McGovern-Dole ProgramFood for Education

Guinea-Bissau

Final program evaluationon USDA Agreement Number FFE-657-2011/023-00.Program implemented byInternational Partnership for Human Development (IPHD)

Evaluators: Uli Locher and Payal Batra, consultantsJune 30, 2015

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Executive Summary of key findings and recommendations

Funded under the McGovern-Dole initiative, theIPHD program operates under the assumptionsthat (A) school feeding contributes positively tohuman capital formation and "a more self-sufficient and productive society" and, (B) theimports of agricultural commodities will not leadto market distortions and a more vulnerableeconomy in Guinea-Bissau. Both of theseassumptions are examined in this evaluation.

Starting in 2007, IPHD has been active in schoolfeeding and the institutional activities thatsupport it, has used schools as conduits forhealth and nutritional interventions and hascontributed to improvements in the quality of participating schools. As the core of all this, over 72Million meals have been served to 145,000 students during the 2012-2015 period.

Key findings

Process and program theories The IPHD process theory is confirmed. The team has been highly successful in all aspects

of program implementation, providing a very impressive record of achievement that ideallycan be exported to other less successful programs. It set in motion processes of commoditydistribution, of community organization and of organizing peripheral activities in responseto emerging needs and opportunities, all of which were successfully accomplished. It neverlost control of its resources and operations, despite much political adversity. It establishedeffective networks of communication and collaboration on individual and institutionallevels which are essential for short-term success as well as longer-term sustainability.

The McGovern-Dole impact theory linking school feeding with human capital formation isnot confirmed. There is no proof that the school feeding program as such has achieved theincreased learning outcomes and human capital formation that are critical to economicdevelopment. In fact, solid empirical studies from other nations point to the contrary: schoolfeeding alone is neither effective nor cost-effective in reaching those objectives. It becomeseffective only if combined with school quality improvements. IPHD is correct where itattempts to link school feeding with school quality improvements.

By shifting focus and some resources to factors that actively enhance learning IPHD nowhas the potential of effecting substantial impact in human capital formation. The programhas established solid institutional bases and exceptional expertise in working with schoolswhich can be leveraged to make this possible. It should be emphasized that, without thework IPHD has accomplished to date, these next steps would not be possible.

School feeding operations School feeding was carried out in competent, responsible and honest ways. Rarely have SF

programs been associated with so little controversy, corruption and waste, which is an

Results at a glance All school feeding targets surpassed Exemplary community mobilization Successful public health campaigns Micronutrient fortification for

children Local capacity building Base laid for concentration on school

quality In line with McGovern-Dole focus on

human capacity

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impressive achievement and a valuable base on which to build next-generation educationalopportunities.

The program has shown exceptional resilience during politically challenging times. It hascontinued when many other service providers simply ceased operation, most notablygovernment schools. As political instability is the rule rather than the exception in SSA,IPHD can be a model of how things should be done.

Health and nutrition Through an exceptional distribution system and thorough field monitoring, IPHD school

meals are contributing to the caloric, macronutrient and micronutrient intakes of the schoolgoing child, an important achievement for a food insecure population.

The rations however are currently not tailored to accommodate the increase in enrolmentover a window of 3 months.

Along with complementary activities such as deworming, specific micronutrientsupplementation and the anti malaria campaign, the program is helping to create a healthyenvironment for the school going child. As noted above, such activities provide a veryeffective base to use with greater educational engagement in future work here.

PTAs and community organizations Embedding school feeding in a network of functioning community organization has been a

hallmark of IPHD. Impressively, PTAs with their local, regional and national organizations have reached a

certain level of legitimacy in the public eye and autonomy of function. Local school committees have experience with contributing to school renovation, provision

of supplementary food items and monitoring of commodity arrivals. Effective and charismatic leaders make a difference in the political weight and the

sustainability of community organizations. The National PTA is led by an exceptionalindividual of considerable influence.

Education context The internal efficiency of most schools in GB is very low because of school quality factors

that limit learning, prevent promotion and result in repetition and dropout. The FFE approach is effective in improving enrolments, retention, attendance and

graduation rates. There is no causal connection between school feeding and improved cognitive results. Many low-to-medium cost interventions practiced elsewhere have a proven high impact on

student learning. IPHD could leverage food for such promising interventions. Most IPHD resources are still concentrated on school feeding activities, i.e., they combine

high cost with low learning impact. Now that the program is firmly established, this can bechanged.

Girls’ education IPHD has succeeded in improving enrolment, retention, attendance and promotion rates for

girls in its schools. This is true in both the rural schools as well as the urban ones, and inMoslem communities as well as Christian

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One limited but particularly successful activity deserves additional mention – the paymentof tuition fees and provision of some school supplies by the program, conditional on schoolattendance by the selected girls.

School infrastructure: buildings, water wells, furniture and supplies, kitchens, gardens Costs were well contained. Community participation served more as a means to promote

local ownership and empowerment than to reduce cost to the program. The need is very great. Not a single school visited was fully equipped with complete and

satisfactory infrastructure, trained teachers and full school supplies. The IPHD workundoubtedly made things much better than they would otherwise have been, but additionalresources are needed to provide facilities at a level that would be expected to enhanceeducation.

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The challenge: abaraca instead of aclassroom, make-dofurniture, virtually notextbooks and othersupplies – but a mealwill be served, thanksto IPHD.

The model school: asafe, clean, well-litclassroom, appropriatefurniture and schoolsupplies, individualstudents’ backpacks, agood meal supplied byIPHD.

