Photovoice to Improve Food Choices in Indonesian Elementary School Students

Indonesia is known to have a double burden of malnutrition. Underweight, stunting and overweight are arising in Indonesian children. Socioeconomic factors are not the primary source of problems since we can find malnutrition in children in families from middle-high socioeconomic levels.

Food choice is one factor contributing to these problems. Indonesian people love to eat fried foods and consume a high proportion of carbohydrates (mostly rice and sugary drinks). That is quite ironic since Indonesia has a good supply of fruits and vegetables and has many ways to cook instead of frying.

The problem of unhealthy food choices is somehow familial and inherited over generations. Efforts to develop healthier food choice programs to decrease malnutrition are complex because of familial, environmental, and cultural issues that must be addressed for efforts to succeed. So far, the program of improving food choices was focusing on the parents, especially the mothers. It is based on the fact that mothers usually provide family food. Even if the family did not cook by themselves, mothers took the responsibility to subscribe the food from local catering services or buy from nearby restaurants.

Children in elementary school should be involved in the movement to improve their food choices because they will get the most impact and hopefully will last to the next life stage. The curriculum in the school has been improved in the last few years, including a healthy diet and other healthy lifestyles. However, it is essential to know what the children really consume daily, relate it to their health condition, to understand how they view the importance of healthy food choices to benefit themselves in the long run.

We can ask elementary school students to show us their food choices using Photovoice. We first need to collaborate with the school to make sure the program aligns with their curriculum and not just giving extra works for the children and their families. It will be much easier in this post-pandemic teaching environment where the school is still keeping the online assignment system.

In the first session, we should inform the children and their parents about the programs, the goals, and getting their consent. To facilitate them taking pictures that are significant for them, we can provide support of mobile internet data voucher since nearly all families have the phone with camera. For families without a camera perhaps we can lend them a phone with camera. It is also important to share some basic ethics in documenting objects with a camera.

The project should be run daily for at least seven consecutive days; the longer, the better. Each day, they will be asked to submit 1-3 photos of their actual meal/snack or other aspects of their lives related to food (it could be the food they do not like or food advertisement that they love). At the end of the program, we ask each student to select two of the photos and write a reflection on them. This reflection part is also in line with the national education program that asked each Indonesian student to reflect (mainly after the given task of reading stories) to improve their literation.

In the second session, each student shared their two selected pictures and thoughts, providing us about the familial, environmental, and cultural context of food choices. We can also ask their parents to join this session to get their confirmation and feedback.

This method can be an insightful and fun way to initiate discussion in improving food choices. Since the daily photo collection spans at least a week, it is hard to make up what they really eat in each day’s photo. So, we can get a variety of food-related photos from a family and infer their family food choices.

Even if they showed the healthier food each day just to get a good impression because they know they are being “watched”, it is a promising finding. We can also ask about the feeling of switching to healthier food choices for one week and the barrier to keeping it as their new family tradition. For the families that are really good at their food choices, we can ask about their tips and tricks on doing that regularly.

If possible, the program should be held each semester or year. So we can make it a routine, helping students and families to improve over time.