 school canteens werestudied in two districts in theWestern Province. The results arepresented according to(i) availability of canteens,(ii) quality of maintaining thepremises of canteens,(iii) availability of food items,(iv) prices of food items,(v) availability of water supply,(vi) availability of food stalls, and(vii) kind of food items sold inthose food establishments closeto the school.

All selected schools were includedin the study. In Homagamadivision, there were only 2 IABschools. Only 63 schools hadhealth promotion committees (seeAnnexure I).

Out of 71 schools, 68 (95.8 percent) schools had a place to buyfood for school children duringschool hours. Among those, 64(94.1 per cent) schools weremaintaining their canteen in apermanent place (Table 3.2).

The 68 schools had 73 canteens.All of them maintained an ordinarycanteen in which main mealsalong with other food productswere sold. In addition, threeschools had an extra canteen, andtwo schools had a milk bar. Thefour schools that did not have apermanent place for a canteen

implementing the school canteenguidelines.

In addition, the data collectorsand the investigators recordedtheir additional observations infield note books.

Four teams of field investigatorswere trained for data collection.Data collection in one educationaldivision was completed within aweek. Key informant interviewswere done during the same week

by the principal investigator andco- investigators.

Data analysis was doneconsidering the selected elementsof the proposed school canteenpolicy and the Ministry ofEducation circular dated 2011/01/18 as the standard. Key informantinterviews were recorded andtranscribed. Thematic analysiswas performed to elicit importantmessages to strengthen schoolcanteens in the future.

This study did not intend toassess or report performance ofindividual schools, educationaldivisions or educational zones.The results are aggregated datafor all the schools. Importantdeviations and findings arepresented without identifying thesource. Ethics review committeeof the Faculty of Medicine,Colombo approved the researchprotocol.

was selling food in road sideoutlet, vehicle outlet, understaircase and by a food vender.

Location & Type Frequency Per cent (%)

DistrictColombo 35 49.3Gampaha 36 50.7

ZoneColombo 18 25.4Homagama 17 23.9Kelaniya 18 25.4Negombo 18 25.4

Type of SchoolType 1AB 23 32.4Type 1C 24 33.8Type 2 24 33.8

Table 3.1Distribution of Schools According to District, Zone andType of School (n = 71)

5


3.1 Main CanteenOnly the information on the main canteen is presented here onwards.

Figure 3.1Cleanliness of the Outside Environment of the Canteen (n = 68)

Of the canteens, 88.2 per centwere located in suitable placesaway from toilets, garbage pits orother unhygienic surroundings.Fifty three (77.9 per cent)canteens had a clean outsideenvironment (Figure 3.1).

Majority of the canteens (79.4 percent) prepare some kind of food inthe canteen itself. Other canteens

(20.6 per cent) solely depend onfood prepared outside. Only 50per cent of the canteens had adining area for school children inthe canteen (Figure 3.2). Therewas no difference according to thetype of school (see Annexure II).

Among the canteens whichprepare food within canteenpremises, 26 (48.1 per cent)

0

10

20

30

40

50

60

70

80

90

100

Canteen islocated in anappropriate

place

Cleanoutside

environment

Presence ofanimals inthe outside

environment

%

Yes

No

prepare all type of food productssuch as main meals, short eatsand some drink items. 16 (29.6per cent) canteens prepareshort- eats with drinks and therest of the canteens (22.2 percent) prepare only drink items(Figure 3.3). There was nodifference according to the type ofschool (see Annexure II).

Canteen Status Availability

Yes No

Frequency Per cent (%) Frequency Per cent (%)

A place is available to buy food 68 95.8 3 4.2

More than one canteen isavailable† 5 7.4 63 92.6

Permanent place is available tomaintain a canteen†(n = 68) 64 94.1 4 5.9

Note: † Only 68 schools had canteens.

Table 3.2Availability of a Canteen in the School (n = 71)

6


Figure 3.2Food Preparation and Facilities for Dining in the Canteen (n = 68)

0 20 40 60 80

Food preparation in the canteen

Availability of dining area

79.4%

50%

20.6%

50%

%

No

Yes

Figure 3.3Type of Food Items Prepared in the Canteen Premises (n = 54)

Housing Characteristic Availability

Yes No


Adequate space available for food preparation 21 38.9 33 61.1

Presence of ceiling in food preparation area 12 22.2 42 77.8

Clean wall in food preparation area 38 70.4 16 29.6

Adequate ventilation 36 66.7 18 33.3

Adequate lighting 40 74.1 14 25.9

Type of floor in food preparation area - Cemented 49 90.7 - -

- Tiled 5 9.3 - -

Clean floor in food preparation area 30 55.6 24 44.4

Table 3.3Characteristics of Housing in the Food Preparation Area (n = 54)

7


The space for food preparation inthe canteen was inadequate in61.1 per cent of canteensaccording to the type of fooditems prepared. 77.8 per cent ofcanteens had no proper ceilingbut a majority of canteens hadadequate ventilation (66.7 percent), adequate lighting (74.1 percent) and clean wall (70.4 percent). 90.7 per cent of canteenshad a floor paved with cement andonly 55.6 per cent of canteenshad a clean floor (Table 3.3).

Although 48 canteens (88.9 percent) had bins in food preparationarea, bins were not kept closed in37 canteens (77.1 per cent). 81.5per cent of canteens had a drainto waste water drainage (Table3.4).

Utensils for food preparation werein usable condition in 66.7 percent of canteens and were cleanonly in 53.7 per cent. Majority ofcanteens (94.4 per cent) hadwater supply in the food

preparation area. Although handwashing facilities were availablein 81.5 per cent of canteens,facilities to properly clean theutensils were available only in48.1 per cent. Toilet was locatedaway from the kitchen in amajority of schools (94.4 percent) (Table 3.5).

Facility Availability

Yes No


Availability of drains for waste water drainage 44 81.5 10 18.5

Availability of bins for waste disposal 48† 88.9 6 11.1

Bins are kept closed(n=48)† 11 22.9 37 77.1

Bins are kept away from food preparation area(n = 48)† 30 62.5 18 37.5

Table 3.4Facilities for Proper Disposal of Waste in the Food Preparation Area (n = 54)

Note: † Only 48 canteens had bins in food preparation area.

Safety Measures Availability

Yes No


Utensils in usable condition 36 66.7 18 33.3

Clean utensils 29 53.7 25 46.3

Working surface in good condition 27 50.0 27 50.0

Facilities to disinfect utensils 26 48.1 28 51.9

Hand washing facility in food preparation area 44 81.5 10 18.5

Water supply availability at food preparation area 51 94.4 3 5.6

Detergents are kept away from food handling area 41 75.9 13 24.1

Light bulbs placement over food handling area 14 25.9 40 74.1

Toilet is away from food handling area 51 94.4 3 5.6

Presence of animals inside food preparation area 12 22.2 42 77.8

Table 3.5Facilities for Maintaining Food Safety in the Food Preparation Area (n = 54)

8


Figure 3.4Status of the Food Storage Area in the Canteen (n = 54)

50 per cent of canteens hadstored the raw materials in anunclean area and 40.7 per cent ofcanteens kept some of their rawmaterials on the floor (Figure 3.4).

Majority of canteens (92.3 percent) had clean cooling equipmentwithout any decomposed fooditems inside them. Out of 26canteens, 18 (69.2 per cent)canteens stored meat and dairyproducts separately and 20 (76.9per cent) canteens stored cooked

food and raw materials separately(Table 3.6).

