A Community-Based School Nutrition Intervention Improves Diet Diversity and School Attendance in Palestinian Refugee Schoolchildren in Lebanon

Abstract

Background School feeding programs have the potential to supply children with healthy school food, alleviate short-term hunger, and improve children's educational outcomes. Objective We linked community kitchens to a subsidized school snack intervention and assessed the impact of this intervention on nutritional (diet diversity, hemoglobin, and anthropometry) and educational (attendance and academic performance) outcomes of Palestinian refugee schoolchildren. Methods We collected data from 1362 students (aged 5–15 years) and their parents at baseline, and at an 8-month follow-up in two control and two intervention schools. We conducted linear, logistic and negative binomial regression analyses to assess changes in outcomes of children participating in the intervention schools as compared to children in control schools (intention to treat). We also assessed the impact of the snack intervention among children that participated at least 50% of the time (HP, high-participation) as compared to those who participated less than 50% (LP, low-participation), or who only received nutrition education (control) (per protocol). All the analyses were adjusted for child age and gender, maternal education, household expenditure and school level clustering effect. Results At endline, there were 648 children in the control group, and within the intervention group, 260 children had LP and 454 had HP. There was a significantly greater increase in overall diet diversity score and dairy consumption in the HP group compared to controls. Both LP and HP groups were more likely to consume proteins, and less likely to consume desserts than controls. Furthermore, HP group had a significant increase in hemoglobin and both LP and HP had a significant decrease in school absenteeism compared with controls. Conclusions This community-based school nutrition intervention had a positive impact on diet diversity, hemoglobin, and school attendance of children.

Ajyal Salima a novel public–private partnership model for childhood obesity prevention in the Arab countries

“…Three other school-based interventions were also implemented in Lebanon, though they targeted vulnerable populations such as Syrian and Palestinian refugees. These interventions aimed to increase nutritional knowledge among school children and provide complementary nutritious meals at school to improve school attendance rates ( 27 – 29 ). In Tunisia, a 3-year school-based intervention program was successful in increasing intake of fruits and vegetables and decreasing rates of overweight and obesity among children aged 11–16 ( 30 ).…”

Perceptions of School Management on the Relationship between School Nutrition and Development of Non-Communicable Diseases in a Rural South African District: A Qualitative Study

“…According to the findings of the current study, the NSNP had a major role in reducing poverty in society by providing nutritious food to children from low-income families. Such healthy nutrition provided by NSNP has been commended for ensuring that children were kept at school with significantly lowered rates of absenteeism [ 19 ]. Improved school attendance, together with improved performance, was considered a perfect recipe for ensuring improved literacy levels in a society, thus leading to improved employment opportunities for the near future.…”

Perceptions of School Management on the Relationship between School Nutrition and Development of Non-communicable Diseases in a Rural South African District: A Qualitative Study

“…Healthy nutrition provided by NSNPs has been commended for ensuring that children were kept at school with significantly lowered rates of absenteeism [19]. Improved school attendance together with improved performance were considered a perfect recipe for ensuring improved literacy levels in a society thus leading to improved employment opportunities for the near future.…”