Classroom Nutrition Prevents Diseases

The project aims to solve the problem of nutrition-related health challenges leading to increased mortality between ages 30 to 70 from NCDs.

Unhealthy eating is common among learners in the low-resources communities including the quintile 1 and 2 schools in the Tshwane district of Gauteng, South Africa. Whereas, the aim of the Life Skills curriculum of the Department of Basic Education is to empower learners to acquire knowledge and skills needed to benefit their lives and the communities.

Evidence has shown that teachers who teach nutrition in Tshwane district primary schools are not adequately equipped to effectively present nutrition messages to learners (Kupolati et al. 2018).

Unhealthy eating among learners often translates to lifelong unhealthy habits and lifestyles. This situation feeds into the rising pool of nutrition-related non-communicable diseases such as obesity, diabetes, hypertension, and certain cancers that are prevalent in South Africa.

The WHO reports that 51% of all deaths in South Africa are caused by non-communicable diseases including cancer, diabetes mellitus, cardiovascular diseases, digestive diseases etc. (World Bank, 2019).

The treatment and management of non-communicable diseases are overwhelming the health care system and constitute a drain on the national economy.

Also, these diseases constitute a threat to the nation's workforce, and hence national development.

Furthermore, nutrition-related non-communicable diseases undermine a person's earning potential and perpetuate the cycle of poverty.

References 

Kupolati MD, MacIntyre UE, Gericke GJ. (2018) A theory-based contextual nutrition education manual enhanced nutrition teaching skill. Frontiers in Public Health. 2018 May 29;6:157.

World Bank. (2020) Cause of death, by non-communicable diseases (% of total) - South Africa, 2020. Available at: https://data.worldbank.org/ind...

The solution is a preventative nutrition education-based approach to primary health care improvement by addressing the root cause of nutrition-related health challenges. It ensures that preventable non-communicable diseases overwhelming the primary health care system are prevented through effective communication of nutrition messages to learners. Learners are empowered to change behavior to lifelong healthy eating.

Teachers are trained to use a teaching strategy to present nutrition messages to learners in ways that are meaningful to them, and they are able to use them in their lives and experiences.

The strategy uses a combination of the social cognitive theory (SCT) and the meaningful learning model (MLM). This combination of theories has been successfully used to facilitate learning and behavior change. The theories are incorporated to impart emotion, reasoning, and the decision-making capacity of learners.

The teaching strategy is unique in that:

1. It is designed to relate to learners' circumstances precisely.
2. The constructs of the SCT and the MLM were used to explain nutrition messages in ways that are easily understood and can be followed.
3. Behaviour change capacity is built into the nutrition lessons through the constructs e.g
      - Learners could link their eating to their aspired dreams
      - Learners are enabled to set personalized goals to practice what they  have learnt
      - Teachers can model healthy eating for learners
4. The teaching strategy template can assist teachers in planning other nutrition lessons tailored to the specific needs of learners.

The following justifies the value addition potential of the teaching strategy

1. The content is aligned with education policies and the current curriculum practice.
2. The teaching strategy integrates the learner-centered teaching method, interactive/participatory method, and enhanced curriculum approach.
3. The outcomes are linked to the content and assessment.
4. The training activities are related to outcomes.
5. The teaching strategy strengthens the teacher’s competence in pedagogical content knowledge.
6. The training materials support the learning outcomes.
7. The nutrition teaching strategy is evidence-based and has been implemented in familiar settings.

The solution serves communities, especially at the local levels, through the local school system consisting of learners and teachers.

The teachers are equipped with the teaching strategy to teach nutrition effectively.

The learners are equipped with the knowledge and skills necessary to practice healthy eating and a lifestyle that can extend to their future life.

The school community, comprising the staff, parents/guardians and volunteers, would benefit from the healthy school food environment that would result from the impact of the nutrition education initiative.

Also, the community would benefit, as learners share their nutrition knowledge and skills with families and friends.

Team WBA is well positioned to deliver the solution as follows:

Human resources: The team comprise highly qualified, experienced, registered nutritionists, nutrition educators, dietitians, psychologists, and researchers who are eminently positioned to implement its school-based and community-based nutrition health initiatives.

Collaboration with government departments: WBA works in close coordination with government departments of the Republic of South Africa, including the Department of Health, the Department of Agriculture, and the Department of Education.

Coalition: WBA’s partnership with Solidarity for African Women’s Rights (SOAWR) enables us to leverage external resources to advance our projects, including the school-based nutrition education initiative.

Collaboration with other civil society organisations:  WBA’s partnership with other community-based organisations contributes to the efficiency with which communities are penetrated and our programmes implemented.

WBA intends to attract more technical partnerships and international collaborations by applying to this challenge.

The challenge would provide an opportunity for WBA to communicate its activities and specifically this initiative to a larger and global audience for extending the frontier of knowledge and impact.

WBA seeks financial resources to take the school nutrition education initiative to scale and to advance WBA’s other development programmes in the communities.

With the pilot of the nutrition education initiative underway, WBA is in discussion with the relevant government departments and parastatals on scaling the project.

Our success in this challenge would earn us credibility and enhance the acceptability among the stakeholders.