In 20 (29.4 per cent) canteens,food was not covered properly toprevent from contamination. Only30.9 per cent had separatespoons to serve different fooditems. Materials used forwrapping and packing of fooditems were not clean in 47.1 percent of the canteens. Price list offood items were also displayed in

only 42.6 per cent of the canteens(Table 3.7).

Food handlers in 94.1per cent and97.1 per cent of the canteenswere not using aprons to coverthe body or gloves to cover thehands, respectively. In 57.4 percent of canteens, bare handswere used for serving food(Figure 3.5).

50 %

59.3 %

16.7 %

50 %

40.7 %

83.3 %

0 20 40 60 80 100

Clean raw material storage area

Raw materials not kept on floor

Chemical contamination risk of raw materials

%

Yes

No

Table 3.6Availability of Refrigeration Facilities and Proper Maintenance (n = 54)

Note: † Only 26 canteens had a cooling facility.


Yes No


Availability of Freezer 9 16.7 45 83.3

Availability of Refrigerator 26 48.1 28 51.9

Clean cooling Equipment (n=26)† 24 92.3 2 7.7

Separate storage of meat and dairy products (n=26) † 18 69.2 8 30.8

Separate storage of cooked food & raw material (n=26) † 20 76.9 6 23.1

9


Among the 68 canteens, rice andkiribath were available in 77.9 percent and 30.9 per cent of thecanteens, respectively. The pulseswere available in less than 50 percent of the canteens. Althoughstring hoppers prepared from riceflour were available in 63.2 percent of canteens, food itemsprepared from wheat flour werealso available in over 50 per cent

of canteens (Table 3.8). No majordifferences were seen in theavailability of food itemsaccording to type of school (seeAnnexure II).

Figure 3.5Practices of the Food Handler in the Canteen (n = 68)

5.9 % 2.9 %

42.6 %

94.1 % 97.1 %

57.4 %

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Food handler wearingApron

Food handler wearinggloves

Food handled with acovering to hands

No

Yes


Yes No


Prepared food kept covered 48 70.6 20 29.4

Separate spoons for different foods 21 30.9 47 69.1

Availability of reusable dishware and cutlery 38 55.9 30 44.1

Clean reusable dishware†(n= 38) 33 86.8 5 13.2

Availability of non-reusable dishware 26 38.2 42 61.8

Price list display 29 42.6 39 57.4

Clean food packing materials 36 52.9 32 47.1

Table 3.7Facilities Available in the Food Serving Area in the Canteen (n = 68)

Note: † Only 38 canteens used reusable dishware for the purpose of serving food.

10


Figure 3.6Availability of Different Kinds of Vegetables for Rice and Curry Menu (n = 49)†

Note: †Although 53 schools were selling rice and curry, it was possible to observe these food items only in 49 schools to confirm themenu.

0

10

20

30

40

50

60

70

80

90

Leafy Vegetable Fruit Vegetable Root Vegetable LegumeVegetable

14.3 % 16.3

36.7

49 %

85.7 % 83.7 %

63.3 %

51 %

%

Yes

No

Table 3.8Availability of Different Food Items in the Canteen (n = 68)

Food Item Availability

Yes No


CerealsRice 53 77.9 15 22.1Kiribath 21 30.9 47 69.1

PulsesChickpea 31 45.6 37 54.4Cowpea 10 14.7 58 85.3Mung bean 4 5.9 64 94.1

TubersManioc 7 10.3 61 89.7Sweet potato 1 1.5 67 98.5

Wheat flourBread 35 51.5 33 48.5Roti 36 52.9 32 47.1String hoppers 9 13.2 59 86.8Pittu 3 4.4 65 95.6

Rice flourString hoppers 43 63.2 25 36.8Pittu 3 4.4 65 95.6Hoppers 23 33.8 45 66.2

Ulundu FlourIdly 10 14.7 58 85.3Dosai 32 47.1 36 52.9

OtherNoodles 34 50.0 34 50.0Pasta 6 8.8 62 91.2

11


Legume vegetable was availablein 49 per cent of canteens whichis a higher per cent compared toother types of vegetables such asleafy vegetables and fruitvegetables (Figure 3.6).

Egg was available in 64 per centof canteens while fish and driedfish were available in 27.5 percent and 19.6 per cent ofcanteens as the source of protein(Table 3.9).

Fresh milk, fresh fruit juice andkola kanda were available in 8.8per cent, 13.2 per cent and 7.4per cent of school canteens,respectively. However,pasteurized milk, carbonateddrink, commercial fruit juice andmalted drinks were available in30.9 per cent, 25.0 per cent, 16.2per cent and 14.7 per cent ofcanteens (Table 3.10).Pasteurized Milk was available ina significantly higher number of

schools in 1AB type compared toother types of schools (seeAnnexure II).

Chocolate was available in 20.6per cent of canteens. Other foodproducts with high sugar contentwere available in a few canteensonly (Table 3.11). No majordifferences were seen in theavailability of food itemsaccording to type of school (seeAnnexure II).


Yes NoFrequency Per cent (%) Frequency Per cent (%)

MilkFresh milk 6 8.8 62 91.2Pasteurized milk 21 30.9 47 69.1

Fruit JuicesFresh fruit juice 9 13.2 59 86.8Commercial fruit juice 11 16.2 57 83.8

Kola kanda 5 7.4 63 92.6

Carbonated drinks 17 25.0 51 75.0

Malted drinks 10 14.7 58 85.3

Table 3.10Availability of Beverages in the Canteen (n = 68)



Fish 14 27.5 37 72.5

Dried fish 10 19.6 41 80.4

Meat (i.e. Chicken) (n = 50) 3 6.0 47 94.0

Egg (n = 50) 32 64.0 18 36.0

Table 3.9Availability of Different Kinds of Protein Source for Rice and Curry Menu (n = 51)*

Note: *Though 53 schools were selling rice, it was possible to observe these food items only in 51 schools to confirm the menu. Availability of meat and egg was checked in 50 canteens only.

12


Deep fried short eats wereavailable in most of the canteens(80.9 per cent). Similarly, otherfood products with high fattycontent are also available in mostof the canteens (Table 3.12). Nomajor differences were seen in theavailability of food itemsaccording to type of school (seeAnnexure II).

The junk food items such astoffees, sweet deserts and chipsitems were available in 57.4 percent, 30.9 per cent, and 48.5 per

cent of canteens, respectively(Table 3.13). No major differenceswere seen in the availability offood items according to type ofschool (see Annexure II).

All the schools had drinking watersupply of which 88.7 per cent arefrom the Water Board and the rest(11.3 per cent) from well water.83.1 per cent of schools store thewater in a water tank and 97.2 percent of the schools distribute thewater via taps (Table 3.14).

Out of 34 canteens, the diningarea for schoolchildren was notadequate in 18 (52.9 per cent) ofthe canteens. 70.6 per cent ofcanteens had no proper ceiling inthe dining area but the majority ofcanteens had adequate ventilation(73.5 per cent), adequate lighting(79.4 per cent) and a clean wall(70.6 per cent). 75.5 per cent ofcanteens had the floor paved withcement in the dining area. Only52.9 per cent of canteens had aclean floor (Table 3.15).



