The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.

COLLEGE OF EDUCATION AND

BEHAVIORAL STUDIES
DEPARTMENT OF EDUCATIONAL
PLANNING AND MANAGEMENT

Assignment
Reseach (EdPM).

Assignment Three:
Reviw of Litrature
(Impacts of School Feeding on Educational and Healhy
Outcome of School Age Children).

Prepared by:
Sirajudin Akmel GSR/1062/13

Submitted to: Dr.Fekadu Mulugeta

March. 2021

The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.
The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.

CHAPTER TWO: LITERATURE

REVIEW

The following related literature cited in this chapter are several sources of
information and ideas that helped enhance the knowledge of the researcher on how
other things or phenomena are associated to the concern of this study. Thus, these
would supplement and complement to the findings of this study.

School Feeding from Global Perspective

October 16 is World Food Day, a day when people come together to declare their
commitment to eradicate hunger within a lifetime. Many school-age children across
the globe depend on school feeding programs for morning and mid-day meals.
School feeding programs incentivize parents to keep children in school and provide
students the essential nutrients to stay healthy and able to learn. School feeding
programs have a long history as a social protection tool. The provision of meals in
schools was one of the first public welfare programs worldwide and among the first
interventions to be widely delivered through the education sector.Evidence shows
that these programs support the development potential of children and offset lost
income for struggling families. With children fed at school, families are better
positioned to navigate financial hurdles, and in doing so, generate large-scale
economic growth nationally.According to the World Food Programme (WFP), nearly
every country in the world has a national school feeding program, serving an
estimated 368 million children worldwide with an investment of up to $ 75 billion.
(ANDY CHI TEMBONLINDA, 2015)

The SFP started in the 1930’s, when feeding schemes were introduced in
the United Kingdom (UK) and the United States of America (USA) with the
purpose of improving the growth of pupils by providing them with milk
(Ritcher et al., 2000).

The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.
The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.

In Brazil after the Second World War in 1945, School Nutrition and Food
Security Programme (SNFSP) in schools was introduced (Swartz, 2009). In
implementation of this programme, Brazil adopted a decentralization
approach as a strategy to manage the programme. Brazil also introduced
the local school meals councils, which involved representatives from the
government, teachers, parents and civil society organizations (WFP, 2009).
School meal movements started in Europe in the late 18 th century and were
initially funded by individual donors and private organisations. The
programmes had similar goals as those in developing countries today:
reducing inequality by supporting disadvantaged people, improving health
standards through better nutrition levels at children-age and stimulating the
economy by improving the population’s educational level through raising
attendance rates and student attention. Besides these similar goals,
additional public intentions raised interest among European and American
leaders in this measure: forming a healthy – male – population base for
military recruitment, as done by the British at the beginning of the 20 th
century or giving a public sales opportunity to the agricultural sector
suffering from massive overproduction and plummeting market prices, as
done by the United States in the 1940s. These purposes secured
governmental funding for school meals (Levenstein, 2003).
School feeding contributes to the education and well-being of children. A
hungry child does not grow, cannot learn as well and faces many health risks in the
future. School feeding can bring children into school and out of hunger. It is far more
than food-giving. They are an investment in the world’s poorest children. They are an
investment in our common future and global stability. School feeding can bring
children into school and out of hunger. Strong partnerships can increase factors that
pull children to school. It is a springboard for many positive outcomes for poor
children and their families. School feeding programs engage parents and
communities in the promotion of public health, education and the creation of an
independent future. Few safety-net programs provide so many multi-sector benefits-
education- gender equality, food security, poverty alleviation, nutrition and health-in
one single intervention (WFP, 2016).

The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.
The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.

School Feeding in Ethiopia

WFP sponsored school meals started in Ethiopia in 1994 with an initial pilot
project in
war-affected zones in Tigray region. Then, the school meal has been provided
in chronically food insecure districts in six of the country‟s nine regional states (Afar,
Amhara, Oromia, SNNPR, Somali and Tigray) by World Food Program, MOE,
Regional education bureaus and the community with a particular focus on districts
with lower enrollment and higher gender disparity. In 2008, WFP provided food for
915 schools with 482,000 children benefited from school meals. The per child food
ration consists of 150 gm. of corn-soya blend 6 gm. of fortified vegetable oil and 3
gm. of iodized salt, provided as a cooked meal on every school day (Pope et al,
2016; WFP, 2008).

