The stakes are considerable. According to the World Health Organization, 31 major foodborne hazards caused approximately 600 million cases of foodborne disease globally in 2010, resulting in 33 million disability-adjusted life years and 420,000 deaths. Diarrheal diseases account for more than half of these infections, and children are among the most vulnerable groups, with diarrhea remaining the second leading cause of child mortality worldwide. Indonesia reports the highest prevalence of diarrhea among five Southeast Asian countries at 18.21 percent, exceeding Cambodia, Myanmar, the Philippines, and Timor-Leste. Within school environments, the risks are amplified by dietary habits: evidence indicates that 98.9 percent of Indonesian school-aged children consume ready-to-eat foods, increasing their exposure to unsafe food handling practices.

The consequences of these exposures are not hypothetical. The study documents a series of recent food poisoning incidents in Indonesian schools, including cases among elementary students in East Java in 2022 after consumption of candy-shaped snacks, 2,897 poisoning cases reported in Bandar Lampung with eight-year-olds among the most affected, multiple outbreaks classified as extraordinary incidents, and an event involving roughly 30 elementary students in Sukabumi in early 2024. These episodes have been attributed largely to improper food handling and limited consumer awareness of food safety and quality, underscoring the urgency of effective school-based education.

Recognizing these gaps, a research team led by Cica Yulia of Universitas Pendidikan Indonesia, working with colleagues from institutions including Bogor Agricultural University and the National Research and Innovation Agency, conducted a comprehensive qualitative needs assessment between April and November 2025. The study was theoretically grounded in three complementary frameworks: the Health Promoting Schools framework, which integrates health education across school policy, environment, learning, and community engagement; the Theory of Planned Behavior, which links attitudes, social norms, and perceived control to behavior; and Experiential Learning Theory, which emphasizes learning through direct experience and reflection. The work was supported by a Riset Kolaborasi Indonesia 2025 grant and received ethical approval from Universitas Muhammadiyah Surakarta.

The researchers employed a qualitative exploratory design using focus group discussions and semi-structured in-depth interviews in two purposively selected regions: Bandung City in West Java Province, representing an urban setting, and Gunungkidul Regency in the Special Region of Yogyakarta, representing a rural context. Participants were recruited through purposive sampling with maximum variation, spanning regional development planning agencies, district education and health offices, food security and agriculture offices, school principals, teacher working group coordinators, nutrition experts, and curriculum specialists. Discussions lasted 90 to 120 minutes and individual interviews 45 to 60 minutes, with all sessions audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s six-phase thematic analysis supported by NVivo 12 software.

The results paint a picture of promising but disjointed activity. Primary schools had established foundational programs, including routine canteen monitoring by health authorities, though participants noted that monitoring quality was not uniform across schools. Many schools had also embraced green economy initiatives such as school gardens, waste banks, and anti-food waste campaigns, which functioned as experiential learning platforms fostering environmental awareness. However, these activities operated largely without a standardized framework, meaning outcomes depended heavily on local leadership and resources. Food safety and nutrition content was embedded across multiple subjects, including Science, Physical Education, Environmental Education, and the Pancasila Student Profile Strengthening Projects, and teachers frequently wove hygiene and nutrition themes into thematic and project-based learning. Yet schools lacked structured modules, clear competency indicators, and assessment rubrics, producing what the authors describe as a curriculum lottery in which instructional depth varied with individual teacher initiative.

Stakeholders were candid about these deficiencies. One school principal emphasized the need for uniform guidance in the form of a dedicated food safety and nutrition module for elementary students, while another noted that annual curriculum reviews allowed adaptation to local contexts but could not compensate for the absence of standardized materials. The analysis identified three priority needs: grade-specific learning modules with explicit outcomes and assessment criteria, formal recognition of food safety and nutrition as core competencies, and behavior-oriented learning strategies grounded in experiential principles. The study also revealed strong multi-sectoral engagement, with health departments supplying pamphlets, videos, and training, and agriculture offices working with extension workers to reduce pesticide use among local food producers. Family involvement emerged as influential but inconsistent, with one teacher coordinator observing that the family role is strong but not uniform across students, highlighting the need for stronger home-school collaboration.

From this five-dimensional needs assessment, the team developed the GREENEDU NEXUS model, an operational adaptation of the whole-school food systems approach tailored to Indonesian primary schools and aligned with the Sustainable Development Goals, particularly SDGs 2, 3, and 12. The model comprises five interconnected pillars. The first, a standardized curriculum, addresses the lack of learning materials through grade-specific modules and behavioral assessment rubrics. The second, experiential learning, translates knowledge into practice through student-led canteen audits, hygiene simulations, and school food gardens. The third, safe and sustainable canteens, targets sanitation and healthy food supply via canteen certification, nutrition labeling, and local food sourcing. The fourth, green behavior and food waste reduction, promotes environmentally friendly consumption through waste banks, zero-leftover initiatives, and composting. The fifth, partnership and advocacy, formalizes cross-sectoral collaboration through parent education, local food procurement, and multi-stakeholder coordination.

The authors argue that the central challenge in Indonesia is not the absence of policy commitment but the limited institutionalization of governance mechanisms that convert national policy into coordinated implementation, monitoring, and accountability at the school level. They contrast the current situation with structured, competency-based food safety education models in Taiwan and China, which have demonstrated sustained improvements in student knowledge and behavior, and note that competency-based school health programs are most effective when curriculum standardization is paired with teacher capacity building, monitoring systems, and supportive school policies. The findings also align with World Health Organization-endorsed Health Promoting Schools frameworks, which recognize that sustainable implementation requires clearly defined governance arrangements and shared accountability across education, health, agriculture, and local government sectors.

The study’s implications extend beyond Indonesia. For policy makers, the research suggests institutionalizing food safety and nutrition education within formal curricula, teacher education, and school food governance through competency-based modules, minimum infrastructure standards, and structured coordination mechanisms. For practitioners, the message is a shift from prohibition-based approaches toward behavioral empowerment supported by enabling food environments, experiential learning, family engagement, and partnerships with local food systems. The authors acknowledge limitations: the findings are context-specific, reflect stakeholder perspectives rather than direct behavioral outcomes, and do not comprehensively explore informal food environments surrounding schools. The GREENEDU NEXUS model has not yet been piloted, and the researchers call for implementation studies using mixed-methods and longitudinal designs to evaluate its effectiveness, scalability, and long-term contribution to school-based food safety, nutrition, and public health. If subsequent trials validate the framework, it could offer a replicable template for low- and middle-income countries grappling with the same gap between food safety policy on paper and protection on the plate.

Subject of Research: Implementation gaps in school-based food safety and nutrition education in Indonesian primary schools

Article Title: Translating food safety and nutrition policy into school-based practice: Evidence from Indonesian primary schools

Article References: Yulia, C., Khomsan, A., Mariana, R. R., Iwansyah, A. C., Rosdiana, D. S., Purwaningtyas, D. R., & Sari, D. R. (2026). Translating food safety and nutrition policy into school-based practice: Evidence from Indonesian primary schools. Public Health in Practice, 12, Article 100844. https://doi.org/10.1016/j.puhip.2026.100844

Image Credits: AI Generated

DOI: 10.1016/j.puhip.2026.100844

Keywords: food safety, nutrition education, primary schools, Indonesia, foodborne disease, GREENEDU NEXUS, Health Promoting Schools, experiential learning, school canteen, green economy, public health policy, qualitative research