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Key recommendations

IPHD has interpreted its mandate primarily as a school feeding mandate and all other activities arecurrently tied to school feeding by taking advantage of the presence of children in school.However, the McGovern-Dole objective of a more productive and prosperous society cannot bemet by distributing food alone.

1. Schools should not be used for large-scale food distribution unless school quality leveragecan be achieved.

2. IPHD should phase out support for inadequate schools that will not be capable of makingeducational improvements.

3. IPHD should expand its support for PTAs by rewarding those that provide an active supportin terms of monitoring and material contributions.

4. IPHD should target additional support at the PTA efforts in radio-education.5. IPHD should accommodate the changing numbers of enrolment in the 2nd and 3rd trimesters

for food ration calculations.6. IPHD should take the lead in elaborating a standard package of interventions aimed at

filling the needs of all participating schools. The package might combine schoolmonitoring, textbooks, teacher’s manuals, classroom supplies, PTA support, selected healthinterventions and micronutrient-fortified school lunches. Using existing channels, apartnership with MOE, MOH, UNESCO, UNICEF and WFP could result in the definitionof the package.

7. IPHD should seek formal association with initiatives to assess the impacts of its food aid.The aim is to draw profit from the large number of studies done in this area. Such anassociation could take the form of retaining the services of an outside researcher, part time,or to allocate some local research capacity. The objective is to refocus the program fromfood aid to human capital formation, in accordance with McGovern-Dole.

Acknowledgements

The evaluation team would like to thank all those persons who assisted in this work,in particular the president of the International Partnership dor Human Development (IPHD),William Pruzensky, who provided much of the background documentation and made himselfavailable generously for help and advice. In Bissau we were welcomed and helped in everyway by Adrian Balan, IPHD country director and Louis Ulrich, associate director. Theirleadership and the whole team are models of competence and perseverance, yet they arehumble enough to actually listen to those ultimate beneficiaries, children and their families,who are the only reason for the program to exist. Many thanks to them.

Good data are not easy to come by in Guiné-Bissau but there is one collection ofnutrition and education data that is of the highest quality, the Multiple Indicator ClusterSurvey (MICS) carried out periodically by UNICEF. We thank Cristina Brugiolo and PatrickNkengne of the Bissau and Dakar offices for sharing their insights and some advance peeks atthe 2014 MICS results, scheduled for publication next month.

We are indepted to Nina Schlossman at Global Food and Nutrition and Susan Robertsat Tufts University for helpful discussions of our task at an early stage as well as detailedcomments on a first draft of this report. Their previous experience in the country and withIPHD, especially through the Micronutrient Study, made them ideal reviewers of our work.As always, of course, any errors are our own.

Montreal and Vancouver, June 30, 2015 Uli Locher and Payal J. Batra

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Contents

1 Introduction 10

2 The IPHD Program Theory 11

2.1 A note on program theory2.2 The theory of McGovern-Dole FFE programs2.3 Dimensions of program activity contributing to positive impact2.4 Schools as conduits for nutritional and health interventions

3 The relevance of the IPHD program in GB 15

4 The effectiveness of the program 19

4.1 Effectiveness inputs, manpower and activities4.2 Effectiveness outputs: Implementation of component activities4.3 Effectiveness results: Utilization of the services by the target population4.4 Effectiveness impact

4.4.1 Change in educational achievement due to program activities4.4.2 Nutrition change due to program activities

4.5 Summary of program effectiveness

5 The efficiency of the program 27

5.1 Cost-effectiveness of inputs5.2 Cost-effectiveness of outputs5.3 Cost-effectiveness results at household and school levels5.4 Program efficiency and impact5.5 Summary of program efficiency

6 Equity considerations 33

6.1 Equity in inputs6.2 Equity in outputs6.3 Equity in results6.4 Is the program impact equitable?6.5 Summary concerning equality and equity

7 Sustainability 38

7.1 Sustainability of inputs7.2 Sustainability of outputs7.3 Sustainability of results7.4 Sustainability of impact7.5 Summary concerning sustainability

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8 List of findings 42

9 Recommendations 44

Annexes

1. Progress indicators2. PTA strategy document3. IPHD organizational charts4. School feeding and disappointing learning outcomes5. School quality interventions and learning effects6. The challenge of getting girls educated7. Food aid and cashew nuts: damaging to GB food security?8. Protocol for health and nutrition observations9. Nutritional aspects of IPHD school feeding10. Field trip report11. List of persons contacted12. Bibliography13. A comment on the USDA monitoring and evaluation policy14. Evaluation Terms of Reference15. Options for conditions of inadequate teacher training16. Steps toward graduation and sustainability

Figures

Figure 1 Program theory for McGovern-Dole FFEFigure 2 Adult literacy rate in Guiné-Bissau, 1970 – 2010Figure 3 Crude enrolment rates, by level, Guiné-Bissau, 1999/00, 2009/10, 2013/14Figure 4 Malnutrition indicators for children, GB, 2000, 2010 and 2015Figure 5 Baseline and effective enrolment in IPHD schools, 2006/7 to 2013/14Figure 6 Percent attendance in IPHD schools, 2006/7 to 2013/14: total, girls and

national averageFigure 7 Dropout rates in the IPHD and WFP programs, by school yearFigure 8 Promotion rates in the IPHD and WFP programs, by school yearFigure 9 Nutrition status of primary-school students in Oio and Cacheu: deficiencies

and development outcomes, in percentFigure 10 Literacy rates of young women (15-24 years) and rates of young child

malnutrition, by region, 2014Figure 11 Percent of students who start first grade at the appropriate age, by rural/urban

residence

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Tables

Table 1 Evaluation Criteria Applied to the IPHD programTable 2 Estimated costs and benefits of participating in school feeding for a rural

household, in $US, per child (without PPP adjustments)

