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首页> 外文期刊>Trials >Evaluation of alternative school feeding models on nutrition, education, agriculture and other social outcomes in Ghana: rationale, randomised design and baseline data
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Evaluation of alternative school feeding models on nutrition, education, agriculture and other social outcomes in Ghana: rationale, randomised design and baseline data

机译：对加纳营养，教育，农业和其他社会成果的替代学校供餐模型的评估：基本原理，随机设计和基准数据

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Background ‘Home-grown’ school feeding programmes are complex interventions with the potential to link the increased demand for school feeding goods and services to community-based stakeholders, including smallholder farmers and women’s groups. There is limited rigorous evidence, however, that this is the case in practice. This evaluation will examine explicitly, and from a holistic perspective, the simultaneous impact of a national school meals programme on micronutrient status, alongside outcomes in nutrition, education and agriculture domains. The 3-year study involves a cluster-randomised control trial designed around the scale-up of the national school feeding programme, including 116 primary schools in 58 districts in Ghana. The randomly assigned interventions are: 1) a school feeding programme group, including schools and communities where the standard government programme is implemented; 2) ‘home-grown’ school feeding, including schools and communities where the standard programme is implemented alongside an innovative pilot project aimed at enhancing nutrition and agriculture; and 3) a control group, including schools and households from communities where the intervention will be delayed by at least 3?years, preferably without informing schools and households. Primary outcomes include child health and nutritional status, school participation and learning, and smallholder farmer income. Intermediate outcomes along the agriculture and nutrition pathways will also be measured. The evaluation will follow a mixed-method approach, including child-, household-, school- and community-level surveys as well as focus group discussions with project stakeholders. The baseline survey was completed in August 2013 and the endline survey is planned for November 2015. Results The tests of balance show significant differences in the means of a number of outcome and control variables across the intervention groups. Important differences across groups include marketed surplus, livestock income, per capita food consumption and intake, school attendance, and anthropometric status in the 2–5 and 5–15 years age groups. In addition, approximately 19?% of children in the target age group received some form of free school meals at baseline. Conclusion Designing and implementing the evaluation of complex interventions is in itself a complex undertaking, involving a multi-disciplinary research team working in close collaboration with programme- and policy-level stakeholders. Managing the complexity from an analytical and operational perspective is an important challenge. The analysis of the baseline data indicates that the random allocation process did not achieve statistically comparable treatment groups. Differences in outcomes and control variables across groups will be controlled for when estimating treatment effects. Trial registration number ISRCTN66918874 (registered on 5 March 2015).
机译：背景“本土”学校供餐计划是一项复杂的干预措施，具有将对学校供餐产品和服务的需求增加与社区利益相关者（包括小农和妇女团体）联系起来的潜力。但是，有严格的严格证据表明实际上是这种情况。这项评估将从整体角度明确审查国家学校供餐计划对微量营养素状况的同时影响，以及营养，教育和农业领域的成果。这项为期三年的研究涉及一项围绕国家学校供餐计划扩大规模而设计的整群随机对照试验，其中包括加纳58个地区的116所小学。随机分配的干预措施是：1）学校供餐计划小组，包括实施标准政府计划的学校和社区; 2）“自家”学校供餐，包括实施标准计划的学校和社区，以及旨在增强营养和农业的创新试点项目; 3）对照组，包括干预措施将至少延迟3年的社区中的学校和家庭，最好不要通知学校和家庭。主要成果包括儿童健康和营养状况，学校参与和学习以及小农农民收入。还将测量农业和营养途径中的中间结果。评估将采用混合方法，包括儿童，家庭，学校和社区级别的调查以及与项目利益相关者的焦点小组讨论。基线调查于2013年8月完成，最终调查计划于2015年11月进行。结果平衡测试表明，干预组中多个结果和控制变量的均值存在显着差异。各组之间的重要差异包括市场剩余，牲畜收入，人均食品消费和摄入量，入学率以及2-5岁和5-15岁年龄组的人体测量学状况。此外，目标年龄组中约有19％的儿童在基线时获得了某种形式的免费校餐。结论设计和实施对复杂干预措施的评估本身就是一项复杂的工作，需要一个跨学科的研究团队与计划和政策层面的利益相关者密切合作。从分析和操作的角度管理复杂性是一项重要的挑战。对基线数据的分析表明，随机分配过程未达到统计学可比的治疗组。估计治疗效果时，将控制各组患者结局和控制变量的差异。试用注册号ISRCTN66918874（于2015年3月5日注册）。

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