The mismatch between canteen guidelines and their implementation at canteens in medical institutions in Anuradhapura District.

Introduction: The 'Guidelines for a healthy canteen in workplaces' (guidelines) was published in 2013 by the Ministry of Health to improve food choices & healthy eating of working community.

Objectives: To determine the extent of implementation of guidelines in canteens at medical institutions in Anuradhapura District.

Methods: A descriptive cross-sectional study was conducted on random working days in canteens providing all three main meals in medical institutions in Anuradhapura District in August and September 2018. Data were collected by observing the canteen and interviewing the canteen owners according to guidelines. Scoring was done according to a scoring system to obtain a percentage.

Results: Ten canteens were included in the study. The median number of customers per canteen was 200 (IQR 100-625). The highest and lowest scores by canteens for overall implementation were 41.8% and 14.1%, while the mean among all canteens was 29.2%. Average percentages for healthy carbohydrate, fruit, snacks, and oil options were 15.2%, 20.0%, 8.8%, and 28.2% respectively. Availability of healthy dairy and use of standard coconut oil was 0.0%. Safe drinking water and hand-washing with soap were available only in 6 and 4 canteens respectively. Implementation of food safety measures was 32.5%. None of the canteens had any posters/ guides regarding healthy eating and none of the owners were aware of the guidelines.

Conclusions: The level of implementation of the canteen guidelines was highly unsatisfactory among the canteens in medical institutions in Anuradhapura District.