Chocolates 14 20.6 54 79.4

Cake 4 5.9 64 94.1

Doughnuts 3 4.4 65 95.6

Ice cream 4 5.9 64 94.1

Watalappam 3 4.4 65 95.6

Table 3.11Availability of Food Products with High Sugar Content (n = 68)


Yes No


Pastry 39 57.4 29 42.6

Biscuits 32 47.1 36 52.9

Deep fried short eats 55 80.9 13 19.1

Table 3.12Availability of Food Products with Fatty Content (n = 68)


Yes No


Toffees 39 57.4 29 42.6

Sweet desserts (i.e. jelly) 21 30.9 47 69.1

Any chips item 33 48.5 35 51.5

Table 3.13Availability of Other Junk Foods (n = 68)

13


Furniture in the dining area forschoolchildren was not adequatein 55.9 per cent of the schools.Although 91.2 per cent ofcanteens had facilities for hand

washing in the dining area, handwashing solution or soap wasavailable only in 55.9 per cent ofcanteens (Table 3.16).

Rice and curry (fish) wasavailable in 14 canteens with themean price of Rs. 52.50 and themode was Rs. 50.00. The mean

Housing Characteristic Availability

Yes No


Adequate space in dining area compared to crowd 16 47.1 18 52.9

Presence of ceiling in dining area 10 29.4 24 70.6

Clean wall in dining area 24 70.6 10 29.4

Adequate ventilation 25 73.5 9 26.5

Adequate lighting 27 79.4 7 20.6

Clean floor in dining area 18 52.9 16 47.1

Table 3.15Characteristics of Housing in the Dining Area (n = 34)

Table 3.14Availability of Safe Drinking Water

Drinking Water Availability


Availability of drinking water 71 100.0 0 0.0

Source

Pre-treated water supply 63 88.7 8 11.3

Well Water 8 11.3 63 88.7

Water stored in water tank 59 83.1 12 16.9

Water dispensed via tap 69 97.2 2 2.8

Safety Measures Availability

Yes No


Availability of waste disposal bins 29 85.3 5 14.7

Presence of animals inside dining area 8 23.5 26 76.5

Adequate furniture in dining area 15 44.1 19 55.9

Clean furniture 14 41.2 20 58.8

Availability of hand washing area in dining area 31 91.2 3 8.8

Availability of hand washing solution or soap 19 55.9 15 44.1

Table 3.16Facilities for Maintaining Food Safety and Other Needs in the Dining Area (n = 34)

14


Tab

le 3

.17

Pri

ces

of

Sel

ecte

d F

oo

d I

tem

s (I

n S

L R

up

ees)

Fo

od

Ite

mM

ean

Med

ian

Mo

de

SD

Min

.M

ax.

Freq

uen

cyP

rice

Pri

ce# (n

)

Pri

ce o

f on

e di

sh o

f ri

ce &

cur

ry (

Fis

h)52

.50

50.0

050

.00

20.9

125

.00

110.

0014

Pri

ce o

f on

e di

sh o

f fr

ied

rice

(E

gg)

46.3

440

.00

30.0

020

.85

25.0

011

0.00

26

Pri

ce o

f on

e di

sh o

f co

wpe

a29

.00

27.5

020

.00

8.43

220

.00

40.0

010

Pri

ce o

f on

e di

sh o

f ch

ickp

ea25

.00

25.0

030

.00

6.58

210

.00

35.0

031

Pri

ce o

f on

e di

sh o

f st

ring

hop

pers

with

cur

ry a

nd s

ambo

l28

.58

27.5

025

.00

4.90

620

.00

40.0

046

Pri

ce o

f on

e eg

g ro

ll25

.71

25.0

030

.00

5.02

010

.00

35.0

035

Pri

ce o

f on

e fis

h ro

ll24

.25

25.0

020

.00

4.74

415

.00

35.0

027

Pri

ce o

f on

e fis

h pa

stry

28.2

630

.00

30.0

05.

956

10.0

040

.00

23

Pri

ce o

f on

e ch

icke

n pa

stry

40.0

040

.00

35.0

07.

071

35.0

045

.00

2

Pri

ce o

f on

e gl

ass

of f

resh

fru

it ju

ice

17.2

210

.00

10.0

010

.92

10.0

040

.00

9

Pri

ce o

f on

e gl

ass

of f

resh

milk

30.0

030

.00

30.0

00.

000

30.0

030

.00

5

Pri

ce o

f on

e bo

ttle

of s

mal

l si

ze c

arbo

nate

d dr

ink

34.4

334

.00

35.0

04.

162

30.0

045

.00

16

Pri

ce o

f on

e fis

h bu

n25

.54

25.0

025

.00

4.27

210

.00

30.0

050

Pri

ce o

f on

e ki

mbu

la b

un22

.71

25.0

025

.00

3.50

210

.00

30.0

035

Pri

ce o

f on

e pl

ain

bun

22.2

720

.00

20.0

03.

768

10.0

030

.00

33

Pri

ce o

f on

e sa

usag

e bu

n30

.71

30.0

030

.00

6.75

310

.00

40.0

014

Not

e: #N

umbe

r of c

ante

ens

whe

re fo

od it

em is

ava

ilabl

e.

15


3.2 UnhealthyAdvertisementsAdvertisements of unhealthy foodproducts were displayed in 6canteens (17.6 per cent).

Within the 200m perimeter of aschool, 36.6 per cent of schoolshad billboards or posteradvertisements of unhealthycommercial food products. Sixtytwo (87.3 per cent) schools hadlocal food stalls outside theirschools. Only 16.9 per centschools had branches ofwell-established local food chainswithin 200m. Among those foodstalls, availability of fast foodsand carbonated drinks were 84.1per cent and 82.5 per cent,respectively (Table 3.18).

3.3 Availability ofH800 Form forRanking of FoodEstablishments(n = 68)

price of one dish of egg fried ricewas Rs. 46.34 among 26canteens with the mode being Rs.30.00. Among the pulses, chickpea was the most available of thepulses compared to other pulseswith the mean price of Rs.25.00.One parcel of string hoppers withcurry and sambol was sold in 46canteens with the mean price ofRs. 28.58. Egg roll was sold in 35canteens with the mean price ofRs. 25.71. The mean prices of fishbun, kimbula bun and plain bunwere Rs. 25.54, Rs. 22.71, andRs. 22.27, respectively. The meanprice of one glass fresh fruit juicewas Rs. 17.22 and the mode wasRs. 10.00. Fresh milk wasavailable only in 5 canteens andits mean price and mode was Rs.30.00. The mean price of onesmall bottle of carbonated drinkwas Rs. 34.44 (Table 3.17).

Among 68 school canteens, only 3(5.9 per cent) canteens had H 800form issued for ranking of foodestablishments by a PHI. Althoughthe PHI had visited many schoolcanteens, food rating form was notmaintained.

Food Stalls & Items Availability

Yes No


Presence of international food chain outlets 1 1.4 70 98.6

Presence of local food chain outlets 12 16.9 59 83.1

Presence of other local food stalls 62 87.3 9 12.7

Presence of unhealthy advertisementsoutside school 26 36.6 45 63.4

Availability of food items on foodstalls outside (n = 63)*

Fresh fruit juices 25 39.7 38 60.3

Kola kanda 10 15.9 53 84.1

Fresh milk 18 28.6 45 71.4

Fast foods (burger, submarine, short eats) 53 84.1 10 15.9

Carbonated drinks 52 82.5 11 17.5

Table 3.18Information on Food Stalls and Food Advertisements in the School Perimeter of 200m

Note: * Only the schools which have at least a single food stall within 200m.

16


4. Perceptions on Implementation of SchoolCanteen GuidelineIn-depth interviews wereconducted with Principals ofschools and canteen operators toelicit their perceptions on thepresent status of school canteensin respect to guidelines. Sixinterviews were done withPrincipals and a similar number ofinterviews were done with thecanteen operators. The 12 schoolsfor the interviews were selecteddepending on the type of school,medium of instruction, location ofthe school and also status of thecanteen as observed by theinvestigators during thepreliminary visit.

