School feeding programs in Sub-Saharan Africa

Monday 8 March 2010 8:50AM (view full episode)

A new venture, the Home Grown School Feeding Project, aims to provide food for underfed children in Sub-Saharan Africa. Rather than importing food from donor countries, they focus on providing the food from local sources.

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Norman Swan: I thought a bit of a reality check might be in order now since childhood obesity isn't actually the world's dominant childhood eating problem. I came across a fascinating new venture a couple of weeks ago focused on what's been quite a controversial area—school feeding programs for underfed children in areas like Sub-Saharan Africa.

They cost quite a lot of money, the food comes from other countries so the aid money stays in the donor countries and sometimes the benefits have been questioned

Well the Home Grown School Feeding Project aims to fix a lot of that and builds on experience in countries like Brazil. The project is in the Partnership for Child Development. Kristie Neeser is the coordinator and Aulo Gelli is the deputy director of the Home Grown School Feeding Project. They're both in the Department of Infectious Disease Epidemiology at Imperial College London.

Kristie Neeser: In many instances in low income studies the health of school-age children tends to be neglected, there's a focus on under-fives or maternal and child health.

Norman Swan: To what extent does the health of children fall off? It's well described that the first year of life even in very poor countries tends to be OK but once you get beyond breastfeeding you really get into strife. To what extent are there problems with school age children particularly in Sub-Saharan Africa?

Kristie Neeser: A lot of school-age children suffer the highest burden of the most common diseases so with intestinal worms school age children suffer the greatest burden, malaria has also been neglected in terms of school-age children.

Norman Swan: So you have a group or a large group of underweight, undernourished, anaemic children who are not developing very well?

Kristie Neeser: Exactly, one of the most cost-effective ways to access them is through the education sector. For example teachers can deliver a de-worming medication to these children once they are trained.

Norman Swan: And overall in Sub-Saharan Africa what's the percentage of children who actually do go to school?

Aulo Gelli: There's a lot of disparity in access to education. There are pockets where only 30% of girls in primary school age actually attend school. But then you've had a lot of success, you have a country like Uganda and Kenya where they've introduced free primary education and enrolment rates have gone up quite steadily.

Norman Swan: Tell me about the school feeding program.

Aulo Gelli: The school feeding as a whole has had a huge re-think as a result of the 2008 food price crisis. The World Bank and the World Food Program, the World Food Program is the main agency that deals with the school feeding covering about 20 million children.

Norman Swan: You'd better explain the food price crises.

Aulo Gelli: We had a confluence of factors that happened in 2008 where prices of food and stable commodities just skyrocketed.

Norman Swan: Food became less affordable.

Aulo Gelli: The problem was exactly that. Vulnerable households already living in poverty who spent about 60% or 70% of their budget on food, if the food itself increases or doubles up as it did in the case of some countries, then of course the first thing that goes is the nutritional quality and then the quantity. So as a result of this there was a huge response in terms of investments going into social safety-nets, and school feeding was one of the most popular ones at the request of the governments in low income countries—for the reasons that Kristie already mentioned, that schools pretty much exist even in the most desolate and poor and food insecure areas. So it was quite easy to use the schooling infrastructure to scale up an intervention that could target the most vulnerable.

Norman Swan: What is the intervention, is it breakfast, is it lunch, what is it?

Aulo Gelli: The beauty of school feeding is that it can be whatever you feel suits best the content including fortified biscuits, they cost about $12 per child per year, cooked meals that range for about $40 per child per year, over a 200-day year or something like that, and then you can also provide bags of food, what we call the take-home rations based on attendance of the kid, so if the kids attend 80% of the school month, let's say, they can get a bag of maize or a ration of vegetable oil, something to act as an incentive for them to attend school. And you can also mix and match the different interventions so that you can target specific vulnerable groups. As in the case of southern Africa, where they have orphans and vulnerable children from the HIV epidemic, so you can provide an on-site meal for most kids and then provide an extra incentive for the most vulnerable kids in the form of take home rations for instance.

Norman Swan: So what are the benefits?

Aulo Gelli: The benefits range mostly from the educational perspective, impact on enrolment.

Norman Swan: So it becomes an incentive to go to school.

Aulo Gelli: Absolutely, it acts as an incentive to the households.

Norman Swan: An alternative to working in the fields.

Aulo Gelli: Working in the fields or working looking after kids.

Norman Swan: So they are going to school, are they learning?

Aulo Gelli: Sixty per cent of the kids that were covered by WFP actually went to school without breakfast. Imagine going to listen to your maths teacher on an empty tummy so if you provide fortified food there's actually benefits both on cognition and learning and have been demonstrated in randomised control trials.

