Evaluation of alternative school feeding models on nutrition, education, agriculture and other social outcomes in Ghana: rationale, randomised design and baseline data

Abstract

Background‘Home-grown’ school feeding programmes are complex interventions with the potential to link the increased demand for school feeding goods and services to community-based stakeholders, including smallholder farmers and women’s groups. There is limited rigorous evidence, however, that this is the case in practice. This evaluation will examine explicitly, and from a holistic perspective, the simultaneous impact of a national school meals programme on micronutrient status, alongside outcomes in nutrition, education and agriculture domains.The 3-year study involves a cluster-randomised control trial designed around the scale-up of the national school feeding programme, including 116 primary schools in 58 districts in Ghana. The randomly assigned interventions are: 1) a school feeding programme group, including schools and communities where the standard government programme is implemented; 2) ‘home-grown’ school feeding, including schools and communities where the standard programme is implemented alongside an innovative pilot project aimed at enhancing nutrition and agriculture; and 3) a control group, including schools and households from communities where the intervention will be delayed by at least 3 years, preferably without informing schools and households. Primary outcomes include child health and nutritional status, school participation and learning, and smallholder farmer income. Intermediate outcomes along the agriculture and nutrition pathways will also be measured. The evaluation will follow a mixed-method approach, including child-, household-, school- and community-level surveys as well as focus group discussions with project stakeholders. The baseline survey was completed in August 2013 and the endline survey is planned for November 2015.ResultsThe tests of balance show significant differences in the means of a number of outcome and control variables across the intervention groups. Important differences across groups include marketed surplus, livestock income, per capita food consumption and intake, school attendance, and anthropometric status in the 2–5 and 5–15 years age groups. In addition, approximately 19 % of children in the target age group received some form of free school meals at baseline.ConclusionDesigning and implementing the evaluation of complex interventions is in itself a complex undertaking, involving a multi-disciplinary research team working in close collaboration with programme- and policy-level stakeholders. Managing the complexity from an analytical and operational perspective is an important challenge. The analysis of the baseline data indicates that the random allocation process did not achieve statistically comparable treatment groups. Differences in outcomes and control variables across groups will be controlled for when estimating treatment effects.Trial registration numberISRCTN66918874 (registered on 5 March 2015).

Agro‐ecological zone and farm diversity are factors associated with haemoglobin and anaemia among rural school‐aged children and adolescents in Ghana

“…Written and verbal informed consent was obtained from all parents/guardians of the children before the interviews. Details of the impact evaluation study design and of the data collected have been reported elsewhere (Gelli et al, ).…”

“…Details of the impact evaluation study design and of the data collected have been reported elsewhere (Gelli et al, 2015).…”

Nutritional status of in-school children and its associated factors in Denkyembour District, eastern region, Ghana: comparing schools with feeding and non-school feeding policies

“…National-scale fortification for instance which includes the addition of micronutrients to staple foods in factories has proven to be an effective method to improve the health of populations [2]. The Ghana school feeding programme (GSFP) introduced in 2005 in some selected schools is one of such interventions to enhance nutrition and improve school attendance and education outcomes [7]. In resource limited nations, majority of school-aged children often walk long distances to school without having a morning and midday meal due to poverty [8].…”

Roads to interdisciplinarity – working at the nexus among food systems, nutrition and health

“…For example, the Ghana School Feeding Program (GSFP) procures local food from small-holder farmers, and aims to improve both child nutrition and school attendance (Gelli et al 2016). However, as Matilda E. Laar and Clement Adamba indicated, challenges exist in evaluating these programmes comprehensively against multiple dimensions, and understanding the obstacles along various stages of the procurement and distribution chain.…”