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1. Introduction

This final evaluation of the IPHD Food for Education program will focus mainly on thedescription, measurement and interpretation of program impact among the target population.To do this it will address three questions, namely, (1) What is the health and nutritionalimpact, (2) what is the educational impact and (3) what is the overall cost/benefit picture ofthis food-for-education program? Answering these three questions will also allow us toaddress the two underlying assumptions of the program, namely, (A) that school feedingcontributes positively to human capital formation and "a more self-sufficient and productivesociety" and, (B) that the imports of agricultural commodities will not lead to marketdistortions and a more vulnerable economy in Guinea-Bissau.

Various indicators of nutritional and educational impacts are listed in project documents andwill be discussed below. We scrutinize them according to the dimensions of relevance,effectiveness, efficiency, equity and sustainability.1 While every program under theMcGovern-Dole Initiative is expected to conform to monitoring and evaluation guidelines setout for such programs there is a certain amount of leeway in terms of such conformity. Theregular interim reports of the IPHD program in GB have always respected the letter ofMcGovern-Dole in a high degree.2 This evaluation intends to respect its spirit despite a muchmore restricted and targeted focus on impact alone.3

A note on international comparisons is in order here. The objective of any evaluation is toimprove future program performance. Such improvement can be facilitated by placingprogram operation into the wider context of international aid delivery and by comparingoutcomes to those of comparable programs elsewhere. FFE programs in particular can profitgreatly from such comparison since a large amount of evidence has accumulated over the pastdecades and successful programs have received considerable scrutiny. We shall make aneffort to compare the impact of the GB program to what has been achieved and learnedelsewhere in Africa and beyond.

1 This represents a slight variation of the standard list proposed in USDA-FAS, 2013 “Monitoring andevaluation policy” and in the ToR of this evaluation of a program started in 2011. Impact is given a higher orderof consideration than in the standard list. The criterion of equity is added, in line with recent public debates onequality and equity in international aid.2 For the exhaustive list see USDA-FAS, 2014 “Food for Progress and McGovern-Dole Indicators andDefinitions.”3 Annex 13 contains a more complete argument for the focus of this evaluation.

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2. The IPHD Program Theory

2.1 A note on program theory

Any program design has a section concerning expected impact, and we shall call this theimpact theory. It also has sections concerning the processes set in motion in order to arriveat the impact, and this section shall be called the process theory, subdivided into plansconcerning program organization on the one hand, and service utilization on the other hand.

The implicit theory of any social program is that services delivered to the target populationwill improve that population’s welfare or quality of life. Program impact theory is a set ofassumptions and statements about how the services are supposed to affect the desired change;it is always about the causality of expected impact. Evaluators will typically use arrows tonote the expected cause-and-effect relationships.

Theory failure is a killer of programs, as it should be. Any program that – despite appropriateimplementation of a service - does not produce the expected ultimate benefit for the targetpopulation should be stopped and revised immediately. There is no justification for producingservices that cannot be used or are proven to be useless.

2.2 The theory of McGovern-Dole FFE programs such as IPHD

As expressed in its full name, “The McGovern–Dole International Food for Education andChild Nutrition Program” apparently has two independent objectives – education andnutrition. However, a closer reading suggests that these objectives are connected in a clearcausal structure. The ultimate goal is to contribute to “more self-reliant, productive societies”,as stated in the 2011 IPHD program agreement - a goal that is essentially economic.Economic development requires increasing a society’s level of education which in turn isfacilitated by satisfying the minimal nutritional needs of school children. This program theorycan be presented in the following figure:

Figure 1 Program theory for McGovern-Dole FFE

Food aid(direct ormonetized) School

quality(teaching,infrastructure)

Studentquality(healthy, alertstudents) Academic

performance(learning,promotion)

Increasedhuman capital;Self-reliant,productivesociety

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This point merits emphasis: McGovern-Dole is not primarily a nutrition program but oneaimed at raising education levels in the interest of economic development. It envisionshealthy, well-fed children not as its ultimate goal but as constituents and building blocks of amore productive society. Emergency nutrition and social safety net programs may have theirplace in development assistance, but McGovern-Dole is not one of them as its objective iseconomic development. IPHD is a McGovern-Dole program and, therefore, must share thesame objective.

2.3 Dimensions of program activity contributing to positive impact

Like many other programs, IPHD started with a high level of donor commitment, control andinputs. USDA, through McGovern-Dole, provided all of the resources while also defining theprogram theory, range of activities and impact expectations. As program activity movedalong the results chain, from inputs to outputs, results and impact, this dynamic changed,endogenous actors intervened to an increasing degree and the political environmentunderwent some drastic changes. Has the vision been maintained through those changes? Tounderstand how and why the program has progressed toward its stated development goals, itis useful to break down the narrative of success by applying some formal evaluation criteria.These are summarized in Table 1.