Evaluation was commissioned to assess to what extent the USDA McGovern-Dole

funded activities contributed to the anticipated outcomes of improved attendance and
attentiveness, and improved equity in primary education access, in the Afar and
Somali regions. The evaluation was intended for both accountability and learning
purposes. It focused on assessing the relevance, effectiveness, impact, efficiency,
sustainability, and coherence of the school interventions. The evaluation also
included two mini-case studies, one of the separate Emergency School Feeding
Programme (ESFP) introduced by the Government of Ethiopia (GoE) and one of the
Take-Home Rations (THR) – Girls Initiative Programme within the McGovern-Dole
operation. Overarching evaluation questions focussed on evaluating the
appropriateness of the programme to the needs of beneficiaries and the context of
the regions, the achievement of its planned outcomes and outputs, the gender and
equity dimensions results, and the overall impact of the programme – including the
factors influencing the results.

The evaluation covered the following activities: 1) daily school meals provided to
primary school children, and 2) capacity building aimed at supporting increased
dietary and health practices, including activities to support the capacity of the
Government to develop a National School Feeding Programme (NSFP).

Key evaluation findings included:

The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.
 The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.

• The appropriateness, relevance, and importance of the school feeding

programmes to children’s needs were confirmed and appreciated by
beneficiaries and other stakeholders. The program is well aligned with
national policies and strategies, except with the Government’s priority of
home-grown school feeding, as the food is currently imported.

• The evidence demonstrates that school feeding, supplemented by specific

interventions targeted at girl students, improves inclusiveness, participation,
and achievements in education.

• While WFP generally has very clear guidelines and an efficient procurement
system in place, issues with the timeliness of delivery were found.

• The GoE ownership of and commitment to SF, at both federal and regional
levels, have increased, and various high-level persons in government became
champions for SF.

• The evidence reviewed suggests that with the end of the programme, the
positive effects on households cannot be sustained as it would require
households to fill the financial gap that is being left. The GoE is not ready to
finance and run a national school feeding programme.

Key recommendations from the evaluation included:

• Prioritize fundraising for the continuation of school feeding and a THR for girls
to the schools that were covered under the McGovern-Dole programme.

• Prioritize finalization of the national strategy and use it as the basis to develop
an implementation guideline with different types of school feeding scenario.

• Develop and implement an adequately funded advocacy strategy that builds

on the key findings of this evaluation and previous work to scale up political
and financial commitment to SF in Ethiopia.

• Ensure that future SF in Ethiopia by WFP includes attention to strategies,

targets, and indicators for increasing the participation of women and girls in
SF design and implementation stages.

• Ensure that the selection of beneficiary schools under the next phase of McGovern-
Dole support to SF in Ethiopia is based on a clustered approach so that the

The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.
The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.

distances between schools do not make monitoring overly onerous or complicated.

(Ethiopia, SFP,2018)

Home Grown School Feeding

Alderman and Bundy highlighted the tendency of favoring the local purchase of FFE
programs which is a movement towards so called home grown school feeding. This
has
increased focus on procurement and quality. The emphasis on food procured in the
communities around the school enhances the rural economy and food quality
(Adelman and Bundy, 2012). Songa (2011) also stated that the Home Grown School
Feeding Program theory act as vehicle for promoting local development and fighting
food and nutrition insecurity within education for the purpose of increasing
enrolment, promoting regular school attendance and retention to improve
children learning.

HGSFP can significantly contribute to the achievement of the Sustainable

Development Goals (SDGs), particularly SDG 2 (on ending hunger, achieving food
security and improved nutrition, and promoting sustainable agriculture) and SDG 4
(on quality education). In recognition of this, numerous governments and regional
organizations, including the African Union and the community of Latin American and
Caribbean States, are including these initiatives in their strategies for achieving food
security and implementing the 2030 development agenda (WFP, 2015). From the
African states, Mozambique has an example of a school feeding program designed
on the concept and principle of „Home Grown School Feeding‟ whereby food
will be directly purchased from the local farming community to foster local economic
development (Lawson, 2012).

Theoretical Frameworks

This study was guided by IncentiveTheory the instinct theory which is considered as
the root for all the motivation and motivation is to survive . The theory depicts that

The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.
The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.

biological or genetic programming causes the motivation to occur and all human
beings share the same motivation as all of us are sharing the similar biological
programming . Then, the incentive theory is among the major theories of motivation.
This theory illustrates the desire to motivate behaviours for enrichment or incentives ,
which means we are motivated to perform actions because of internal desires and
desires, yet at other times, our behaviours are passionate by a desire for external
rewards. Besides that, the arousal theory illustrates the maximum level of eagerness
or arousal . People with high optimum levels of arousal will perform high enthusiastic
behaviours, like bungee jumping, scuba diving and so on. While the rest of us are
feeling contented with less exciting and less unsafe activities. The theory depicts the
ability to do what needs to be done, without influence from others or
circumstances(Valarmathie Gopalan et al,2017)

when this theory is applied to the study, the argument is that, when children
are served with meals/food at school as an external reward and as
motivation to perform will be arose which is the internal desire , they attend
and stay in school and improve the attention span by solving short-term
hunger. Therefore, the provision of food/meals through SFPs enhances
school enrolment and attendance, alleviates short-term hunger and
improves nutritional status. From this theory, the researcher therefore
attempted to apply it to assess the impact of the SFPs at primary schools.