Furthermore, it would open doors for all the resources needed for scaling the initiative and implementing the associating interventions,

Associating interventions include the development of school gardens which is expected to cascade to home gardens towards alleviating household food insecurity.

With WBA’s success in this challenge, we envisage open doors to extend the intervention to other African Nations.

The solution approaches primary health care improvement from a dimension often ignored. Preventative measures are often neglected. The phrase “healthy eating, healthy life” seems to be a bridge too far in many communities. Whereas evidence shows that the root cause of many primary health challenges is nutritional transgressions over considerable periods.

The innovative aspect of the solution is initiating behaviour change to healthy eating using classroom nutrition messages from an early age.

As the advocacy regarding the initiative goes on, it is expected to initiate a catalytic effect to bring about the desirable change in the teaching of nutrition topics in primary schools.

It is expected that relevant government authorities and development agencies would facilitate the policy documentation and implementation.

The impact goal of the Classroom Nutrition Prevents Diseases initiative over the next year is to engage with 40 primary schools and train 120 teachers who teach nutrition in grades 5 and 6, potentially influencing the eating behaviour of up to 10800 learners.

The impact goal of the project over the next five years is to engage with 200 primary schools and train 600 teachers who teach nutrition in grades 5 and 6, thereby potentially influencing the eating behaviour of up to 54000 learners. Our focus on grades 5 and 6 learners is because the learners are at the age at which their eating behaviours can be influenced. Also, these grades feature more nutrition topics in the curriculum.

We plan to achieve our goals by:

1. Conducting four (4) nutrition education workshops each year to equip teachers with the teaching strategy to effectively deliver nutrition messages to learners.
2. Facilitating the development of school gardens in the schools that participated in the nutrition education workshop.
3. Providing follow-up support for teachers during the nutrition teaching activities and the schools concerning the sustainability of the school gardens.
4. Replicating the school nutrition education programme and expanding it to other districts and provinces through partnerships with the relevant government departments, including the Department of Education, the Department of Health, and the Department of Agriculture.

The progress of the impact of the programme would be measured as follows:

Process evaluation:

Qualitative feedback on the project implementation will be obtained from the trained teachers through one-on-one interviews and focus group discussions on an ongoing basis. The input will be used to continue to improve the project implementation.

Impact evaluation: The number of teachers and learners reached by the intervention is recorded in our database. The impact of the intervention on the nutrition knowledge, attitudes, and practices of learners and teachers would be assessed through scientific research in collaboration with the Human Nutrition Department, University of Pretoria.

The theory of change in our solution uses a theory-based teaching strategy grounded in the Social Cognitive Theory (SCT) and Meaningful Learning Model (MLM).

The teaching of Life Skills subjects in the primary school’s curriculum aims at promoting learners’ understanding of nutrition to the extent that they can use nutrition knowledge to improve their health and that of their families and the community.

The Department of Basic Education’s stance is to realise behaviour change to healthy eating among learners. For this realisation to occur among learners, teachers must use methods that help learners acquire nutrition knowledge and practically use it in their daily lives.

Therefore, we used the SCT and the MLM constructs to explain the nutrition topics and develop lesson plans to help learners understand nutrition concepts and practice healthy eating and lifestyle. The followings explain the theory of change in our solution.

Our solution is best described as nutritional science and technology leveraging traditional and natural technologies.

The core technology that powers our solution combines the behavioural and learning theories, namely SCT and MLM.

The constructs of the SCT were used to influence reasoning, affective and decision, while the constructs of the MLM were used to achieve consolidated learning.

The organizations that collect primary health care data for our solution include the Department of Health in the Republic of South Africa, UNICEF, WHO, World Bank, and FAO.

1. The Department of Health in South Africa collects health data to inform policy and for resource allocation.
2. UNICEF collects health data for the purpose of monitoring and evaluation and to inform policy.
3. WHO collects health data for policy, planning, monitoring and evaluation purposes. 
4. World Bank collects health data for policy, planning and development.
5. FAO collects health data to inform member states for policy implementation and development.

WBA is committed to nurturing and protecting a diversity, equity and inclusion culture through its values engrained in integrity, service, empowerment, respect, and teamwork.

In demonstrating diversity, WBA maintains an equal and conducive working atmosphere for people of all backgrounds.

WBA demonstrates its equity standpoint by maintaining a fair and equitable treatment opportunity and engagement for all.

In demonstrating inclusion, WBA fosters an environment that respects and values all viewpoints and ensures that persons from previously disadvantaged groups are included.

The business model below describes an overview of WBA’s business and operation model.

WBA’s sustainability plan includes:

Funding assistance through grants.

1. The long-term financial investment for income generation to fund its projects.
2. Consultancy services to private and corporate organizations.
3. Continued partnership with existing partners and initiating new partnerships with national and international development agencies such as DFID, USAID, GIZ, and more.

WBA has successfully mobilised funding through two (2) national funders, DG Murray Trust (DGMT), and the Investment Development Corporation (IDC).

WBA has ongoing partnerships with national and international partners, namely, the Department of Health, the Department of Education, and the Solidarity for Africa Women’s Rights.