Enhancing Linkages Between Healthy Diets, Local Agriculture, and Sustainable Food Systems: The School Meals Planner Package in Ghana

Citation: Fernandes M, Galloway R, Gelli A, et al. Enhancing Linkages Between Healthy Diets, Local Agriculture, and Sustainable Food Systems: The School Meals Planner Package in Ghana. Food and Nutrition Bulletin. 2016;37(4):571-584. doi:10.1177/0379572116659156 

Relevant to: 

Dietitians-Nutritionists working in school meal programs or other foodservice settings linking menus with local agriculture. Most relevant for low to middle income countries, particularly sub-Saharan Africa.  

Question:

This paper describes the development and adaptation of the School Meals Planner Package in Ghana. The package was developed by the Partnership for Child Development (PCD), based at Imperial College London and was piloted by the Ghana School Feeding Programme.   

Bottom line for nutrition practice: 

School meal menus offer a practical opportunity to link nutrition and agricultural objectives – by offering nutrient rich local foods to students. The School Meals Planner Package (SMPP) was designed to help governments operationalize the United Nations, World Food Programme “home-grown school feeding” (HGSF*) in parallel to meeting student nutritional needs. The SMPP was piloted in 42 out of 216 districts in Ghana. Following the pilot, the government has adopted the tool as official policy, and over 21 other governments in sub-Saharan Africa have also voiced interest in the program. 

 The School Meals Planner Package (SMPP) is an open-sourced software package that includes the School Meals Planner tool, ‘‘handy measures,’’ and behavior change communication activities and materials. It allows users to plan nutritionally balanced meals using locally sourced foods, and to cost out the meals. It also enables local farmers to understand what foods are required by schools. 
 
*see “of additional interest 

Abstract:

Background: 
Interventions that enhance linkages between healthy diets and local agriculture can promote sustainable food systems. Home-grown school feeding programs present a promising entry point for such interventions, through the delivery of nutritious menus and meals. 
Objective: 
To describe the adaptation of the School Meals Planner Package to the programmatic and environmental reality in Ghana during the 2014 to 2015 school year. 
Methods: 
Guided by a conceptual framework highlighting key considerations and trade-offs in menu design, an open-source software was developed that could be easily understood by program implementers. Readily available containers from markets were calibrated into “handy measures” to support the provision of adequate quantities of food indicated by menus. Schools and communities were sensitized to the benefits of locally sourced, nutrient-rich diets. A behavior change communication campaign including posters and songs promoting healthy diets was designed and disseminated in schools and communities. 
Results: 
The School Meals Planner Package was introduced in 42 districts in Ghana, reaching more than 320 000 children. Monitoring reports and feedback on its use were positive, demonstrating how the tool can be used by planners and implementers alike to deliver nutritious, locally-sourced meals to schoolchildren. The value of the tool has been recognized at the highest levels by Ghana’s government who have adopted it as official policy. 
Conclusions: 
The School Meals Planner Package supported the design of nutritious, locally sourced menus for the school feeding program in Ghana. The tool can be similarly adapted for other countries to meet context-specific needs. 

Details of results:

Training was provided at district, community and school levels, including menu planning, nutrition, and a community level behavior change communication (BCC) campaign. The government issued a directive to caterers and cooks in the project districts to participate. Monitoring reports and qualitative feedback were collected, providing information on how to improve the tool and scale up the intervention. 

 About 66% of district desk officers reported that the tool was easy to use. Partial compliance was seen in 30% of the districts. The authors report that participants valued the opportunity to learn about nutrition, local foods and how to determine quantities to procure. While the implementation of BCC campaign activities in schools was uneven, community level activities occurred in all districts. Campaign messages were clear; however, while some noted that they understood the need for diverse diets, the cost was a barrier for foods such as fruit and vegetables. Focus group discussions raised concerns that meeting nutritional requirements (30% RDAs) may exceed allowable costs per meal. The authors also state that further research is required to document the effectiveness of SMPP in relation to the nutrition and agricultural objectives of the Ghana school food programme.  

As well as enabling a more nutritious menu overall, the SMPP helps to make menus more nutrition sensitive by focusing on micronutrients important for child growth and development using locally sourced food. The tool also helps decision makers assess trade-offs (e.g., costs, diet quality and regional diversity). The pilot identified that adjustments could be made to the tool to automatically propose lower cost, higher nutrient alternatives for meals, and to include adjustments for protein quality and bioavailability of specific micronutrients (e.g., iron and zinc). 

The SMPP is based on a framework for developing menus for home-grown school feeding programs (HGSF). While menus are designed at the district level, they can be adapted to include foods grown locally. This pilot identified that HGSF programming could be strengthened through use of the SMPP 
by improving communications between caterers and local food suppliers and farmers, including communicating in advance what foods will be required. 

Of additional interest:

The home-grown school feeding (HGSF) focuses on sourcing nutrient-rich foods local foods for school meals, contributing to both agriculture and nutrition outcomes. Interest in HGSF has increased in low- and middle-income countries wishing to manage their own school feeding programs, rather than relying on external donor and technical support. One aim of HGSF is to decentralize the procurement of school food to community producers or markets. HGSF was included as a key intervention under the food security pillar of the Comprehensive Africa Agriculture Development Programme in 2003. By 2014, a minimum of 47 out of 54 countries in Africa were implementing school feeding programs with at least 20 countries implementing HGSF.  

See: Home Grown School Feeding programmes https://www.wfp.org/home-grown-school-feeding 

Editor’s comment:

It is exciting to read about a program that practically supports the use of locally sourced food. Perhaps this tool may have the potential to be used in settings beyond schools.  

Open access link to article:

https://journals.sagepub.com/doi/pdf/10.1177/0379572116659156 

Conflict of interest/ Funding:

The School Meals Planner tool, the research framework and the program activities were supported by funding from the Bill and Melinda Gates Foundation, the World Bank and Dubai Cares. 

External relevant links:  

N/A

Transparency | Diversity | Dynamism | Evidence-based |

AdministrationFoodservicePublic Health
EducationMenu ChangePolicy ChangeProgramming
AfricaGlobal