Drivers of healthy eating in a workplace in Nepal: a qualitative study

Objective To explore the perceptions, enablers and barriers to employees' healthy eating in a hospital site. Design A qualitative study including focus group discussion and in-depth interview, data were analysed using thematic analysis method. Setting The study was carried out among employees of Dhulikhel Hospital-Kathmandu University Hospital, located about 30 km east of Nepal's capital Kathmandu. Participants Focus group discussions were conducted among the 33 participants, who were divided into four groups: (a) support staff (drivers, cook, laundry, gardeners and ward boys), (b) hospital administrators and managers, (c) health personnel (doctors, nurses and assistants) who work 8-12 hours shifts and (d) health personnel who work during office hours. Nine in-depth interviews were conducted among six canteen operators and three managers. Results The major factors for promoting healthy eating were identified as the availability of affordable healthy food options in the cafeterias, a commitment to such promotion by the cafeteria manager, operators, staff and hospital administration and the level of education of the employees. The most commonly reported barriers for healthy eating were the unavailability of healthy options, including the lack of food supply from local market, the higher cost of healthy foods, individual food preferences and limited human resources in the cafeteria. Conclusion The availability of affordable healthy foods, supply of healthy foods from the market, commitment from cafeteria managers, hospital administrators and health awareness among cafeteria operators may promote healthy eating among employees in a Nepali hospital setting.