Number of students in the twelveschools ranged from over 3,000 tojust over 400 students. Studentsbelonged to different ethnic andreligious background. In someschools, canteens were located inpermanent housing. In a fewschools, food was sold inmakeshift arrangements.Students in all the schools belongto socio-economic strata ofmiddle income to lower incomehouseholds.

4.1 Nutritional Statusof Students andEducationAcross all the interviews, bothPrincipals and the canteenoperators recognized theimportance of proper nutrition asa key factor for successfulattainment in education. However,there were differences in the

understanding of proper nutritionin respect to intake of food items.The differences of understandingwere not only between Principalsand canteen operators but alsowithin those two groups.Principals were looking at both thequantity and quality of food intheir judgment while most canteenoperators were mainly relating thequantity and the affordability.

There were clear differencesamong Principals when theycommented on choice of food inrelation to healthy and unhealthy.Most Principals were comfortablein categorizing traditional foods ashealthy in a blanket mannerwithout evaluating the nutritionalvalue of those. The canteenoperators were more concernedabout the value of the food thatcan be sold for an affordable priceto students. Their perception ondifference of healthy versusunhealthy was almost limited torice flour based products to wheatflour based products and sweets.

Several schools provide 10minutes at the beginning of theschool for students to havebreakfast. Principals find that asubstantial number of studentscome to school skipping thebreakfast and it affects learning.They have noticed less issues ofsick reporting in the morningsession after providing a smallbreak in the morning to havebreakfast. Principals admit thatsome students do not bring foodor buy them from the canteen dueto economic issues.

Canteen operators also find manystudents buying food items forbreakfast from the canteen. Theyobserve that students comingfrom a distance as well as whoreside close to school, purchasefood in the morning for breakfast.Hence, they have some amountof sale in the morning beforestarting school. Both Principalsand the canteen operatorsattribute the habit of skippingbreakfast, to issues at home.They felt that parents shouldmake it a habit to providebreakfast to children beforeleaving home if this behaviour isto be changed.

4.2 Guidelines onBringing Food toSchools by StudentsAccording to the instructionsgiven by the Education Ministry,many schools have issuedguidelines for bringing food fromhome. These are implemented inthe primary sections but not in themiddle or upper schools. Manychildren in the primary classesadhere to the instructions.However, Principals feel thatteachers are in an embarrassingposition when they are toimplement the guidelines. Inparticular, implementing theguidelines is very difficult in someschools, where large numbers ofchildren come from the lowersocio- economic strata. Althoughthe teachers have to physicallycheck the food items brought by

17


the students, it is difficult toimplement it fully due to thesensitive nature of the issue.Teachers do not want toembarrass students if they havenot brought any food from homedue to economic difficulties or dueto ignorance of the parents.Although teachers do spotchecks, it is difficult to enforcethe guidelines as stipulated.

On the other hand, teachers alsosometimes experience situationswhere students would bring thestipulated food items for the dayas a formality, still they do notconsume those food items andstay hungry till they return home.This has resulted in lowcompliance from parents andsometime creating unpleasantsituations to the Principal,teachers and parents. Principalsadmit it is not practical to enforcethose guidelines to students inthe middle or upper school wheremost of the students do not bring

food from home.

4.3 Awareness onSchool CanteenGuidelinesMajority of the Principles (4/6)have seen the circular sent oncanteen guidelines. Others haveheard but not seen the circular.Although Principals had a generalunderstanding of the content ofthe circular, most of them werenot aware on the specific issuesaddressed. All of them knew thatschool canteens should not havesoft drinks and refrain from sellingsweets. They also knew thatwheat based food items needed tobe restricted and rice and riceflour based food should beencouraged. Only a few

Principals admitted that they havegiven the printed guidelines to thecanteen operator. They assumedthat the Zonal Education Officewould have done it as part of thetender procedure. Canteenoperators are aware of theinstructions given by educationauthorities. They mainly recollectthe instructions imposed onrestricted food items but little onthe promotive aspects.

Principals were not familiar withsome technical issues addressedin the circular namely, foodstorage, proper maintenance ofequipment, maintenance ofutensils in the canteen andcompliance with the Food Act.Unawareness on those issues hadsome bearing on theirunderstanding on the guidelinesand monitoring of schoolcanteens. This was evident fromthe observations done on foodpreparation, storage and servingin school canteens.

4.4 Food Habits andGuidelinesFood habits of the students wasseen by Principals as the mainbarrier to implement a healthycanteen policy as well as to havea better nourished studentpopulation. They attribute this tothe up-bringing of children athome, food culture at home,affordability and attitudes ofparents on the food habits ofstudents. In addition, the media isalso influencing food habitsgreatly. All the Principals pointedout that the school cannot changethe existing food habits ofstudents in isolation. A studentstays only 6 hours in the schooland has all three main meals athome. They emphasize that the

home environment should takethe lead in changing it. The schoolcan only support the change.

Majority of the students like thefood items categorized as oily,sugary or unhealthy in broadterms. In canteens, the maindemand is for pastries, frieditems, and sweets. Although softdrinks are not available now inmost school canteens, it was oneof the frequently sold itemspreviously. The least demand isfor pulses which arerecommended in the guidelines asalternative food items. Principalsand canteen operators bothinsisted that, it is extremelydifficult to convince students tohave them. Serving rice and curryis promoted in the guidelines as asuitable food item. According toPrincipals most of the canteensserve it as a main food item.However, according to thecanteen operators and ourobservations, the demand is for‘fried rice’ and not for rice andcurry. Hence, rice as a food itemis sold more often as fried ricewith a minute amount of friedvegetables (carrot and cabbage)and chili paste. Apart from friedrice, some canteens also offerrice and curry packets.

Apart from the food items listed inthe tender documents, many otheritems are sold in canteens.Canteen operators reveal thatthose items have more demandthan those in the list given by theEducation Department. Also, theyearn more from those items.According to the canteenoperators and on our ownobservations, most students bringRs. 10-20 to buy food from thecanteen. Students in higherclasses may bring 30-50 rupees.However, most students cannotafford food items beyond

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Rs. 20-25. Hence, students arecompelled to buy food items thatare affordable to them. In turn, thecanteen has to provide food itemswithin their reach. Rice and curryor fried rice is generally priced onor above Rs. 30. Same is for“kotthu roti” which has a highdemand from older schoolchildren. Main food items that arewithin the reach of students are,fried items like vade, bakeryitems as fish bun, pol roti,hoppers, dosai, bite packets(manioc, murukku), biscuits andsweets. Students can buy onlyone piece of those items for theamount of money they possess. Itis also seen that several studentspool money to buy food items andshare it to increase theaffordability. Hence, food itemsare sold in the canteens to caterfor the demand and affordability ofstudents. Food items consideredas healthy such as pulses, kolakanda and red rice is generallyconsumed by teachers. Hence,such food items are brought tothe canteen in small amounts.

Most of the canteen ownersrevealed that they use “soupcubes” when preparing fried riceand Kotthu. When they have notadded “soup cubes”, studentscomplain that the food is nottasty. They admit that studentslike that taste and they arecompelled to use it. Further, noneof the canteen operators knew theharmful effects of those additives.It was also found that most of thefood items labelled as “rice based”is actually prepared by a mix ofwheat flour and rice flour. Theyfind it is difficult to prepare purerice flour food items inlarge-scale. Canteen operatorsaffirm that students like the tasteand the texture of mixedpreparation rather than the purerice flour made food items.

