@article{fdi:010092001,
  title = {{H}ow do publicly procured school meals programmes in sub-{S}aharan {A}frica improve nutritional outcomes for children and adolescents : a mixed-methods systematic review},
  author = {{L}iguori, {J}. and {O}sei-{K}wasi, {H}. {A}. and {S}avy, {M}athilde and {N}anema, {S}. and {L}aar, {A}. and {H}oldsworth, {M}ichelle},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjective: {T}his 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-{S}aharan {A}frica and (ii) identify challenges and facilitators to implementing effective school meals programmes.{D}esign: {M}ixed-methods systematic review (n 7 databases). {N}utritional outcomes assessed were anthropometrics (underweight, stunting, wasting, overweight/obesity), micronutrient deficiencies, food consumed and food environment. {Q}ualitative findings were coded using a nine-step school food system framework: production of food, wholesale and trading, transportation and storage, processing and distribution, food preparation, distribution to students, student stakeholders, community involvement and infrastructure support.{S}etting: {S}ub-{S}aharan {A}frica.{P}articipants: {C}hildren/adolescents (5-18 years), parents, school personnel and government officials.{R}esults: {T}hirty-three studies (twenty-six qualitative, seven quantitative) from nine sub-{S}aharan {A}frican countries were included. {S}ix studies found a positive impact of publicly procured school meals programmes on nutritional outcomes (wasting (n 1), stunting (n 3), underweight (n 1), vitamin {A} intake (n 1) and dietary diversity (n 1)). {F}ifty-three implementation challenges were identified, particularly during food preparation (e.g. training, payment), distribution to students (e.g. meal quantity/quality/diversity, utensils) and infrastructure support (e.g. funding, monitoring, coordination). {I}mplementation facilitators were identified (n 37) across processing and distribution (e.g. programme coordination), student stakeholders (e.g. food preferences, reduced stigma) and community involvement (e.g. engagement, positive perceptions). {I}ncluded policy recommendations targeted wholesale and trading, food preparation, student stakeholders and infrastructure support in nine, fifteen and twenty-five studies, respectively.{C}onclusions: {A}s many challenges remain, strengthening implementation (and therefore the nutritional impact) of school meals programmes in sub-{S}aharan {A}frica requires bold commitment and improved coordination at multiple levels of governance.},
  keywords = {{P}ublic procurement ; {S}chool meals ; {F}ood environment ; {P}olicies ; {S}ub-{S}aharan {A}frica ; {AFRIQUE} {SUBSAHARIENNE}},
  booktitle = {},
  journal = {{P}ublic {H}ealth {N}utrition},
  volume = {27},
  numero = {1},
  pages = {e213 [23 ]},
  ISSN = {1368-9800},
  year = {2024},
  DOI = {10.1017/s1368980024001939},
  URL = {https://www.documentation.ird.fr/hor/fdi:010092001},
}