Table 1 Evaluation Criteria Applied to the IPHD program

Criteria Inputs Outputs Results ImpactRelevance Explicit program

theoryComponentactivities adapted toevolving contexts

Mechanismsmaintaining programrelevance

Strong institutions thatcontinue to raiseeducation levels

Effectiveness Material inputs,manpower andactivities

Implementation ofcomponentactivities;Services offered

Utilization of theservices by the targetpopulation

Change in educationlevels due to program

Efficiency Unitary cost ofactivitiesDistribution ofcost across allactivities

Cost per unit of“installed capacity”for services

Cost and benefit ofservice use per targetunit (e.g., household)Internal efficiencymeasures

External efficiencymeasureCost per impact unit

Equity Distribution ofinputs andactivities byregion, ethnic orincome groups,gender, etc.

Distribution ofservices offered byregion, ethnic orincome groups,gender, etc.

Evidence ofcommunityparticipation, solidarityand empowerment

Evidence of equitableimpact over time

Sustainability Continued flow ofnecessaryresources

Installed servicesand activities haveachieved adequatenon-projectfinancing, autonomyand legitimacy

Evidence of ongoingcommunity ownershipof services

Evidence of impactover time, particularlyimpact due to post-project interventions

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Reader beware: The formality of the above table helps us to distinguish activities that weremerely effective from those that were actually cost-effective and those that remained inputsfrom others that actually achieved impact. Such clarity is required in order to fully understandthe trajectory a program takes over the duration of its implementation. However, it alsorequires the reader to submit to the formal process of analysis and be satisfied with the factthat, e.g., a chapter on one dimension (such as equity) will deal with that dimension alone.

Section 2.4 Schools as conduits for nutrition and health interventions

Given the need for reducing hunger and investing in universal primary education(Millennium Development Goals 1 and 2), schools appear to be an effective conduit toimplement health and nutrition interventions by providing an operationally preexistinginfrastructure and an environment of learning. Such programs are common in high-incomecountries and a majority of middle income countries and have gained popularity in lowincome countries. For low to very low income countries, such interventions have the capacityto have a dual impact on the education and health of a countries’ younger generation, helpingthem raise human capital and achieve economic growth (Multiple impacts, WFP). In theinterest of the current context, the focus of this section is the implications of school healthand nutrition programs in the low to very low income countries.

As observed by Bundy and colleagues, low income countries by and large have more teachersthan nurses and more schools than clinics (Bundy, 2006). Thus, intervening at the schoollevel provides a natural and convenient setting to attract children to schools and possibly keepthem there. Additionally, such an approach is also cost effective as expressed in DisabilityAdjusted Life Years (DALY) (Box 1, Del Rosso, 1996). School health initiatives could referto a myriad of programs such as de-worming, hygiene and sanitation, HIV/AIDS awareness,anti malaria campaigns, immunization, micronutrient supplementation and school feeding.More often than not, school based initiatives include a basket of nutrition and healthinterventions with school feeding as a central component, together serving as a springboardfor positive outcomes for both the direct beneficiary and their families.

The transmission of public health related messages is one of the prime benefits of workingthrough schools. Communities in their entirety tend to hear and benefit from the messages. Atthe same time, seeing positive results connected with an operating school increases thecommunity’s sense of ownership of the school and makes it less likely that school closureswill be tolerated. To quote one teacher:

“The community also gains from what the children are taught in school. An exampleof this is the hygiene campaign by IPHD and UNICEF. The messages weretransferred to the parents of the children by the children themselves. Another veryimportant impact has been the reduction of strikes, the entire community comestogether to avoid such situations, to motivate teachers to continue teaching.”

As a direct impact, interventions like school feeding alleviate short term hunger. Sometimesit is hard for parents in low income countries to understand the importance of education andhaving an immediate benefit encourages them to send their child to school. Over time, suchprograms have the capacity to improve the nutritional and health status of the school aged

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child, potentially influencing learning and school performance. School-age children withlower levels of disease reduce the overall transmission of disease in the wider community.Besides, healthier children increase the likelihood of healthier adults, leading to improvedhuman capital and economic gains. Research has shown that school health and nutritioninterventions can add four to six points to IQ levels, 10 percent to participation in schooling,and one to two years of education together contributing 8 to 12 percent to labor returns(Bundy, 2006).

One can argue that suchprograms do not fullyoverride early life nutritiondeprivation and the resultantcognitive and physicaldeficits. However, it isimportant to remember thatsuch initiatives carry forwardindirect benefits spilling overto the next generations andthe community. In lowincome countries, parentaleducation, especiallymaternal, is a strongdeterminant for well being ofthe next generation. Thelikelihood of having astunted child decreases byabout 4–5 percent for everyadditional year of formaleducation achieved by mothers (Semba et al. 2008; Bundy, 2009). Similarly, in the GB MICSdata from the years 2000 as well as 2015, educated mothers were less likely to haveunderweight or stunted children. Further, nutrition and health initiatives have the potential toengage parents and communities in the promotion of public health and good nutrition. Goodexamples of these are the PTAs and SLCs at schools in GB that conduct various activitiesranging from awareness and education campaigns to the management of such initiatives. Spillover examples worth noting are the IPHD school garden and hygiene and sanitationinitiatives. Albeit small, field visits brought out the domino effects of these programs.Inspired by the school gardens and having the technical know-how, a few communities havestarted their own gardens.

In terms of development investment, school based health and nutrition programs offer a modeto improve the quality of life of the school going child and the next generation and contributeto national development and productivity.

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3 The relevance of the IPHD program in GB

Some aspects of education have improved considerably in GB over the last few decades.According to government sources and MISC studies, in 1970 less than 1 percent of the adultpopulation was literate. That proportion has changed quite radically, to reach 55% in 2010(Figure 2). Similarly, primary school enrolment increased rapidly, to reach a first-grade crudeenrolment rate of 98% in 1999/2000 (Figure 2).4 By all accounts, despite such progress, theeducational needs in GB are still enormous.