4.5 Feasibility ofOperating SchoolCanteen According tothe GuidelinesAll the Principals admitted that thespace provided to the canteen isnot adequate. They also agreedthat the facilities in the canteensare not adequate to maintain themaccording to the stipulatedguidelines. Most of the schoolsdo not have housing that is madefor the purpose of a canteen.Either they use an old class roomor a room that is not been usedfor any other purpose. Some ofthe class rooms have been latertransformed into a canteen bysupplying water and a waste waterline. However, the canteens donot have dedicated areas plannedfor preparation of food, storageand dining. They admitted thatthere is no space to providedining area for students inside thecanteens. In most canteens,teachers are provided one or twotables and few chairs to havetheir meals. Students are notallowed to use that facility.

Most canteens prepare someitems of food within the canteenpremises. The canteen operatorsalso express the inadequacy ofspace to do their work properly.Within the available space, theytry to accommodate a table and afew chairs for teachers. They findit is an obligation to provide adining area for teachers. However,they continue to allow students tohave their meals in the open,outside the canteen. They admitthat provision of dining area forstudents is beyond their capacityand it should be looked into bythe school authorities. ThePrincipals state that they are

unable to expand the space andfacilities of the canteen due toinadequate funds from theeducation authorities to do so.Further, three Principals statedthat the building of the existingcanteen is provided by thesupport of parents andwell-wishers. Principals find itdifficult to solicit support fromparents on a continuous basis toimprove the canteen as they haveto approach parents for manyactivities of the school. Parentscoming from middle to low incomecommunities find it difficult tofinance school developmentactivities in a long-term basis.

All Principals stated that theyhave either appointed a committeeor an in-charge teacher tosupervise the canteen activities.Principals themselves monitor theactivities from time to time.However, they admitted that it isnot easy to comply with thecanteen guidelines fully due tovarious reasons.

One of the key issues identifiedby both Principals and thecanteen operators is shops,bakeries and eating houses closeto the school. All the food itemsbanned or restricted in the schoolare available in those places.Therefore, students have easyaccess to those food items ontheir way to school and also afterschool. In some schools,students in the higher classespatronize those shops during theinterval too. Many parents buyfood from those shops in themorning for the students in thelower grades when they request.School authorities do not haveany jurisdiction over the activitieshappening beyond the schoolpremises. Hence, theimplementation of the guidelinesin the school canteens iseffectively negated.

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4.6 Present Systemof Selecting CanteenOperatorsPrincipals are not contacted or notinvolved in the selection of thecanteen operator. Only a Principalof a national school admitted thatthey had the opportunity to gothrough the credentials of thecompetitors before awarding ofthe tender. Awarding of thecanteen tender is totally handledby the Zonal Education Office.Most Principals revealed that theyare not even informed whentenders are called. They only getto know when the canteenoperator is appointed. Minimumamount for the tender is decidedby the zonal office. Principalsunderstand that competitorsindicate a higher quota to win thetender irrespective of the groundreality. At present, tender pricesare decided on the basis of a percapita rate for a day for a studentin the school. Hence, the totalamount payable to the school perday would be per-capita rate intototal number of students in theschool at the beginning of theyear. The fluctuation in thestudent numbers during the year,their absenteeism or their actualuse of the canteen is notconsidered. The selling prices offood items agreed at thebeginning of the year cannot bechanged. Possible price changesof raw materials and fuel duringthe year is also not consideredwhen setting maximum prices forfood items. The canteen operatorshould pay the school this amounton a daily basis. The Principalsadmit that only a proportion ofstudents use the canteen on aregular basis. The selectedcanteen operator only realizes theground situation when they find it

difficult to achieve the sales toaccommodate the costs whenadhering to tender specificationson food items.

The Principals find this situationdifficult to handle. The canteenoperator at this stage either willabandon the agreement and leaveor they will sort to other means ofincreasing their income. If thecanteen operator leaves, thePrincipal has to close the canteentill a new person been appointedby the zonal office. However, thiscircle would continue. If theschool wants to continue thecanteen, the Principle has tooverlook some of the deviationsfrom the agreement. Hence, allPrincipals expressed that it is notpossible to adhere to thestipulated guidelines fully if thecurrent tender procedure iscontinued. Principals observe thatcanteen operators who have beenin the business for some time,know how to manipulate thesituation to evade restrictions andgain profits.

In addition, new restrictions havebeen imposed in several schoolsdue to the dengue epidemic.Many schools have bannedselling yogurt and milk packets inthe canteens as the emptycontainers are said to be breedingsites for mosquitoes. Principalsfear prosecution by public healthauthorities. These are productsthat have a high demand from thestudents and also provide anearning to the canteen. Inaddition, use of lunch sheets hasbeen banned citing the samereason. Canteen operators used towrap food items like pulses, stringhoppers, and rice using lunchsheets. Students have beenadvised to bring lunch boxes tobuy those food items. Thecanteen operators find it difficultto supply other types of

disposable wrapping material orreusable dishes to serve food fora large number of students withina small time period. If theypurchase reusable dishes theyhave to spend a substantialamount that cannot be recovered.This has also reduced the sale offood items in the canteens.

4.7 Future of SchoolCanteensPrincipals feel there should be auniform plan for building canteensin all schools which providesadequate space for differentactivities carried out in thecanteen. They take the newly builtMahindodaya science laboratoriesacross the country using acommon template as an example.Using a common template andsimilar facilities will help toestablish better infrastructure tomaintain a healthy schoolcanteen.

Main concern was the existingmethod of selecting the canteenoperator based on tenderprocedure. Most Principals believethat an alternative method needsto be developed. However, theywere reluctant to take up theresponsibility at school level dueto the fear of possible allegationon financial handling. One of thesuggestions to improve thecurrent system was to carry out asimple study on the utilization ofthe canteen by students beforepreparation of tender documentsfor each school. This can be doneby the school itself. It shouldinclude the number of studentsgenerally using the canteen,facilities available to operate thecanteen, affordability of studentsand pattern of sale of food itemsin the canteen. This could provide

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insights to decide the minimumfees to be charged from thecanteen operator. Canteenoperators should be educated onthe actual business opportunitiesthey will have when adhering toguidelines. This will preventcompetitors citing higher bids thatcannot be earned through ahealthy canteen.

Many Principals believe thatprovision of compulsorybreakfast, sponsored by thegovernment could solve thenutrition issues of students tosome extent. If this can beundertaken, the canteen will not

be a serious need for the school.They propose that such a systemshould be based on theparticipation of parents. However,Principals could not come up witha practical mechanism for asustainable programme of thiskind. It was clear that Principalsdo not want to be a part offinancial handling in school mealprogrammes.

Canteen operators were reservedin suggesting new ways ofoperating school canteens. Theyfeel that the tender procedure wasappropriate provided that thepayment is adjusted according to

the utilization of the canteen andnot depending on the total numberof students in the school. Theyalso feel there should be flexibilityto change the price of a food itemaccording to the fluctuation offood prices in the market.Both Principals and the canteenoperators believed that foodhabits of students can bechanged only through a nationwide approach on healthy food.When unhealthy food is widelyavailable and intensivelypromoted, they find that schoolcanteen can play only a marginal

role in changing food habits.

5. Discussion and ConclusionsThis study was undertaken toassess the implementation ofselected aspects of guidelines instrengthening school canteens intwo districts. The proposedschool canteen policy in 2006 andthe circulars issued in 2007 and2011 included several directionsto improve nutritional statusamong school children. The studyconcentrated on a few aspects ofthe guidelines that could help toassess the current level ofimplementation.

