Community-based nutrition-sensitive approach to address short-term hunger and undernutrition among primary school children in rural areas in a developing country setting: lessons from North and North-Eastern Uganda

Abstract

Background Undernutrition in childhood is an important factor that greatly impedes the achievement of full human potential at adulthood. Despite increased enrolment of pupils in primary schools in developing countries, short-term hunger and undernutrition continue to impact negatively on school attendance, retention and education outcomes in economically disadvantaged rural areas. This study examined the feasibility of a community-based participatory action research approach building capacity of rural women food vendors to use local food resources to produce nutritionally enhanced food products for primary school feeding in rural localities in a developing country setting. Methods Mixed methods approach incorporating focus group discussions (FGDs) to evaluate parents’ and school administrators’ perceptions of the community-based approach, participatory experimental improvement of nutritional quality of an energy-based cassava product (gari) involving community women food vendors, and cross-sectional acceptability assessment of improved products among rural primary school children. Qualitative content analysis, one-way analysis of variance and correlation analysis was used to analyse FGD data, compare nutritional profile and consumer sensory profile of different products, and examine associations between sensory attributes and acceptability of the products, respectively. Results The approach of using local food resources to produce nutritious products targeting school feeding was strongly recognised by parents, school administrators, teachers and small scale rural women food vendors as an adoptable nutrition-sensitive means of addressing short-term hunger among primary school children in rural settings. The action research resulted in a highly accepted nutritionally enhanced product (consisting of cassava, soy and silver fish) exhibiting superior nutritional properties (23.29% protein, 90.5 g/100 g calcium, 4.5 g/100 g zinc, 11.6 g/100 g iron, 40.40 g/100 g phosphorus, 61.57 μg/100 g vitamin A) compared to the original energy-dominated cassava product (2.18% Protein, 55.6 g/100 g calcium, 1.2 g/100 g zinc, 4.4 g/100 g iron, 6.6 g/100 g phosphorus, 11.23 μg/100 g vitamin A) (p < 0.05). Nutritional computation revealed that serving 120 g of the new product would suffice to meet 30% of the recommended dietary allowance for essential nutrients that children should receive from school meals. Conclusion Community-level nutrition-sensitive innovation using local foods resources offers the opportunity for rural women food vendors to contribute to addressing short-term hunger and undernutrition challenges in primary schools in economically-disadvantaged localities in developing countries.

Household food security, child dietary diversity and coping strategies among rural households. The case of Kole District in northern Uganda

“…Relatedly, previous studies suggested that more youthful mothers or child caregivers may participate in broader economic activities such as small trade which can widen their access to more and better diverse foods [ 38 ]. On the otherhand, as previous scholars such as [ [39] , [40] , [41] , [42] ] emphasized the need for nutritional education, we observe in this study that integration of nutritional training in antenatal care programs greatly influences the feeding practices, dietary diversity and has a strong positive association with household food security. It is therefore apparent that nutritional education should be an integral part of training for mothers and caregivers of infants and young children.…”

Integrating Family Farming into School Feeding: A Systematic Review of Challenges and Potential Solutions

“…From a cultural standpoint, school menus based on local food preparations are associated with greater acceptance by the school community, as well as contributing to the preservation of food habits, biodiversity conservation, and sustainability [33]. In addition, the underutilization of locally available food resources and lack of knowledge about their food potential reduce opportunities for the inclusion of strategic foods in school meals, especially in economically disadvantaged areas [39].…”

Benefits and Difficulties of Implementing Family-Farming Food Purchases in the Brazilian National School Feeding Program

“…There is a growing awareness of the power of institutional food services to promote sustainable food production and consumption through healthy food procurement strategies [1,2]. The direct purchase policy of family-farming food in the School Feeding Program can contribute to developing more sustainable agrifood systems by reducing poverty and social inequality [3,4], improving school meal quality [5][6][7], encouraging the incorporation of regional foods in school menus [8], diversifying family farm income sources [9] and increasing food security and nutrition [10][11][12].…”