Figure 2 Adult literacy rate in Guiné-Bissau, 1970 – 2010Source: UNESCO and MISC estimates

Figure 3 Crude enrolment rates, by level, Guiné-Bissau, 1999/00, 2009/10, 2013/14Source: MISC, 2015c

Figure 3 shows yet another serious issue, the grave consequences of violent political events.The two top curves are significantly higher than the bottom curve in this graph, representinggreat progress in enrolments during the 1999/00 to 2009/10 decade. But the two top curvesoverlap, so there has been no progress at all during the next four years. Those were the yearsof the coup d’état, the strikes and other conflicts. They brought educational progress to a halt.Paul Collier has presented an impressive analysis of coups, emphasizing that the short-term

4 The crude enrolment rate includes all those overage children in grade 1 which the net rate would exclude.

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visible effects such as those in the above figure are only “the tip of the iceberg.” Coups mayoccasionally be the only solution available in a political crisis but their consequences areusually “awful”. (2009:141) The GB economy shrunk by an estimated 15% in the coup yearof 2012.

On the nutrition front, the situation in GB does not reflect progress comparable to education,if it reflects progress at all. The following Figure 4 shows anthropometric data from the mostrecent large-scale study of children 0 to 60 months old. While levels of wasting andunderweight have declined since the earlier MISC studies, stunting remains at extremely highlevels and has even increased over the 15 year period. Over 30% of young children arestunted in their growth, i.e., have suffered developmental disadvantages which cannot bemade up in later life.

Figure 4 Malnutrition indicators5 for children 0-5 years old, GB, 2000, 2010and 2015Source: MICS, 2015a

The relevance of IPHD in terms of child nutrition appears beyond question.6 Equallyconvincing is the combination of nutrition interventions with an education program. Aconsiderable amount of evidence suggests that improving education levels is indeed anecessity of economic development and that – given correct implementation in the rightcontext - school feeding is indeed one of several valid means to achieve this desired outcome.School feeding programs provide a net addition to households’ food budget, often on theorder of 10 percent or more. Beyond the safety net function in contexts of severe food deficit,school feeding programs can also increase enrolments and attendance, cognition andeducational achievement, particularly if combined with other actions such as deworming and

5 Underweight: below minus two standard deviations from median weight for age of reference population;Wasting: below minus two standard deviations from median weight for height of reference population;Stunting: below minus two standard deviations from median height for age of reference population.6 Figure 4 shows that more than one half of children starting school, at age 6 or later, already have a history ofmalnutrition behind them, most often of its most severe type.

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micronutrient fortification.7 Asking the question of relevance goes to the heart of suchprograms: it forces the articulation of a program theory and the consideration of each factorthat can contribute to achieving the desired impact.

Such positive assessment of school feeding does not address the question of its cost-effectiveness which will be dealt with below, in the section on efficiency. Besides, schoolfeeding programs can also be operationally limited, degrading into activities concerned solelywith putting food through the system, without much concern for the ultimate objectives ofeducation and productivity. In terms of McGovern-Dole, a program that does not result inimproved human capital is a failure. The key to keeping programs on track towardseducational impact lies in building strong institutions which maintain the relevance andimpact orientation of FFE programs. IPHD has undertaken the following steps in this respect:

Parent-teacher associations have come into existence in virtually every one of the 688schools served by IPHD but are rare in other schools and thus provide an importantexample for the rest of the nation. They are the units that articulate demand, voicecriticism and generally organize local participation in the program. At the nationallevel, they were instrumental in keeping schools open and ending the teachers’ strikeof 2012, whereas schools outside the IPHD network typically closed. While theirprincipal focus is on the school lunch program they understand the widerramifications of education, as evidenced in their impressive strategy document(Annex 2).

Each school has a committee concerned specifically with the administration of theschool lunch program. All of the practical aspects of this activity are handled by thesecommittees, from deciding on storage to the provision of labor, supplemental foodinputs from school gardens, collection and use of fuel wood and much more. Thecommittees are formed by volunteers and are independent of governmental authority.It is important to emphasize that this is an impressive resource created by IPHD thatwill be critical for all future projects.

AMIC (Associação dos Amigos da Criança), a national level association of “friendsof youth” composed mainly of teachers does not appear to be a strong institution atthis time but does have considerable potential. It provides volunteers at many schoolsand helps monitor the program. The education lobby in GB is notoriously weak whichhas led to a scandalously low level of government financing of the sector (11 percentof the national budget in 2010)8. AMIC maintains an office led by three people on theIPHD payroll and might yet become a strong voice in education, distinct from theteachers’ union and with a broader range of interests.

The Ministry of Education is, of course, the largest institution charged with promotingeducation. Under IPHD influence it has adopted two measures which have thepotential of helping to convert school lunches into educational achievement. It hasinstalled an office for school feeding within the Ministry and it has moved to atentative schedule for gradually assuming full responsibility for this activity

7 These issues will be discussed in more detail below. A definitive, relatively recent, account of all aspects ofschool feeding is found in Bundy et al., 2009.8 The new government has started to correct this problem by yearly 1% raises. For 2015 the figure is 14% so far,90% of which is for salaries.