A total of 71 school canteenswere studied in two districts in theWestern Province. A check listand a data recording sheet wereused to record the observationsdone in the school canteens. Inaddition, we conducted KeyInformant Interviews withPrincipals of participating schoolsand persons operating the schoolcanteen to obtain perception ofimplementing the school canteenpolicy/circular. The data collectors

and the investigators recordedtheir additional observations in logbooks. The data obtained throughqualitative inquiry supplementedthe quantitative findings.

5.1 Directive forHealthy CanteenThe environment can exert astrong influence on people’s fooddecisions. If schools foodenvironment can be made healthy,it can influence students to makehealthy food choices and develophealthy eating habits. Hence, it isimportant that the school foodprogramme is healthy (Mensink,Schwinghammer, & Smeets,2012). Many initiatives have beentaken on this approach by severalcountries during the last decadeand a half. Healthy “Food andDrink Policy” of the WesternAustralian Department of

Education and Training in an effortto improve the food environmentwithin the government schools in2007, a legislative enactment in astate in Brazil in 2001 to laydown criteria for provision ofsnacks/ drink services ineducational institutions andhealthy school canteenprogramme in the Netherlands area few examples (Pettigrew,Pescud & Dovonan, 2012; Menisk,Scwinghammer & Smeets, 2012;Gabriel, Vasconcelos, Andrade &Schmitz, 2009). The World HealthOrganization resolution WHA 57.17in 2004 provided an impetus forinitiatives on healthy dietthroughout the world (WorldHealth Organization, 2004).Initiation of a dialogue on ahealthy canteen policy in SriLanka during 2006/2007 periodand subsequent directives onmaintaining a school canteen thatpromote healthy nutrition amongschool children could be

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considered as a part of the globalpush towards healthy diet.

The most comprehensiveapproach on healthy schoolcanteen could be seen from theprogramme initiated by theAustralian government. Thedirectives from the NationalHealthy School Canteens Projectprovided clear guidelines for foodselection, food safety, foodhandlers, training modules,information system, monitoringand evaluation of the programme(Department of Health, Australiangovernment, 2013). This providedsufficient guidance and technicalsupport to the school authorities.Guidelines from the Ministry ofEducation in Sri Lanka to theschool authorities were almostrestricted to the two circulars andthe attachment. A detail resourceon maintaining a healthy canteenfor the school authorities and thecanteen operator would have been

helpful.

5.2 Facilities in theSchools to Operate aCanteenMajority of the schools (95%) hada canteen in the school. This is apositive finding. Students of thethree schools that did not have acanteen had to rely on outsidesources such as roadside foodvenders and shops. Despitehaving a canteen, four schoolscould not provide a permanentplace for it to function. When theschool could not provide apermanent place, the canteen waslocated in a road side outlet,vehicle or a make shift locationfor the day. Even when thecanteen is given a permanentplace, suitability of the location

and the cleanliness of the outsideenvironment were questionable inone fifth of the cases.

Most canteens were preparingsome kind of food within thecanteen premises itself (79%).However, majority of the canteensdid not have separate areas oradequate facilities to preparefood. As the majority of theschool canteens are housed in oldclass rooms or in inappropriatebuildings to maintain a foodestablishment, the canteenoperator is using the limitedspace available to perform all thetasks of a canteen. Hence, theability to maintain appropriatestandards of hygiene and goodpractice is compromised.Unavailability of proper storagespace to keep both raw materialsand cooked food was observed inmost canteens. At present, theschool is able to provide onlysome old furniture. All the utensilsfor food preparation, storage andserving food are brought by thecanteen operator. Usage ofunsuitable, unclean utensils forfood preparation and storage ofcooked food and raw materialscontravening the provisions of theFood Act of 1980 in some schoolscould be attributed at least partlyfor not providing adequatefacilities. The findings raise twokey issues on the guidelines,provision of facilities for foodinside the canteen and foodsafety. As the circulars have notexplicitly provided the standardsof maintaining the canteen anddirections for establishing purposemade premises for the canteen,school authorities have to dependon their own knowledge andexperiences. Establishment,maintenance of foodestablishments and all regulatoryprocedures in relation to food iscontrolled by the Food Act(Parliament of Democratic

Socialist Republic of Sri Lanka,1980). This Act empowers theDirector General of Health andspecified subordinates asauthorized officers. Ministry ofEducation needs the support andcoordination of the Ministry ofHealth to exercise food safetywithin the school premises as it isnot reasonable to expect schoolauthorities to be conversant onoperational details of the FoodAct. The circular provides this linkthrough mentioning theimportance of obtainingassistance from the PHI inmaintaining the canteen healthy.However, it has not establishedadequate tools to strengthen thecoordination with the healthauthorities. Although the schoolhealth programme, a joint activitybetween the Ministry of Healthand the Ministry of Education, isexpected to deal with nutritionalaspects in school children, themain thrust of the programme atpresent is medical examination ofschool children. Currently, theinformation system of schoolhealth is restricted to medicalreturns and thus, does notsupport monitoring of healthy foodhabits or facilities in that respect.

Behaviour and practices of foodhandlers in school canteens needto be improved in a substantialmanner to maintain the hygienestandards. Particularly, notwearing an apron and handlingfood with bare hands was seen asa major issue that can lead tocontamination of cooked food. Inone-third of schools, food itemswere not kept properly covereduntil served. Although mostcanteens provide bins for wastedisposal, no effort was taken tokeep them closed. These can becorrected with simpleinterventions and propersupervision. Training of canteenoperators and use of a

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pre-qualification mechanism in theselection of canteen operatorscan improve food hygiene in amajor way. Pre-qualification ofcanteen operators can be donethrough an assessment testbased on basic knowledge andskills of food safety and hygiene(Department of Health, Australiangovernment, 2013). Successfulcompletion of training and aqualifying test of canteenoperators and his staff could be aprerequisite for registration as acanteen operator in the Ministry ofEducation. Brazilian experiencehas shown that training ofoperators of canteens, schoolauthorities as well as regularinspection is necessary toimprove the compliance with theguidelines (Gabriel , Vasconcelos,Andrade , & Schmitz , 2009).

Majority of the canteens do notprovide a dining area for students.Even when there is a space, it ispartly covered without adequateseating arrangements. Diningarea is provided only for teachersin most school canteens as it isconsidered an obligation by thecanteen operators as well as theschool. In all schools, watersupply was available for drinkingand hand washing within thecanteen premises or close to thecanteen. Also, half of thecanteens supplied soap for handwashing. Toilets were locatedaway from the canteens in themajority of the schools. Those arepositive measures taken to upholdhygienic practices in schools.

5.3 Food Items andFood BehaviourOne of the key elements of theguidelines is to provide healthyfood in school canteens and topromote desirable food habits ofstudents to improve the nutritionalstatus of the student population.As evidence suggests thatprovision of unhealthy foods incanteens leads to the belief thatsuch products are appropriate forregular consumption, it is a usefulstrategy to use schools as amodel for healthy diet (Bell &Swinburn, 2005). The findings ofthis study present a selectiveimplementation of the foodguidelines in relation to the itemsavailable in school canteens.School authorities have tried toimplement the guidelines to makea canteen a healthy setting byimposing certain restrictions onfood items while promotingalternatives. However, it wasfound that practical realities atground level make it difficult tocompletely adhere to theguidelines. Most of the majorobstacles to institute a healthycanteen are beyond the schoolsand the education authorities.

