Liguori Julia, Amevinya Gideon Senyo, Holdsworth Michelle, Savy Mathilde, Laar Amos
UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri-food systems), Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro Montpellier, IRD, Montpellier, France.
University of Ghana, Department of Population, Family & Reproductive Health, School of Public Health, Accra, Ghana.
BMC Nutr. 2024 Sep 27;10(1):127. doi: 10.1186/s40795-024-00936-9.
The Ghana School Feeding Programme (GSFP) provides public primary school pupils with a free daily meal. Each meal is expected to follow set menus, providing 30% of children's' (6-12 years) energy requirements. This study assessed the nutritional quality and diversity of planned and provided GSFP meals, engaging school caterers to identify how meal quality in the Greater Accra Region could be enhanced.
A cross-sectional mixed methods study design was used. Multistage sampling was used to select 129 schools implementing the GSFP in six districts of the Greater Accra Region. GSFP district menus were collected as well as a one-week school caterer recall of provided school meals. The meal served on the day of data collection was recorded and photographed. Nutritional quality was evaluated based on nutrient profiling methods: energy density (low<125kcal/100g; medium 125-225kcal/100g; high>225kcal/100g) and nutrient density (low<5%; medium 5-10%; high>10%). Meal diversity was assessed by a simple count composed of 5 food groups: cereals, pulses/nuts/seeds, animal-source, vegetables and fruits. Caterers' views on programme facilitators and barriers were also explored.
Planned menus included 14-20 weekly options, composed of eight minimally processed traditional dishes. All meals, except white rice, had a high nutrient density/100g. Energy density was varied (low, n=2; medium, n=2; high, n=4). Meals included only 2/5 or 3/5 food groups, mainly starchy staples, pulses/nuts/seeds, and sometimes vegetables. Fruit was never reported. About half of caterers (51.1%) reported deviating from the planned menus: 11.7% served alternative meals, with some including animal-sourced food (17.0%), and 39.4% repeated meals provided during the week, often based on starchy staples, influencing overall nutritional quality. Most caterers reported food item cost and lack of food purchase guidelines as barriers to providing school meals, while food safety training and guidelines for food preparation were facilitators.
While school meals are composed of minimally processed, nutrient dense, local foods, there are notable gaps in meal diversity and compliance, as reflected in provided meals. Caterer compliance to planned menus varied greatly, reflecting recent food price inflation. Upwardly adjusting the current meal allocation of 1.2 cedis (0.22USD) per child per day could enhance access to more affordable, nutritious and diverse foods in school meals.
加纳学校供餐计划（GSFP）为公立小学学生提供每日免费餐食。每餐预计遵循既定菜单，提供儿童（6 - 12岁）能量需求的30%。本研究评估了GSFP计划内和实际提供餐食的营养质量及多样性，与学校餐饮服务商合作以确定如何提升大阿克拉地区的餐食质量。
采用横断面混合方法研究设计。通过多阶段抽样，在大阿克拉地区的六个区选取了129所实施GSFP的学校。收集了GSFP地区菜单以及学校餐饮服务商对提供的学校餐食的一周回忆记录。记录并拍摄了数据收集当天供应的餐食。基于营养成分分析方法评估营养质量：能量密度（低＜125千卡/100克；中125 - 225千卡/100克；高＞225千卡/100克）和营养密度（低＜5%；中5 - 10%；高＞10%）。通过由谷物、豆类/坚果/种子、动物源性食物、蔬菜和水果5个食物组构成的简单计数来评估餐食多样性。还探讨了餐饮服务商对该计划促进因素和障碍的看法。
计划菜单每周有14 - 20种选择，包括8种最少加工的传统菜肴。除白米饭外，所有餐食每100克的营养密度都很高。能量密度各不相同（低，n = 2；中，n = 2；高，n = 4）。餐食仅包含2/5或3/5个食物组，主要是淀粉类主食、豆类/坚果/种子，有时还有蔬菜。从未有水果。约一半的餐饮服务商（51.1%）报告偏离了计划菜单：11.7%提供替代餐食，其中一些包含动物源性食物（17.0%），39.4%重复一周内提供过的餐食，通常以淀粉类主食为主，这影响了整体营养质量。大多数餐饮服务商报告食品成本和缺乏食品采购指南是提供学校餐食的障碍，而食品安全培训和食品制备指南是促进因素。
虽然学校餐食由最少加工、营养丰富的当地食物组成，但在提供的餐食中反映出餐食多样性和合规性存在显著差距。餐饮服务商对计划菜单的遵守情况差异很大，这反映了近期食品价格上涨。向上调整目前每位儿童每天1.2塞迪（0.22美元）的餐食分配，可增加学校餐食中获取更实惠、营养丰富且多样食物的机会。