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nationwide (see Annex 16). The Ministry is in the privileged position to leverageschool feeding into the pedagogical improvements necessary for improvededucational outcomes.9

All of the non-governmental institutions (or institutional components) are young and theircapacity has not been tested sufficiently. But they have already created partnerships favoringlearning and capacity building, and they provide buffers and spaces for exchange anddialogue between various stakeholders. They are essential if the program wants to effectlasting change in an environment that is difficult for the educational enterprise. The relevanceof IPHD in creating and improving institutional capacity is uncontested.

In summary, the vision, impact expectation and institutional approach of IPHD are inline with McGovern-Dole, have proven to be efficient, functional and valid during timesof great political turmoil and continue to be relevant for the foreseeable future. Theprogram has invested considerable energies in the creation and strengthening of intermediaryinstitutions which constitute networks of stakeholder representation, debate andcollaboration. Service delivery has been taken out of the stark polarity of foreign donor andcentral government and made into an activity involving many groups at many levels. Suchdecentralization, promoted by IPHD, is the key to success and sustainability of all newdevelopment initiatives.10

9 Among the conventional options of MOE is increased teacher training, both pre-service and in-service. Sommeother options will be discussed in Annex 15 of this report.10 One study found that social sector programs in Latin America practicing this network approach achievedtwice the success of projects involving only the polarity donor – central government (Locher, 2001)

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4 The effectiveness of the program

4.1 Effectiveness inputs, manpower and activities

Agricultural commodities constitute the program’s principal input factor. Despite somesignificant delays due to political instability and, sometimes, donor administrative schedules,the program has generally maintained the anticipated input levels and adapted them to localcircumstances. E.g., during the most recent reporting period (October 1, 2014 – March 31,2015) a total distribution of 330.015 MT of rice, beans, oil and potato flakes to some 181schools and kindergartens. At the highest point of its history the program served close to 700schools.

The reduction in the number of schools supplied during the final phase of the program isreflected in a reduction of the number of employees on the payroll, from a maximum ofslightly over 60 to a current number of 24 (see Annex 3).

4.2 Effectiveness outputs: Implementation of component activities

School lunches obviously are the dominant activity of the program. At the high point in 2014about 145,000 daily meals were served in some 700 schools.

Other activities since 2006 have included:

Organization of PTAs and the first National PTA Association comprising 9 regionaloffices, 38 sector offices and 512 community PTAs and a total of over 15,000members.

Malaria and health campaigns. IPHD distributed 112,823 mosquito nets, 4,490,448iron sulphate pills, 4,442,000 multi-vitamins and1,530,194 deworming pills.

125 sessions on malaria prevention, health andsanitation and dietary improvements were givento 2,655 teachers.

111 school sessions were given to train 953children health leaders.

17 community workshops were held to train 663community members as local leaders in healthand nutrition.

136 local committees were formed to deal with malaria and other diseases. 1,138 community sessions were held to raise awareness of health and nutrition issues,

reaching 29,000 participants. 9,340 school sessions were held,

dealing with health and nutritionissues and involving over 596,000children, 3,000 teachers and 14,000family members (These numbers involve some double-counting since someindividuals participated more than once.)

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Posters on malaria, cholera and Ebola were designed anddistributed through 1,000 schools.

Since 2008-09, IPHD repaired or built 615 classroomswhich benefit 23,000 children.

Between 2012 and 2014, 57 school wells were built. Since 2007, 550 school kitchens were built and 421 schools

received cooking and eating utensils. 270 school gardens were developed. The MOE’s teacher training center in Bolama was repaired

and refurbished. Prior to IPHD financial help, it graduated only 75 teachers per year;now it graduates 300 per year.

Between 2005 and 2012, IPHD purchased 911.5 metric tons of local food andcondiments for the school feeding program.

With the help of UNICEF, IPHDdistributed 1.6 million textbooks andteachers guides in 2014. A few yearsbefore this, IPHD distributed 600,000textbooks.

In 2011-14, under two pilot micronutrientprojects funded by USDA/FAS, partnered withTufts University and Global Food & Nutrition,IPHD conducted micronutrient studies with a U.Sproduced dairy supplement on over 5,000primary school students. It was the firstcomprehensive study of its kind on primaryschool students in Guinea-Bissau. (Some resultsof these studies are presented elsewhere in thisreport).11

The program has fully implemented the activities outlined in the original Agreement, madeadaptations where the context required them and, by cooperating with other donors(UNICEF, WFP), increased the effectiveness of their operations while at the same timeextending the program’s reach.

4.3 Effectiveness results: Utilization of the services by the target population

School feeding is universally popular. It comes as nosurprise that children, parents and teachers participated inall of the program’s activities. Some of the serviceutilization goes beyond the confines of the school. E.g.,some water wells serve entire communities. To quote thePTA president of one school visited:

11 This list is adapted from the ToR of this evaluation. More complete enumerations of activities are found in theperiodic reports of the program to USDA, the last one dating from May, 2015.

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“The FFE program has had a huge positive impact on our community. IPHD alsohelped us with the well and now that we have our own water we are motivated to startthe school garden next year. We like the way IPHD works with us, not just for us.”

Many of the health and nutrition activities also benefit entire communities. The most visibleresult of the program’s effectiveness is the increase in enrolments in IPHD-supportedschools. Once enrolled, children tend to attend school at unprecedented levels – betterthan 95% on average. According to MOE officials, the average attendance in GBschools not offering food is around 50% to 60%.These stark statistics justify IPHD’s decision tomake school meals a central feature of the work, andthe new emphasis on improving educational qualitycan now be undertaken only because of the priorsuccess in establishing the school meal programs.School feeding is one of the best incitements forchildren to attend school. Actually, after the SFprogram was closed in one of the schools visited, attendance suffered immediately. As oneteacher put it:

“Now that they don’t receive food, they keep running out of class in search for it,some manage to buy bread around the school, some run home and don’t come backfor that day.”

