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    An exploration of stakeholder perspectives on primary school food provision in Medina, Saudi Arabia

    Elyas, Hanadi Abdulhamid (2018) An exploration of stakeholder perspectives on primary school food provision in Medina, Saudi Arabia. Doctoral thesis (PhD), Manchester Metropolitan University.


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    Childhood obesity currently represents a major public health challenge in Saudi Arabia (KSA), prompting calls for research into contributory factors. This study examines how the current system of school food provision (SFP) in Saudi state primary schools relates to KSA‘s broader nutrition environment, in order to inform future policy and practice in SFP. It focuses principally on the perspectives of two stakeholder groups, parents and teachers from Medina, KSA, adopting a mixed-method approach using questionnaires, focus groups and interviews to gauge opinions on current SFP for 6-12 year-olds, explore attitudes towards implementing change and identify factors likely to facilitate or hinder this. Questionnaire results from a sample of parents (n=295) and teachers (n=77) highlighted the importance of SFP in the nutrition environment of 6-12 year-olds and indicated broad support for changing current provision. Results also suggested that family finances, school facilities and funding models merited careful consideration when designing new SFP. Focus group data analysis identified other factors likely to facilitate or hinder changes to SFP while interviews with officials provided insights into how SFP related to the broader socio-cultural, economic, regulatory and legislative context in KSA. Findings were synthesised with evidence from existing literature to produce a socio-ecological model of KSA‘s nutrition contexts, illustrating the broader influences on food behaviours of 6-12 year-olds in the school environment. Enablers/barriers to implementation of healthier SFP in KSA were also identified. Recommendations emphasised the importance of adopting a whole school approach to SFP to ensure this is more likely to address childhood obesity concerns, by creating curriculum links to health, nutrition and physical activity, engaging stakeholders and improving food quality and facilities. They also highlighted the need for connectedness in government policy/strategy, accountability/transparency in the regulatory context and a new financial model for SFP.

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