School Feeding Attendance and Enrolment

Children in poor health start school later in life or not at all. A study in Nepal
found that the probability of attending school was 5% for stunted children versus
27% for children of normal nutritional status (Moock and Leslie, 1986). In Ghana,
malnourished children entered school at a later age and completed fewer years
of school than better nourished children (Glewwe and Jacoby, 1994). The
number of days that a child attends school is related to cognition and
performance. SFPs can have a positive effect on rates of enrollment and
attendance.

A recent evaluation of an on-going school feeding program in Burkina Faso

found that school canteens were associated with increased school enrolment,

The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.
The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.

regular attendance, consistently lower repeater rates, lower dropout rates in

disadvantaged provinces, and higher success rates on national exams,
especially among girls (Moore, 1994).
A small pilot school feeding programme in Malawi was evaluated for its effect on
enrolment and attendance. Over a three month period there was a 5% increase
in enrollment and up to 36% improvement in attendance/absenteeism compared
to control schools over the same period (WFP, 1996).
Niger has one of the five lowest school enrollment rates in the world; the school
feeding programme is intended to enhance attendance of nomad and
transhumant families, particularly of girls. Beneficiaries receive the equivalent of
the total daily recommended food intake (2,079kcal) in three meals per day. In
addition, as an incentive for girls’ participation in schools, some families receive
an additional take-home ration. Evidence from past experience with the SFP
shows that it contributes to its objectives: Whenever canteens have been closed,
even provisionally, immediate and high absenteeism follows and children are
withdrawn from school. In areas with nomadic and transhumant populations, the
school year cannot commence until food stocks arrive (WFP, 1995 p43; 1996
p13).
Although not a school feeding programme in the traditional sense, school-based
food distribution has also been used successfully to improve enrollment and
attendance among school-age children, particularly girls.
In Bangladesh, a programme of school-based food distribution increased
enrollment by 20% versus a 2% decline in non-participating schools (Ahmed and
Billah, 1994 p34).
In Pakistan, a programme provides an income transfer in the form of one or two
tins of oil to families whose girls attend school for 20 days per month. In its pilot
phase, the oil incentive programme demonstrated that it could make a significant
contribution to full attendance.In participating schools enrollment improved by
76% compared to 14% in the province overall. Attendance increased from 73%
to 95% among participants. The programme also claims to put additional food
into the hands of mothers and to serve as a contact between mothers and
teachers on distribution days (WFP, 1995 p41; 1996 p14).
These food transfer mechanisms do not offer the same potential benefits, for
example, meeting short-term hunger and specific nutritional needs, as
The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.
The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.

programmes that deliver food directly to beneficiaries. These kinds of

programmes should, therefore, be assessed within the context of other food and
resource transfer programmes. A detailed discussion of the range of options
from food stamps, coupons and vouchers to a cash transfer for food can be
found in the desi
School Feeding and Academic Improvement

The potential impact goal of targeting children through Food for Education programs
is to increase their educational achievement so as to improve their potential future
productivity and earnings. However, improvement in educational achievement due to
serving food in SFPs Through three paths first, increase school attendance by
lowering the opportunity costs of attending school and providing additional incentives
to engage in formal education. This leads to more time spent in school and more
time spent towards learning. The second is through the alleviation of short term
hunger which improves children’s cognitive functioning and attention span. The third
path is through the improved nutritional status of children by providing them calories
and nutrients in addition to their regular diet. This leads to better health and better
resistance to infections diseases and illnesses that would keep children from
attending school (Buttenheim et al. 2011). Thus, better nutrition indirectly improves
educational achievement by increasing school attendance by children. Relationship
between SFP and potential outcomes and impacts on school children Improved
Cognitive Skills and Behavior.Short-term Hunger Alleviated Increased Enrollment
and Attendance.