A key message is to promote riceand rice based food in schoolcanteens and to do away withwheat flour based and fried items.The efforts made to promote riceas a main food item in thecanteens has been derailed due tointroduction of “fried rice” in thecanteens as a major demanditem. In addition, use of tasteinducers for preparing food items(monosodium glutamate) wasfound as a major issue in foodsafety. The guidelines clearlymention to avoid harmfulpreservatives and food additives.The school authorities were

unaware of the use ofmonosodium glutamate by thecanteen operators in a major wayto induce demand on food. On theother hand, the food regulationsalso do not prohibit use ofmonosodium glutamate in general.Although introduction of pulsesintended to keep students awayfrom wheat based pastries, it hasnot been successful due to theextremely low demand. Pastriesand deep fried items have thehighest demand among thestudents. It is well establishedthat children will prefer fattysugary snack foods to morenutritious food and also, thepreference of parents for convenefoods that can be easily carried toschool (Bell and Swinburn, 2004).In school it is likely that studentsprefer those foods partly due toconvenience to have those fooditems in a short period of timeduring the interval and the taste itholds. Further, when there aremore alternatives, there islikelihood of children resorting toless optimal choices in regard tonutritive value. Also, the demandinduces the supply of “unhealthy”food unless suitable alternativesare provided. In this study it wasfound at present that “healthy”alternatives offered to students inthe canteen has failed to createenthusiasm on healthy foodhabits.

Owing to restrictions on sellingmilk packets and yogurt inschools due to dengue prevention,students in several schools havelost access to one of the mainprotein sources. Despite the banon carbonated drinks, it wasfound that one fourth of canteensstill sell them. Ratnayake andEkanayake (2012) reported that allexcept one (n=65) in their sampleof Colombo schools sold softdrinks in the canteen. They further

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reported that 82 per cent ofadolescents consumed sugarsweetened soft drinks one or moretimes in a week. This providesevidence for the existing demandfor carbonated beverage in schoolgoing children. In comparison,Kolakanda and fresh juice weresold in only a small number ofcanteens and with poor demandfrom students.

It was found that completelyremoving oily and sugary itemsfrom the canteens is practicallydifficult. The proposed alternativesfor pastries, fried food and sugaryitems in the school canteens havenot been able to satisfy thedemand. According to Bell andSwinburn (2004), the drivingforces behind school canteensales are also non-nutritive.School canteens exist for profitand fast foods are considered tobe the most profitable items.Thus, to sustain the canteeneconomically viable, canteenoperators have drifted from theguidelines to some extent. ThePrincipals also had to ignoresome deviations for the same.From the parents’ side, the schoolcanteen is treated as anopportunity to “reward” thechildren, hence, are not botheredon healthy choices (Bell &Swinburn, 2004).

5.4 Prices ofSelected Food ItemsOnly 40 per cent of canteensdisplay a price list that helpstudents to choose the food itemaccording to their affordability.Most students can afford onlyRs. 25 or less to buy food items.Observation on the median pricesof selected food items sold in

school canteens is around Rs. 25.It also shows that a student canafford to buy only one piece of aparticular food item for theamount they spend. The canteenoperator need to price a food itemconsidering the actual cost ofpreparing it, the amount that hasto be paid for the school and theintended profit. When the canteenoperators try to price the fooditems within the limits ofaffordability while retaining aprofit, they invariably compromisethe quantity and quality. TheWestern Australian experiencesuggest a canteen should beprimarily a resource for ensuringaccess to appropriate food tosustain the children during theschooldays rather than a sourceof revenue for the school. Hence,the financial target should be abreak-even and not profits(Pettigrew, Pescud, & Donovan,2012). Affordability of students cancertainly be increased in the SriLankan set-up if the share of theschool could be removed from thepricing equation of food items.

In this study, the quantity of foodoffered at a given price was notconsidered due to practicaldifficulties. It should be also notedthat guidelines issued from theMinistry of Education also wasnot based on the nutrition profileof specific food items and thepricing method. As the schoolcanteen is used within a broaderstrategy to combat childhoodmalnutrition (National NutritionCouncil, 2013), an approachencompassing nutrition profileneed to be considered in selectionof food items. However,considering the affordability ofstudents and pricing of food itemsat present, possibility of supplyinga nutritious food with adequatecaloric value in a school canteenis doubtful.

5.5 Food StallsLocated in CloseProximity to theSchoolOne of the key obstaclesexpressed by Principals andcanteen operators for operating ahealthy canteen was the presenceof food stalls close to the schoolthat sell unhealthy food. It wasfound that a majority of theschools have food establishmentsin the vicinity including outlets ofcorporate food establishments.Majority of these offer fast foodand carbonated drinks which arerestricted in the school canteenguidelines. However, it was foundthat some of the food stalls alsooffer healthy foods namely, kolakanda, fresh fruit juices and freshmilk. Food establishments aregoverned by the trade policiesand regulation outside thejurisdiction of school authorities.Display of unhealthy foodadvertisements were also seenclose to one third of schools.Hence, school children retain theaccess to unhealthy food itemsand are influenced by advertisingon their way to school. AsRatnayake & Ekanayake, (2012)noted, carbonated drinks areavailable even in most remoteplaces in Sri Lanka andaggressively advertisedparticularly by multinationalcompanies. All these factorseffectively reduce the efforts ofhealthy canteen guidelines tosome extent.

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5.6 SuggestionsUnawareness of canteenoperators, employees on healthyand unhealthy food andunfavourable attitudes and wrongpractices can be correctedthrough training andprequalification mechanisms. Apool of competent canteenoperators needs to be developedthan open award of tenders. Thisneed to be coupled with regularmonitoring of canteens usingstandard tools and trainedpersonnel. An information systemcross-cutting Ministry ofEducation and the Ministry ofHealth would help to monitor thestrengths and weaknesses of thesystem to take appropriatedecisions at the correct time.Evaluation mechanism tested inNational school canteen project inAustralia could be used as a baseto develop a tool for Sri Lanka(Department of Health, AustralianGovernment, 2013).

Unavailability of a purpose builtcanteen premises was found to bea major issue in maintaining ahealthy canteen. Less attentionhas been paid for the structuralarrangement of the canteen inalmost all schools. A commonground plan with appropriatespace and facilities will help tofunction a canteen in a hygienicmanner catering to the needs ofthe students. Although this will bea capital intensive initiative fromthe government side, it is worthattempting it in a pilot scale. Itcould generate interest inpotential sponsors among alumniand the private sector to take itforward. A basic ground plandeveloped by the authors isattached (see Annexure III).

Although the discussion onhealthy food has caught attentionin health as well as food scienceforums for over a decade in SriLanka, scientists and healthauthorities have failed to deliver

economically viable, culturallyacceptable and appealing healthyalternatives to unhealthy food.The available healthy alternativeswithin the budget of the majorityare not appealing to the youngerpopulation. Hence, a consortedeffort is needed to develophealthy recipes appealing andaffordable to the school children ifwe are to change the current foodhabits. As learnt in the Brazilineffort, prohibiting caloric foodsand restricting their advertisingper se will not resolve the issue. Acombined effort of parents,teachers, professionals, canteenoperators, legislators andadvertising agencies amongothers are necessary to promotestrategies that enable healthyeating habits among students(Gabriel, Vasconcelos, Andrade, &Schmitz, 2009).

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ReferencesBell, A., & B. Swinburn, (2004), “What are the Key Food Groups to Target for Preventing Obesity and Improving

Nutrition in Schools?” European Journal of Clinical Nutrition, 58,258–263. doi:10.1038/sj.ejcn.1601775.

Bell, A., & B. Swinburn, (2005), “School Canteen: Using Ripples to Create a Wave of Healthy Eating” TheMedical Journal of Australia, 183(1), 5-6.

