Gelli Aulo, Al-Shaiba Najeeb, Espejo Francisco
United Nations World Food Programme, Rome.
Food Nutr Bull. 2009 Mar;30(1):68-76. doi: 10.1177/156482650903000107.
The provision of food in and through schools has been used to support the education, health, and nutrition of school-aged children. The monitoring of financial inputs into school health and nutrition programs is critical for a number of reasons, including accountability, transparency, and equity. Furthermore, there is a gap in the evidence on the costs, cost-efficiency, and cost-effectiveness of providing food through schools, particularly in areas of high food insecurity.
To estimate the programmatic costs and cost-efficiency associated with providing food through schools in food-insecure, developing-country contexts, by analyzing global project data from the World Food Programme (WFP).
Project data, including expenditures and number of schoolchildren covered, were collected through project reports and validated through WFP Country Office records. Yearly project costs per schoolchild were standardized over a set number of feeding days and the amount of energy provided by the average ration. Output metrics, such as tonnage, calories, and micronutrient content, were used to assess the cost-efficiency of the different delivery mechanisms.
The average yearly expenditure per child, standardized over a 200-day on-site feeding period and an average ration, excluding school-level costs, was US$21.59. The costs varied substantially according to choice of food modality, with fortified biscuits providing the least costly option of about US$11 per year and take-home rations providing the most expensive option at approximately US$52 per year. Comparisons across the different food modalities suggested that fortified biscuits provide the most cost-efficient option in terms of micronutrient delivery (particularly vitamin A and iodine), whereas on-site meals appear to be more efficient in terms of calories delivered. Transportation and logistics costs were the main drivers for the high costs.
The choice of program objectives will to a large degree dictate the food modality (biscuits, cooked meals, or take-home rations) and associated implementation costs. Fortified biscuits can provide substantial nutritional inputs at a fraction of the cost of school meals, making them an appealing option for service delivery in food-insecure contexts. Both costs and effects should be considered carefully when designing the appropriate school-based intervention. The costs estimates in this analysis do not include all school-level costs and are therefore lower-bound estimates of full implementation costs.
通过学校提供食品已被用于支持学龄儿童的教育、健康和营养。对学校健康和营养项目的资金投入进行监测至关重要，原因有很多，包括问责制、透明度和公平性。此外，在通过学校提供食品的成本、成本效益和成本效果方面，证据存在缺口，特别是在粮食不安全程度高的地区。
通过分析世界粮食计划署（WFP）的全球项目数据，估计在粮食不安全的发展中国家背景下通过学校提供食品的项目成本和成本效益。
通过项目报告收集包括支出和覆盖学童人数在内的项目数据，并通过粮食计划署国家办事处记录进行验证。每个学童的年度项目成本在设定的供餐天数和平均口粮提供的能量数量基础上进行标准化。使用诸如吨数、卡路里和微量营养素含量等产出指标来评估不同交付机制的成本效益。
在200天的现场供餐期和平均口粮基础上进行标准化，每个儿童每年的平均支出（不包括学校层面的成本）为21.59美元。成本因食品方式的选择而有很大差异，强化饼干是成本最低的选择，每年约11美元，带回家的口粮是最昂贵的选择，每年约52美元。对不同食品方式的比较表明，就微量营养素（特别是维生素A和碘）的提供而言，强化饼干是最具成本效益的选择，而现场餐食在提供卡路里方面似乎更有效率。运输和物流成本是成本高昂的主要驱动因素。
项目目标的选择在很大程度上决定食品方式（饼干、熟食或带回家的口粮）及相关实施成本。强化饼干能以学校餐食成本的一小部分提供大量营养投入，使其成为在粮食不安全背景下提供服务的有吸引力选择。在设计适当的校本干预措施时，应仔细考虑成本和效果。本分析中的成本估计不包括所有学校层面的成本，因此是全面实施成本的下限估计。
