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Title: Hunger and learning : evidence on the costs and effectiveness of providing food through schools in food-insecure areas
Author: Gelli, Aulo
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2013
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Globally, over the last decade primary school access has improved significantly. Yet challenges remain: 67 million primary school-aged children are not in school. Poor nutrition and health among schoolchildren are important barriers in achieving education-for-all goals. School feeding is a popular intervention supporting the education, health and nutrition of children in food-insecure settings. However, school feeding programmes are complex, involving a broad range of stakeholders across different sectors and implementation levels. This thesis is aimed at providing evidence to support policy-makers in managing trade-offs among alternative targeting approaches, feeding modalities, and costs. This work is also aimed at building an evidence-based framework to guide Governments in managing the inherent complexity of school feeding interventions. The thesis includes an analysis of a natural experiment involving survey data from 32 countries across sub-Saharan Africa that suggested that school feeding increased enrolment by 10 percent. Enrolment changes varied by modality and gender, with onsite meals having stronger effects in the first year of treatment in lower grades, and onsite combined with take-home rations being effective post-year 1, particularly for girls. Expenditures across 62 countries indicated considerable differences in costs across modalities, ranging from $23 USD for fortified biscuits to $75 USD for take-home rations. This raises important questions of cost-effectiveness and sustainability, also in terms of school-level costs not normally captured in programme expenditures. Findings also suggest that school level costs are substantive, and are a considerable overhead, considering that these costs are generally borne by food-insecure communities. The thesis also highlights that scaling-up school feeding requires significant financing, on average equal to 40 percent of primary education costs. Despite these opportunity costs there is strong buy-in on school feeding from governments in sub-Saharan Africa. The implications of this thesis also suggest that the complexity of school feeding as an intervention has perhaps been underestimated by policymakers. Strengthening the evidence linking outcomes to the design of school feeding and to the quality of the service delivery, including the trade-offs between implementation modalities, remains a critical area of future research. This thesis provides both a foundation and a step towards answering these complex questions in a comparable and meaningful way.
Supervisor: Donnelly, Christl ; Drake, Lesley Sponsor: Biotechnology and Biological Sciences Research Council
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral