Does a school snack make a difference? An evaluation of the World Food Programme emergency school feeding programme in Lebanon among Lebanese and Syrian refugee children.

Zeina Jamaluddine,Sara Abou Fakher,Hala Ghattas,Nehmat El-Helou,Soha Moussa,Dominique Anid,Chaza Akik,Gloria Safadi

doi:10.1017/s1368980022000362

Abstract

To investigate the effects of providing a daily healthy school snack on children's nutritional, social and educational outcomes and explore stakeholders' perceptions of an emergency school feeding programme (SFP). Convergence triangulation mixed-methods study design. Associations were examined between receiving the school feeding intervention and children's outcomes using multivariable regression models. Quantitative data were complemented with interviews and focus group discussions with parents and staff. In vulnerable communities in Lebanon, the World Food Programme has implemented an emergency SFP targeting Lebanese (attending morning sessions) and Syrian refugee children (attending afternoon sessions) in public schools. Children from ten intervention schools (morning n 403; afternoon n 379) and ten matched control schools (morning n 399; afternoon n 401), as well as twenty-nine parents and twenty-two school staff members. Diet diversity was higher in intervention schools as compared with control with a significantly higher consumption of dairy products, nuts and fruit in both sessions. Child-reported food insecurity experience was lower in children attending the afternoon session of intervention v. control schools. The SFP intervention was associated with higher school engagement and sense of school community in the morning session only. While the SFP was significantly associated with higher attendance for children in afternoon sessions only, it was significantly associated with school retention of children in both sessions. A daily healthy snack potentially acts as an incentive to improve children's nutritional outcomes, school engagement, sense of belonging, equality between students and improvement in children's attendance and retention in public schools.

Highlights

Hosting around 1.5 million Syrian refugees, Lebanon still has the highest per capita refugee concentration in the world[1, 2]
The morning session sample had a mean age of 11 years (11.23 ± 0.07 years in control and 11.23 ± 0.67 years in intervention group), most children were of Lebanese nationality with other children being of either Syrian or Palestinian origin (Table 1)
This study shows that snack distribution through an emergency School Feeding Programme (SFP) is associated with higher child diets and food security in low-middle income countries (LMIC), with potential knock-on effects on school attendance as well as on psychosocial wellbeing in this context of chronic crisis[38]

Summary

Introduction

Hosting around 1.5 million Syrian refugees, Lebanon still has the highest per capita refugee concentration in the world[1, 2]. Lebanese and Syrian refugee children attend the same public schools as part of a national response plan to ensure high educational coverage in vulnerable school-aged children[3]. This was made possible by creating two academic sessions during the school day: a morning session for Lebanese children and an afternoon session for Syrian children[3]. Lebanese children’s enrolment rates in public schools remained high[3], while the enrolment of Syrian refugee children aged 6 to 14 years was around 69%(4). At the other end of the spectrum, the prevalence of food insecurity remains high among Syrian refugee children along with a reduction in diet diversity[4]. There are preliminary reports of a rise in food insecurity amongst Lebanese populations[3, 10]

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Results

Discussion

Conclusion