Promotion of Community Participation

Schools that depend on the community to organise and implement SFPs offer
certain advantages. These advantages include increasing the contact, and
hence communication, between parents and teachers, officials and others;
giving parents the opportunity to become more aware of what goes on at
schools; and serving to raise the value of education/the school for parents and
the whole community. For example, school canteens are viewed as an important
feature of education policy in Morocco. Since 1978, WFP and the government
have supported school feeding. The programmes have strong government and

The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.
The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.

community support and are viewed as part of a necessary package of inputs for
improving education. The feeding programme is credited with helping to maintain
high enrollment and attendance and encouraging community participation in
education. School cooperatives support the school canteens and parents
associations assist with the transportation of food aid (WFP, 1993).

School Feeding and Health

The nutrients in food enable the cells in our bodies to perform their necessary
functions. This quote from a popular textbook describes how the nutrients in food are
essential for our physical functioning.

The majority of research examining food insecurity in general and its effects on
health outcomes has concentrated on children. This research has found that food
insecurity is associated with increased risks of some birth defects, anemia, lower
nutrient intakes, cognitive problems, and aggression and anxiety. It is also
associated with higher risks of being hospitalized 8 and poorer general health and
with having asthma, behavioral problems, depression, suicide ideation, and worse
oral health. Exhibit 2 gives details about the data sets and methods used in a subset
of these papers and, in some cases, the magnitude of the effects reported. For
example, compared to children in food-secure households, children in food-insecure
households had 2.0–3.0 times higher odds of having anemia, 2.0 times higher odds
of being in fair or poor health, and 1.4–2.6 times higher odds of having asthma,
depending on the age of the child.(Craig Gundersen and James P. Ziliak,2015)

"Nutrients are the nourishing substances in food that are essential for the growth,
development and maintenance of body functions. Essential meaning that if a nutrient
is not present, aspects of function and therefore human health decline. When
nutrient intake does not regularly meet the nutrient needs dictated by the cell activity,
the metabolic processes slow down or even stop."

Even when quality schools, textbooks, and teachers are all provided, children can
only receive effective education if they are in school and prepared to learn. Poor
health and hunger both reduce attendance and hamper learning in school. School
health and school feeding (SHSF) programs can help overcome these barriers to
learning for all—especially among children and youth from poor households, who are

The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.
The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.

most likely to suffer from health and nutrition problems(Grantham-McGregor et al.

(1998) and Jacoby et al. (1998).

In univariate analysis, thinness was commoner in nonschool feeding program

schools (37.5%) compared to school feeding program schools (27.8%) but stunting
was less common (48.3% versus 58.5%). However, afteradjustment for confounding,
there was no difference in stunting levels, but the adjusted odds ratio for thinness
innonschool feeding program schools was 2.6 (95% CI: (1.8, 3.8)) times higher than
in school feeding programschools. Other independent risk factors for thinness were:
having uneducated mother, being a male and takingmeal once daily. Independent
risk factors for stunting were ethnicity, having uneducated mother, un-piped
watersupply, taking meal once daily, type of diet and being a male(Yeshalem
Mulugeta Demilew and Azezu Asres Nigussie,2020)

Research has shown that two most important contributions to cognitive

development and physical development differences are heredity and nutrition
(Myers 1988). A child has a continuous individualised process of change in
complex levels of cognitive, emotional, socialisation, body movement and
speech among others, if the diet of the child is of nutritious values. He argues
that a healthy child makes gain in language, cognitive and motor development
compared to a child who is malnourished and retarded in growth. This helps the
child in better performance.

Pollit (1984) says that malnutrition has become the highest risk-factor for the
educational future of children. It has serious developmental implication on young
children because their ages are critical in growth and development. Eshiwani
(1990) states that nutrition education may be the single most effective way to
enhance economic productivity and to promote the well being of a family.
Therefore, the actual effectiveness of nutrition education in promoting the well
being of a family needs further determination. The Kenyan government should
dedicate its efforts towards improving the well being of its people by enhancing
education and eradicating poverty and disease.

King (1966) argues that the most serious long term effects of sickness or
malnutrition are of course those permanently affecting the intellectual functions
and the learning capacity. This does not exclude the day to day effects of

The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.
The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.

hunger. It is an everyday observation that children who are on a poor diet show
little activity and lack energy. The children in pre-school are losing part of the
most important period of education. Hough (1987), in his book Education and
the National Economy says lack of food, good health and hygiene have a major
effect on life and thus performance in education. Many children do not get
enough of the right food to eat. They do not grow well, they become ill, many die
and they do not grow up as clever, as healthy or as tall as they should be.

A well nourished child is able to attain better grades, learn all day and has some
energy left to make most of other evening activities like coping with pressure,
stress, resist infection have alert and active mind. These are positive ingredients
of good performance and even beauty goes hand in hand with key players of
correct nutrition as the skin and hair reflects your diet. In order to cater for the
health and nutritional needs of pre-schoolers, pre-school institutions are advised
to introduce lunches, feeding programmes and milk services. Pre- school
teachers should encourage parents to organise mid morning refreshments and
lunch for children who stay at school the whole day. They should be taught
about nutrition, food groups, nutritional deficiencies, food production, planning
and preparing family meals, food hygiene, and diet for expectant mothers,
babies and pre-school children.
Students have shown that hunger has adverse effects on cognition problem
solving and concentration as they contend that hungry children are found to be
less alert and lethargic (UNESCO 1990). Kings (1966) argued that more
effective methods be sought and it should be noted that children need nutritious
foods to support growth, play and learning thus creating interests in schools. He
believed that only healthy children could utilise fully the opportunities provided by
schools to develop to the full their intellectual potentiality.

School Feeding and Attention

A research conducted by Pollit (1984), revealed that there is a three-way
relationship between health, nutrition and psychological development of a child,
which influences food intake and absorption. For example, a child who is not
happy may not eat well and even

The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.
The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.

when he/she eats may not benefit fully from the food eaten. In addition, a child
who is sick or hungry is less active and does not interact well with the
environment around him or her (Werner 1982). Mitchell (1983) argues that
eating is a crucial part of every person’s life. We need food for energy to do all
the activities and all our body complex bio-chemical processes. This fuel comes
in different forms like in proteins, vitamins, water carbohydrates and mineral
salts.
It is well known as Gagne (1977) argues that nutritional problems and sickness
interfere with learning because they reduce the degree of concentration. This
has been succinctly expressed as generally poor health, recurrent illness,
inadequate diet and unsatisfactory home which all contribute to rendering the
child insufficiently alert and receptive in the class room. School feeding really
helps alleviate this problem and helps to increase participation, capacity and
concentration in school.

Oyugi (2007) in her study stated that feeding programmes in various preschools
have given the participation of children direct benefits and that parents, teachers,
and stakeholders have acquired better knowledge and skills on issues related to
health nutrition and care of the children. SFP is, therefore, of great concern to
the well being of children as it plays a great role in their development. Those
who care for the children, for example the pre-school teachers, should,
therefore, ensure that the food given to children is well balanced.

Conceptual Framework
The impact of SFPs is to increase educational achievement and wellbeing of

student’s healthy. Through this programme of school feeding it can increase

students’s healthy,school attendance by lowering the opportunity costs of attending

school and also by providing additional incentive to engage in formal education.

This may lead to more spending towards learning in schools. Also SFPs may

alleviate short–term hunger which improves children’s cognitive functioning and

attention span.

The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.
The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.

Furthermore, through SFPs it helps to improve nutritional status of children by providing

them calories and nutrients in addition to their regular diet. This leads to better health

and better resistance to infectious diseases and illness that would keep children from

attending school (Buttenheim et al, 2011).Therefore; Figure 1.1 shows the relationship

between SFP and potential impacts on school children.

School Feeding Programme

Improved health status Increased enrolment and Short –term hunger

attendance
alleviated

Engaged in learning Improved cognitive skills and

behavior

Educational achievement and

health
Figure 1.1 Conceptual Framework
Source: Adapted from Lucy Muthoni Munyiri,2010

The Knowledge Gap from Reviewed Literature

There are various studies on the SFP which have been done in many
nations worldwide and in Ethiopia in particular. Some of the studies took at
a general approach, while others have focused on specific areas. A number
of studies have shown that there is a link between lack or inadequate food
intake and hunger among pupil and their health,educational outcomes
(enrollment, attendance and performance).
In the reviewed literature, school feeding had assumed an important role in
solving the issue of unhealthy,low enrolment, poor attendance and

The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.
The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.

performance. A number of studies show an increase in overall wellbeing,

school enrolment, attendance and performance after school feeding started
and yet high enrolment and attendance do not necessarily translate into
high rates of achievement for children.

In general the above reviewed literature provide valuable information, but failed to
give a comprehensive picture of the effectiveness of School Feeding Programmes
across the the city because they were limited in their scope, therefore in Ethiopia
particular in Addis Ababa little has been achieved to some of schools to address the
issue of school health,school enrolment, attendance and academic performance
despite the implementation of the SFPs, that is why the researcher intended to
assess the Impact of school feeding on educational and healthy outcome of school
age children.

The Impact of School Feeding on Educational and Healthy Outcome of School Age Children.