Norman Swan: But does it mean less pneumonia, less anaemia, less malaria?

Aulo Gelli: Yes, if you talk about the micro-nutrient status there's actually good evidence that fortified foods provided at the right time can actually improve both iron and vitamin A.

Norman Swan: Now there's been a lot of international criticism about food aid programs and some people argue there's a direct relationship, a causal relationship between food aid and famine, and that food aid causes famine and that you're not helping societies you're just pasting over the surface. And you should really be investing the way say Oxfam does in agriculture, digging wells, tractors, transport and forgetting about these food programs which are just damaging communities. They might make you feel better but the end result is pretty crappy.

Aulo Gelli: I think you've done your research really well and the causal relationships I know it is not easily captured and having worked with food aid before I realise that there are situations where food aid can work and there are others where clearly it doesn't work. But the beauty of this grant is you are actually trying to harness...

Norman Swan: Sorry, grant?

Aulo Gelli: Yes, we are talking about the Home Grown School Feeding grant that was awarded to the partnership of child development by the Bill and Melinda Gates Foundation and it's a $12 million grant over a period of five years to support national governments in developing their own cost-effective Home Grown School Feeding programs and the idea behind this is to really harness the potential demand that comes from school feeding programs and ground it into the local economy. And more particularly, ground it into the agricultural development.

Norman Swan: So you're not flying biscuits in from America?

Aulo Gelli: Well if there's an emergency like in Haiti you would do that but...

Norman Swan: The idea is you buy from the local producers?

Aulo Gelli: As much as possible, realising that it takes 20 or 30 years to do but we've been asked to act a little bit as a catalyst.

Norman Swan: What do you do about the fact that in a lot of these countries the government is very weak, they just don't have the infrastructure, you know some bright people but they don't have the infrastructure or the bureaucracy to actually implement this stuff.

Aulo Gelli: I'm afraid to say I don't have an easy answer to that. One thing that the Bill and Melinda Gates Foundation has asked us to do is focus very much on governance. For instance in Kenya decentralisation of budgets to the school level enables the communities around the school to have access to exactly what finances the schools have been asked to disburse. But at the same time it gives an accountability chain back to the national governments and the local communities. Bear in mind that the grant itself is not for food, it is to develop the supporting systems to enable these programs to run more efficiently.

Norman Swan: And how will you know if you've succeeded?

Aulo Gelli: At the end of the day I think our focus is very much on the kids and we go to the schools and see are the children actually receiving food, where is the food coming from.

Kristie Neeser: Another indicator of success will be looking at the farmer levels so we will be monitoring farmer income over the course of the grant in the communities that we will be working in.

Norman Swan: And how do you deal with the pricing issue because sometimes you can get landed food from another country where there are very efficient producers, it's cheaper than locally produced?

Kristie Neeser: We are trying to develop cost-effectiveness tools to help the schools to determine 'OK, I can buy this food for such a price but what are the benefits that I'm getting out of this', examining the tradeoffs that are involved.

Aulo Gelli: We are linking up with countries in South America, who have over the last 10 to 15 years really developed leading edge skills on how to make these programs work. And countries like Brazil have been running very decentralised home grown school feeding programs and have actually institutionalised these to the point that within the actual constitutions they have written that every child has to receive a hot meal a day and 30% of the food has to be procured within the municipality. And they have been dying to really share what they've learned to enable countries in Sub-Saharan Africa work their way around these many pitfalls that can arise in running these potentially wonderful programs.

Norman Swan. Allo Gelli, and before him Kristie Neeser of the Home Grown School Feeding Project. They're both in the Department of Infectious Disease Epidemiology at Imperial College, London. I'm Norman Swan and you've been listening to the Health Report.


Kristie Neesar
Coordinator of the Home Grown School Feeding Project,
Department of Infectious Disease Epidemiology,
Imperial College London,
Aulo Gelli
Deputy Director of the Home Grown School Feeding Project,
Department of Infectious Disease Epidemiology,
Imperial College London,


Dr Norman Swan
Brigitte Seega

Comments (1)

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  • Morailane Morailane :

    11 Jun 2011 5:47:58pm

    There are undoubtedly benefits to children from school feeding programmes. However, I believe there can be more benefits if the food can be sourced from the locals despite of the initial uncompetitive prices. Normally under nourished kids are from families where parents are unemployed, sick or bereaved. If you insist on higher procurement targets from locals you are likely to impact profoundly on economic activities in the locale. Who knows this may lead to a burgeoning economy that increases food security in the long term