India national school meal program linked to improved growth in children of beneficiaries

Women who received free meals in primary school have children with improved linear growth, according to a new study by researchers at the International Food Policy Research Institute (IFPRI).

India is home to the highest number of undernourished children and the largest school feeding program in the world—the Mid-Day Meal (MDM) scheme—yet long-term program benefits on nutrition are unknown. As school feeding programs target children outside the highest-return "first 1000-days" window spanning from conception until a child's second birthday, they have not been a focal point in the global agenda to address stunting. School meals benefit education and nutrition in participants, but no studies have examined whether benefits carry over to their children.

"Findings from previous evaluations of India's MDM scheme have shown a positive association with beneficiaries' school attendance, learning achievement, hunger and protein-energy malnutrition, and resilience to health shocks such as drought—all of which may have carryover benefits to children born to mothers who participated in the program," says study co-author, Harold Alderman.

The study, "Intergenerational nutrition benefits of India's national school feeding program", co-authored by University of Washington's Suman Chakrabarti and IFPRI's Samuel Scott, Harold Alderman, Purnima Menon and Daniel Gilligan, was published in Nature Communications. The authors used nationally representative data on mothers and their children spanning 1993 to 2016 to assess whether MDM supports intergenerational improvements in child linear growth. Further, they suggest a potential pathway through which school feeding programs may have intergenerational effects on child nutrition outcomes.

The study found that investments made in school meals in previous decades were associated with improvements in future child linear growth. "Our findings suggest that intervening during the primary school years can make important contributions to reducing future child stunting, particularly given the cumulative exposure that is possible through school feeding programs," explains study co-author Suman Chakrabarti.

Study results also show that school meals may contribute to education, later fertility decisions, and access to health care, reducing the risk of undernutrition in the next generation. "School feeding programs such as India's MDM scheme have the potential for stimulating population-level stunting reduction as they are implemented at scale and target multiple underlying determinants of undernutrition in vulnerable groups," explains study co-author Samuel Scott. Importantly, further research is required to understand whether improving the quality or quantity of meals provided and extending the program beyond primary school might further enhance its benefits.