Figure 5 Baseline and effective enrolment in IPHDschools, 2006/7 to 2013/14Source: IPHD, 2015.

Enrolment increased from 105,262 students in 542 schools in October 2011, to 145,944students in 690 schools at the end of 2014. This means that the number of schools rose by27% and that of students per school, by 9%. Enrolment every year goes beyond the numberestablished in the MGD agreements for the same number of schools, asmore parents send their children to school for a school lunch.

Girls’ enrolment rate at the beginning of the program in 2006 was 43.6percent. By 2012 it had increased to 48 percent. Currently, it is 48.1

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percent. The enrolment increases for girls are significant though not spectacular, especiallysince the rates appear to be crude rather than net rates. Basically we learn that even with thepowerful incentive of free meals more than one half of girls in the project regions are not yetenrolled in primary school. (For more on the challenge of getting girls educated, see Annex6).

Once enrolled, students and their parents have to decide on actually attending school. It takeshigh motivation to decide that school is worth attending even during a season of risingopportunity costs, such as the cashew harvest season. As one teacher put it to the evaluationteam:

“The most important change for us that even in the most sensitive period of cashewharvest, more children stay in school instead of running away to the field in the pastyears.”

Verification of this teacher’s impression in her school led to the conclusion that she wasright: the cashew-dependent attendance decline in that school changed from 3.3% to under1% following the implementation of school feeding.

Girls’ attendance rates increased from 42.8 percent in 2006 to 47.9 percent currently. Thismay not seem much but is in fact a major success. Throughout African education to makegirls attend school has proven to be a thorny problem. IPHD seems to be making significantprogress.

Figure 6 Percent attendance in IPHD schools, 2006/7 to 2013/14: total, girls andnational averageSource: IPHD, 2025.

4.4 Effectiveness impact

4.4.1 Change in educational achievement due to program activities

Other indicators parallel enrolment. Basically, there is a sizable improvement of children’spresence, persistence and promotion in the primary school system. Under the IPHD program,the following evolution was observed over the past four years:

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Dropout rates fluctuate between 1.9 percent and 7.6 percent annually – far below thegovernment’s national numbers of 23 to 27 percent. These rates are comparable to whatwas found in the WFP program during last year’s evaluation. Here is a comparison of dropoutrates under the two largest school feeding programs in the country.

Figure 7 Dropout rates in the IPHD and WFP programs, by school yearSources: IPHD, 2015 and WFP, 2014. (WFP figure: girls; boys)

Both programs had dropout rates far below the national averages. In fact, the differencebetween these programs on the one hand and national averages on the other hand is so greatthat it cannot be ascribed to methodological issues such as the month of measurement or thevarying numbers of grade levels covered. Other things being equal we certainly attribute thisperformance to the incentives coming from the school feeding programs.

The promotion rate at the end of 2011 was 83.9 percent in the IPHD program; in 2013/14, itincreased to 93 percent. Bolama, Quinera, Oio and Tombali regions have the lowestpromotion rates. Biombo region went from 84.8 percent to 94.9 percent.

Figure 8 Promotion rates in the IPHD and WFP programs, by school yearSources: IPHD, 2015 and WFP, 2014.

The two graphs in Figure 8 at first view have a common message: far too many students failto be promoted to the next grade level. In the IPHD schools on average about 83% of studentspass while 17% do not. In the WFP case the pass rates are fairly constant, at about 74%,meaning that about 26% will repeat or drop out. We do not have sufficient information to

IPHD

WFP

IPHD WFP

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explain the substantial difference in dropout rates between the two programs. Several morepoints can be made about these two graphs:

Startup years are difficult; the positive program impact is not discernable yet. In theIPHD case the promotion rate in year one was below 70%. We do not have year onedata for WFP to confirm this statement.

IPHD schools have made regular progress over the years; WFP schools have not.12

The authors of the WFP evaluation attribute the drop-off in 2013 to the “aggravatingfactors” of expanding teachers’ strikes and deteriorating economic situation.13

Promotion rates differ between boys and girls, with boys’ rates always being slightlyhigher. The WFP graph shows this clearly. A detailed data presentation by IPHDshows the same trend (IPHD, 2015).

The program does not produce data on the learning outcomes of school feeding. This is notsurprising since good studies in this area are difficult, expensive and frequentlyinconclusive.14 Nevertheless, it is reasonable to ask: what is the point of attracting increasingnumbers of children to schools where they don’t learn much? The theoretical argument ofMcGovern-Dole is based on learning outcomes, not on years wasted in weak or evenworthless schools. Or, as one teacher put it during one of our focus groups: “What is theschool for – for eating or for learning?”

There is one recent study in GB which addresses the question of learning outcomes – theMICS study of 2014. We can, unfortunately, not cite its results formally in this report sincethe complete study document is only scheduled for publication in July of 2015. However,some of its data have been made available publicly in an advance document and at a meetingof education partners in Bissau (MICS, 2015a; 2015b). Additional data was obtainedinformally under the provision of not publishing the tables, and through informal discussions(MICS, 2015c). Here is what can be said at this time on the basis of the MICS study:

Levels of student learning in GB primary schools are generally low. Most studentsfailed the tests of Portuguese and Mathematics given at grades 2 and 5. Part of theexplanation is found in the low level of teacher preparation as evidenced by teacherperformance on those same tests.

