Background: Nutrition problems among primary school children increase the risk of illness, reduce school attendance, and impair academic performance. The Indonesian national school feeding program (ProGAS—Program Gizi Anak Sekolah) was developed to address these issues through the provision of healthy breakfast, nutrition education, and character building. Methods: This study employed a mixed-methods design involving 454 primary school students aged 8–14 years from 24 schools across four provinces. Data collection included structured questionnaires, 24 h dietary recalls, and anthropometric measurements. In-depth interviews with school principals, teachers, cooking teams, parents, students, nutritionists, and district education office staff were conducted to capture experiences and opinions on the ProGAS implementation. Results: ProGAS significantly improved students’ dietary diversity, meal frequency, handwashing with soap, and nutrition knowledge, alongside a positive trend in school attendance. Improvements included higher mean dietary diversity, increased proportion of students eating ≥3 meals/day, greater correct responses on balanced nutrition, and higher rates of handwashing before meals (all p < 0.01). Children also developed positive behaviors such as praying before meals, queuing, and taking responsibility for cleaning dishes. However, students’ breakfast habits did not significantly improve, the delivery of nutrition education was suboptimal, and no significant changes were observed in nutrient intakes or nutritional status based on BMI-for-age. While the energy and protein contributions of the ProGAS menu met the recommended 25–30% of daily requirements for breakfast, its micronutrient contributions remained below the recommended levels. Key management gaps include the delivery of nutrition education to students and the monitoring of implementation by local and national authorities. Conclusions: ProGAS demonstrated positive impacts on some dietary and hygiene practices as well as learning environment. To achieve greater improvements in breakfast habits, nutrient intake and nutritional status, it is recommended to strengthen the school feeding menus not only for dietary diversity but also for nutrient density, enhance capacity building for teachers, deliver regular and engaging nutrition education, and reinforce program monitoring.

Indonesia is experiencing a double burden of malnutrition,especially in young children. Many studies show that community empowerment andnutrition education are effective at reducing the risk of malnutrition whencombined with attractive tools and appropriate nutrition and parenting messages.Therefore, we developed innovative picture storybooks as a fun learning tool to equipteachers and parents with a way to improve their understanding and awareness ofthe quality of early childhood dietary habits and social behavior. The studyconsisted of three stages, including formative research, book development, andevaluation. Our formative research triangulated information on preferences andkey messages on food, nutrition, parenting, and child characteristics throughfocus group discussions (FGDs), in-depth interviews (IDIs), and observations of school foodenvironments. The FGDs were held for the children (n=6), teachers (n=6), andmothers (n=6). The IDIsexplored opinions from a story teller, a nutritionist, a communication expert,a child psychologist, and an illustrator team. Finally, books were developed bythe researcher and evaluated by the expert team (n=10) and teachers (n=8). Thestudy took place in early childhood education centers and kindergartens inCentral Jakarta’s urban areas. Children preferred picture storybooks that represented a unique conditionof magical power and provided characters from the fantasy genre. Following theIDI’srecommendations and observations, three picture storybook series were developed: healthysnacking, integrated with messages to stimulate a child’s disciplined behavior;eating vegetables, especially green ones, with the motivation to increasetruthfulness; and a healthy eating portion guide with a variety of foodscombined with messages to motivate grateful attitudes. The book contentintegrated key messages on nutrition, parenting, and social behavior withunique characters and colorful pictures. The expert team recommended theappropriate development of the picture storybooks and emphasized paying attention to cleargenres, text structure, content, themes and ideas, language, vocabulary,illustrations and graphic design, and messages delivered. The picture storybookspresent key messages on nutrition, parenting, and child behavior using anattractive, colorful and unique appearance. These books can be used to teachearly childhood nutrition and parenting intervention by integrating them withother approaches such as story-telling, eating meals together, and othersupporting activities.

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