Implementation of the National Midday Meal Program at Community Schools of Nepal

The research Project entitled 'Implementation of National Midday Meal Program in the Community Schools of Nepal' is now in the implementation phase led by Dr. Devaraj Acharya. The Government of Nepal (GoN) has introduced the National Mid-Day Meal Program (NMDMP) as part of this comprehensive nutrition plan to reduce undernutrition among community school-age children since 2020. The project aims to asses the national midday meal program, which is primarily supported/funded by Government of Nepal. The research project is national representative covering 22 districts from all provinces including mountain, hill, and terai coving both rural and urban areas. The project is supported/funded by the Research Development and Coordination Council, Office of the Rector, Tribhuvan University. A mixed-methods case study design has been followed in this research and guided by CIPP model/system theory [context, input, process, output]. The research covers both basic and secondary community schools. 

A total of 2556 samples size were determined by multistage sampling methods for anthropometric analysis from 22 districts covering the seven provinces; however, we collected 2727 samples since it was a census at school level. For qualitative information, 15 focus group discussions [FGD] for exploring the issues and practices of NMDMP. Similarly, 51 participants such as head teachers, focal teachers, representatives of local governments, cook/helpers, and women group members conducted an in-depth interview [IDI] and 10 case studies. All schools  in which the quantitative data collected, were also included in the observation.

For the reliability of validity of the research tools, it was validated by test re-test methods including Delphic techniques. Piloting, pre-test, orientation and pre-test for field enumerators, data collection and cast study were conducted on April 3-9, May 5-7, May 10-31, and Oct. 3 to Nov. 6, 2023 respectively.

We found that the average weight of the participants was 32.6±7.6 kg, height 140.6±9.2 cm, skin fold Triceps 5.3±3.5 mm, and Subscapular  3.6±2.9. Similarly, the prevalence of weight for age [WAZ], height for age [HAZ], and body mass index for age [BAZ] z scores (within ±2 s) were 72%, 75%, and 82% respectively and out of these scores are considered malnutrition. Sociodemographic characters are significantly associated with malnutrition, while province, residence setting, age group, gender, wealth status, and ecological belts were noticed as significant predictors for having good or bad nutritional status. The situation of malnutrition remains almost similar to the previous study. That means that existing nutritional interventions need to be reevaluated and redesigned since they were unable to minimize the situation of malnutrition.