2021 Working Paper (2021-02)

Working Paper 2021-02
Evaluating a Community-Led Central-Kitchen Model for School Feeding Programs in the Philippines: Learnings for Multisectoral Action for Health
Vanessa T. Siy Van, Carmina P. Siguin, Andrew C. Lacsina, Lean Franzl Yao, Zarah G. Sales, Normahitta P. Gordoncillo, Leslie Advincula-Lopez, Joselito T. Sescon, and Eden Delight Miro

Abstract 

In devolved governments like the Philippines, local government units (LGUs) must be engaged to develop and coordinate responses to tackle the multisectoral problem of childhood undernutrition. However, current Philippine nutrition interventions, such as school feeding programs (SFPs) generally rely on the national government or private sector, to mixed results. The central-kitchen SFP-model was developed by 2 Philippine non-government organizations and facilitated large-scale feeding through community multisectoral action. This paper evaluated the model’s impact in 1 urban-city and 1 rural-province using data from 24-hour dietary recalls with 308 rural and 310 urban public-school students and household surveys with their caregivers. Enabling factors were explored in focus-group discussions with 160 multisector participants and implementers, and a review of official documents. The program had greater impact on rural beneficiaries and improved dietary habits and school participation in both sites, though menu modifications could increase program impact. The locally-led-and-operated central kitchens were a multisectoral investment that served as a scaffold for other health, education, and social-welfare interventions. Program sustainability was attributed to affording communities agency to operate and modify the model according to local needs, embed volunteer pools in social networks, and organize demand for related services from their LGU. Public participation in local policymaking compelled LGUs to rally non-health sectors to address non-health determinants of undernutrition. Operations were sustained despite political leadership changes through formal and informal accountability mechanisms and transparent monitoring and evaluation across sectors. The model demonstrated empowering civil society can hold local governments accountable for multisectoral action in decentralized settings. Future interventions should also focus on educating local leaders, as their knowledge of the relevance of holistic health interventions was a necessary precondition that motivated their stewardship and coordination of different government sectors.

Keywords: community-led central kitchen model, school feeding program, childhood nutrition