UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-Food Systems), University of Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro Montpellier, IRD, Montpellier34000, France.
School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
Public Health Nutr. 2024 Oct 18;27(1):e213. doi: 10.1017/S1368980024001939.
This review aimed to (i) synthesise evidence of the impact of publicly procured school meals programmes on nutritional outcomes of children/adolescents (5-18 years) in sub-Saharan Africa and (ii) identify challenges and facilitators to implementing effective school meals programmes.
Mixed-methods systematic review ( 7 databases). Nutritional outcomes assessed were anthropometrics (underweight, stunting, wasting, overweight/obesity), micronutrient deficiencies, food consumed and food environment. Qualitative findings were coded using a nine-step school food system framework: and .
Sub-Saharan Africa.
Children/adolescents (5-18 years), parents, school personnel and government officials.
Thirty-three studies (twenty-six qualitative, seven quantitative) from nine sub-Saharan African countries were included. Six studies found a positive impact of publicly procured school meals programmes on nutritional outcomes (wasting ( 1), stunting ( 3), underweight ( 1), vitamin A intake ( 1) and dietary diversity ( 1)). Fifty-three implementation challenges were identified, particularly during (e.g. training, payment), (e.g. meal quantity/quality/diversity, utensils) and (e.g. funding, monitoring, coordination). Implementation facilitators were identified ( 37) across (e.g. programme coordination), (e.g. food preferences, reduced stigma) and (e.g. engagement, positive perceptions). Included policy recommendations targeted , , and in nine, fifteen and twenty-five studies, respectively.
As many challenges remain, strengthening implementation (and therefore the nutritional impact) of school meals programmes in sub-Saharan Africa requires bold commitment and improved coordination at multiple levels of governance.
本综述旨在：(i) 综合评估撒哈拉以南非洲地区公开采购学校供餐计划对儿童/青少年（5-18 岁）营养状况的影响；(ii) 确定实施有效学校供餐计划的挑战和促进因素。
混合方法系统评价（7 个数据库）。评估的营养结果包括人体测量学指标（消瘦、发育迟缓、消瘦、超重/肥胖）、微量营养素缺乏、食物消耗和食物环境。定性结果使用九个步骤的学校食品系统框架进行编码：规划、采购、准备、供应、摄入、管理、监督、宣传和评估。
撒哈拉以南非洲。
儿童/青少年（5-18 岁）、家长、学校人员和政府官员。
来自九个撒哈拉以南非洲国家的 33 项研究（26 项定性研究，7 项定量研究）被纳入。六项研究发现公开采购学校供餐计划对营养结果有积极影响（消瘦（1）、发育迟缓（3）、消瘦（1）、维生素 A 摄入（1）和饮食多样性（1））。确定了 53 个实施挑战，特别是在规划（例如培训、付款）、采购（例如餐食数量/质量/多样性、餐具）和供应（例如餐食数量/质量/多样性、餐具）阶段。还确定了 37 个实施促进因素，涵盖规划（例如方案协调）、采购（例如食物偏好、减少污名化）和供应（例如参与、积极看法）等各个方面。纳入的政策建议分别针对规划、采购和供应三个方面，在九项、十五项和二十五项研究中有所涉及。
鉴于仍然存在许多挑战，加强撒哈拉以南非洲地区学校供餐计划的实施（从而提高其营养影响）需要在多个治理层面做出大胆承诺和改进协调。
