Abstract

Background: Food fortification refers to the process of adding nutrients to foods during their production. It is a cost-effective strategy with well-documented health, economic, and social benefits. Food fortification practices in school meal programs need guidance and legal support from various national policies. Aim: This study aims to analyze how various national policies—such as those related to school feeding, nutrition, health, food safety, agriculture, and the private sector—associate with the implementation of in-school food fortification among countries with school meals programs. Methods: The Bayesian Mindsponge Framework, combining the reasoning strengths of Mindsponge Theory and inference advantages of Bayesian analysis, was employed on a dataset of 126 government representatives who manage large-scale school meal programs in 126 different countries. Results: Findings showed that food safety policy and agriculture policy were positively and significantly associated with the in-school food fortification practices, while school feeding policy and private sector policy had ambiguous relationships with these practices. Nutrition policy and health policy had a significant negative association with food fortification practices among countries implementing school meal programs. Conclusions: Findings underscore the strong position of food safety policy and agriculture policy in guiding food fortification practices in school meal programs. There is a need to re-assess the implemented nutrition policy and health policy due to their significant negative associations with these practices. Enhancing and strengthening the school feeding policy and private sector policy may increase their potencies in giving positive impacts on in-school food fortification practices.