Assessment of School Nutrition Environments in North Macedonia

Highlights

The Assessment of School Nutrition Environments conducted in collaboration with the Ministry of Education and Science, the Ministry of Health and the Institute of Public Health, with UNICEF support, presents the first comprehensive national analysis of school nutrition environments in North Macedonia. Covering across 40 schools using the NEAT-S methodology, the assessment examines food availability, physical activity conditions, nutrition education, and support services for students.

The assessment reveals important strengths and persistent challenges shaping students’ access to healthy food and opportunities for healthy living. While some schools have infrastructure to support nutrition and physical activity, the overall environment is marked by limited provision of healthy meals and snacks, widespread availability of unhealthy foods, and inconsistent access to nutrition education and support services. The predominance of unhealthy food choices within and outside school grounds, and the lack of policies restricting these, continue to undermine efforts to promote healthy eating habits. Nutrition education and referral systems are not yet systematically embedded within the school system, and students overwhelmingly express a desire for improvements in these areas.

To address these gaps, strong legislative action, investment in universal healthy school meals, expansion of nutrition education led by trained professionals, and restrictive policies on unhealthy foods and marketing are recommended. Collaboration across sectors and active engagement of schools, health services, families, and local food producers are essential for creating supportive and sustainable school environments.