Department of Health, Australian government, (2013, November 05), 2010 National Healthy School CanteensGuidelines. Retrieved December 30, 2014, from Department of Health, Australian government:http://www.health.gov.au/internet/main/publishing.nsf/Content/phd-nutrition-canteens

Gabriel, C., F. Vasconcelos, D. Andrade, & B. Schmitz, (2009), “First Law Regulating School Canteens inBrazil: Evaluation after Seven Years of Implementation” Archivos Latinoamericanos de Nutrición,59(2), 128-138.

Jayatissa, R., M. Gunathilaka, & D. N. Fernando, (2012), National Nutrition And Micronutrient Survey. Colombo:Medical Research Institute.

Mensink, F., S. A. Schwinghammer, & A. Smeets, (2012), “The Healthy School Canteen Programme: A PromisingIntervention to Make the School Food Environment Healthier” Journal of Environmental andPublic Health, 2012, 8 pages. doi:10.1155/2012/415746

Ministry of Education, Sri Lanka (2012), Sri Lanka Education Information. Colombo: Ministry of Education.

Ministry of Healthcare and Nutrition (2010), National Nutrition Policy of Sri Lanka. Colombo: Ministry of Healthcareand Nutrition.

National Nutrition Council (2013), Vision 2016: Sri Lanka, A Nourished Nation - Multi-sector Action Plan forNutrition. Colombo: National Nutrition Secretariat .

Parliament of Democratic Socialist Republic of Sri Lanka (1980), Food Act No 26 of 1980. Colombo: Parliamentof Democratic Socialist Republic of Sri Lanka.

Pettigrew, S., M. Pescud, & R. J. Donovan, (2012), “Outcomes of the West Australian School Healthy Food andDrink Policy” Nutrition & Dietetics, 69, 20-25. doi:10.1111/j.1747-0080.2011.01564.x.

Ratnayake, N., & L. Ekanayake, (2012), “Soft Drink Consumption in Sri Lankan Adolescents” Public HealthNutrition, 15(8), 1333–1337. doi:10.1017/S1368980012001061

World Health Organization (2004), Global Strategy on Diet, Physical Activity and Health” Fifty-Seventh WorldHealth Assembly WHA57.17. World Health Organization. Retrieved December31,2014,from http://www.who.int/dietphysicalactivity/strategy/eb11344/strategy_english_web.pdf.

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AnnexureAnnexure IInformation on School Health Promotion Committee and School Medical Inspection (SMI)

a. Availability of School Health Promotion Committee and School Medical Inspection (SMI)

Status Yes No


Availability of School HealthPromotion Committee 63 88.7 8 11.3

School Medical Inspection (SMI) is conducted 61 85.9 10 14.1

b. School Health Promotion Committee and School Medical Inspection According to Type of the School

Status Variable categories Type 1AB Type 1C Type 2 Total

Availability of School Yes 21 21 21 63Health Promotion No 2 3 3 8Committee

School Medical 1. All the grades areInspection (SMI) covered by SMI 3 2 4 9

2. Only Grade 1, 4, 7 and 10

are covered by SMI 15 19 18 52

3. SMI is not conducted 5 3 2 10

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Annexure IlAnalysis of Some Selected Factors and Food Items Available in the Canteen According toType of the School

b. Type of food items prepared in the canteen premises according to type of the school

Food Types Type of SchoolTotal

Type 1AB Type 1C Type 2

Main meals, short eats and drinks

( hot or cool) 12 9 5 26

Short eats and drinks (hot or cool) 5 3 8 16

Only drinks item (hot or cool) 2 6 4 12

Total 19 18 17 54

x2 – 7.158 p – 0.128 df - 4

a. Food preparation and facilities for dining in the canteen according to type of school (n = 68)

Facility Type of School Total x2 p


Food preparation in the Yes 19 18 17 54 0.998 0.607

canteen No 3 6 5 14

Availability of dining area Yes 12 14 8 34 2.485 0.289

No 10 10 14 34

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c. Availability of different food items in the canteen according to type of the school (n = 68)

Food Item Type of School Total x2 p


CerealsRice Yes 20 18 15 53 3.491 0.175

No 2 6 7 15

Kiribath Yes 7 7 7 21 0.051 0.975No 15 17 15 47

PulsesChickpea Yes 11 12 8 31 1.116 0.572

No 11 12 14 37

Cowpea Yes 3 5 2 10 1.291 0.524No 19 19 20 58

Mung bean Yes 1 1 2 4 0.608 0.738No 21 23 20 64

TubersManioc Yes 2 3 2 7 0.195 0.907

No 20 21 20 61

Sweet potato Yes 0 0 1 1 2.122 0.346No 22 24 21 67

Wheat flourBread Yes 13 13 9 35 1.564 0.458

No 9 11 13 33

Roti Yes 13 13 10 36 0.843 0.656No 9 11 12 32

String Hoppers Yes 2 4 3 9 0.578 0.749No 20 20 19 59

Pittu Yes 0 1 2 3 2.161 0.339No 22 23 20 65

Rice flourString hoppers Yes 19 13 11 43 7.569 0.023

No 3 11 11 25

Pittu Yes 1 1 1 3 0.005 0.997No 21 23 21 65

Hoppers Yes 7 8 8 23 0.106 0.949No 15 16 14 45

Ulundu FlourIdly Yes 3 4 3 10 0.114 0.945

No 19 20 19 58

Dosai Yes 14 10 8 32 3.717 0.156No 8 14 14 36

OtherNoodles Yes 11 11 12 34 0.348 0.840

No 11 13 10 34

Pasta Yes 5 1 0 6 8.062 0.018No 17 23 22 62

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e. Availability of food products with high sugar content according to type of the school (n = 68)



Chocolates Yes 4 6 4 14 0.442 0.802No 18 18 18 54

Cake Yes 1 2 1 4 0.402 0.818No 21 22 21 64

Doughnuts Yes 2 0 1 3 2.251 0.325No 20 24 21 65

Ice cream Yes 1 2 1 4 0.402 0.818No 21 22 21 64

Watalappam Yes 2 0 1 3 2.251 0.325No 20 24 21 65

d. Availability of beverages in the canteen according to type of the school (n = 68)



MilkFresh Milk Yes 4 2 0 6 4.531 0.104

No 18 22 22 62

Pasteurized Milk Yes 12 6 3 21 9.226 0.010No 10 18 19 47

Fruit JuicesFresh fruit juice Yes 3 3 3 9 0.017 0.991

No 19 21 19 59

Commercial fruitjuice Yes 7 3 1 11 6.404 0.041

No 15 21 21 57

Kola Kanda Yes 1 1 3 5 1.887 0.389No 21 23 19 63

Carbonated Drinks Yes 9 5 3 17 4.707 0.095No 13 19 19 51

Malted Drinks Yes 6 1 3 10 4.915 0.086No 16 23 19 58

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g. Availability of other junk foods according to type of the school (n = 68)



Toffees Yes 16 14 9 39 4.568 0.102No 6 10 13 29

Sweet desserts Yes 11 5 5 21 5.588 0.061(i.e. jelly) No 11 19 17 47

Any chips Item Yes 13 9 11 33 2.170 0.338

No 9 15 11 35

f. Availability of food products with fatty content according to type of the school (n = 68)



Pastry Yes 12 11 16 39 3.499 0.174No 10 13 6 29

Biscuits Yes 12 14 6 32 5.177 0.075No 10 10 16 36

Deep fried short Yes 18 17 20 55 3.010 0.222eats No 4 7 2 13

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Annexure IllA Sample Floor Plan for a School Canteen

An Assessment of the Implementation of Guidelines in ... Nutritional Status of Students and...

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