Abstract Background Food allergies (FA) represent an emerging public health concern in developing nations, with schools being critical settings for preventing life‐threatening anaphylaxis. This study assesses the FA preparedness in China's primary and pre‐primary institutions to identify key determinants of readiness and inform evidence‐based policy. Methods A national cross‐sectional survey was conducted between June and December 2024. A principal‐designated staff member from 4769 schools across 32 provinces and 300 cities completed an online questionnaire. Data were collected on school demographics, existing FA policies, staff training protocols, emergency medication access (specifically epinephrine), and staff knowledge of allergy management. Results Significant disparities in FA preparedness were identified between government‐funded (public) and self‐funded (private) institutions. Public schools demonstrated superior preparation regarding emergency medication availability (adjusted odds ratio aOR = 1.392, p < .001) and policy implementation (aOR = 1.161, p = .029). Preparedness drivers also differed by school type: public schools were primarily influenced by the presence of students with known allergies (aOR = 1.806), whereas private schools were more strongly driven by the presence of a school physician (aOR = 8.608). Furthermore, private schools reported greater barriers to policy implementation ( τj : 2.253 for public vs. 2.540 for private, p < .001). Conclusions A school's funding model is a key determinant of its FA emergency preparedness. These findings underscore the urgent need for uniform national standards for FA management in schools. In countries where there is no standardized FA management policy, a nationally approved evidence‐based policy would not only enhance student safety but also empower the staff at school to manage severe food allergic reaction. The establishment of such policy are of particular importance in developing countries where the prevalence of FA will increase with economic advancement.
Wang et al. (Sun,) studied this question.