Test scores are significantly lower in schools offering school feeding than in otherschools. Part of the explanation must be that the enrolment increases caused by schoolfeeding have disproportionately attracted students from poorer and more distanthomes. Feeding does not discourage learning but it changes the selection of students.(For more on this issue see Annex 4).

The design characteristics of the MICS study preclude any definitive conclusionsconcerning the learning effects of school feeding. There was no baseline, no before-and-after testing, no randomized trial, and no purposely established control group.

12 One is tempted to speculate about the much stronger community partnership under IPHD which makes theprogram more crisis-proof.13 The major income source for many households being cashew nuts, the depressed cashew prices of those yearsmust have meant that more children were being put to work at home, to help fend off starvation (see Annex 2,Figure 3).14 The best summaries of this research are contained in Fuller (1986), Schiefelbein et al. (1998) and Bundy et al.(2009).

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Above all, the effort was purely descriptive, without guidance from theory, formalhypotheses or international comparison.

Another question not yet addressed in this section on effectiveness is whether school feedingis the best, most cost-effective way of promoting student learning. Could the investment of$18 M (of the last 2-year program agreement have produced better results had it gone intotextbooks,15 teacher training or other school quality factors (see Annex 5)?

4.4.2 Nutrition change due to program activities

School feeding programs are often central to school health initiatives and are far more thanjust the provision of food. As an immediate effect, they bring the children to school and outof hunger (WFP, 2004). Macronutrient estimations (based on calculations for a 5 kilo basketprovided by IPHD and accounting for the fact that the meal is distributed on average to morechildren because of the rolling enrollment period of 3 months in GB; refer to Annex 9)indicate that each child receives approximately 822 kcals per meal16 which is above theinternational averages for school meals (Aliyar 2012). Caloric contributions and theobservations from the various field visits echoed this immediate “hunger” benefit. Parentsand teachers alike across regions reported that when children received food at school, theyweren’t as hungry and were able to stay at school through out the day. Former IPHD schoolsthat did not receive food during the academic year 2014-2015, reported hunger as an obstaclein the ability of the child to stay awake and aware during class hours. In theory, this shortterm benefit is caused by the increase in blood and brain glucose and could have positiveimpact on concentration, motivation and learning (Greenhalgh, 2007).

We have enough evidence to support the notion that school meals indeed alleviate hunger,but an additional important question here is whether school feeding is enough to combatyears of nutritional deprivation without separate emphasis on adequate nutrition for childrenduring the years before school starts. From this viewpoint, school meals indeed cannot fullyreverse stunting and other long-term consequences of malnutrition stemming from the first1000 days or 5 years. However, micronutrient deficiencies are reversible at any age and canimpact learning and cognitive functioning as well as immunity and sick days. The evidenceof school feeding itself on overt nutritional deficiencies has been mixed (Greenhalgh, 2007;Schlossman, 2014). But there is good evidence that activities complementary to schoolfeeding, especially deworming and micronutrient supplementation can offer importantnutritional benefits (WFP, 2006). Iron deficiency for instance, the most common form ofmicronutrient deficiency in school-age children, is a result of inadequate diet and infection,particularly hookworm and malaria.

15 The IPHD textbook distribution not part of the $18M investment. It was carried out on behalf of UNICEF,under financing independent of program funds.16 This is the best estimate for the average meal served. See Annex 9.

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Figure 9 Nutrition status of primary-school students in Oio and Cacheu:deficiencies and development outcomes, in percentSource: Saltzman et al, 2015 (unpublished data)

For the current program there is no way to quantify the impact of school feeding andcomplementary health interventions on anthropometric or micronutrient status as the programindicators relied heavily on enrollment and attendance as outcomes. However, as a proxyindicator, a reduction in drop out and absenteeism following mebandazol distribution and antimalaria campaigns (as reported in the semi annuals) could be attributed to improvedmicronutrient status. The micronutrient Randomized Control Trial (RCT) carried out byIPHD could have also contributed to an overall improved micronutrient status. Feedbackfrom parents and teachers also showed less sick days and an overall improvement in thehealth of the children. And the variety of the diet is appreciated. School feeding breaks themonotony of “mangoes in the morning, mangoes in the afternoon and mangoes in the night”deplored by parents in one of our focus groups.

Finally, such programs are only as good as the distribution systems that get the commoditiesand messages to the beneficiaries. From the various field visits, interviews and observations itwas evident that IPHD is doing this exceptionally well, and indeed should be a model forother less efficient programs in other countries. Active PTAs and SLCs and the domino effectof complementary IPHD activities such as school gardens and hygiene and sanitationpractices point towards the potential of the program to have a greater outreach, and to impactthe health and nutrition of the entire community.

4.5 Summary of program effectiveness

The program has fully lived up to expectations in terms of effectively channeling resourcesinto school feeding. This has led to significant enrolment increases. Increasing rates ofattendance and promotion suggest that the positive effects of human capital formationintended by McGovern-Dole are indeed being reached. Such a conclusion, however, ispremature. While some teachers and parents have provided impressionistic accounts ofimproved student learning, the only quantitative study so far appears to show that the manynewly enrolled students have brought average performance levels down. We havequantitative proof that the program has been effective in channeling food aid and increasingenrolment in primary schools. We do not yet have such quantitative proof that the programhas been effective in human capital formation, and such evidence is now needed.

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5 The efficiency of the program

Efficiency is the ability to do things well, without wasting efforts, money and time. It alwaysinvolves a comparison of costs and effects. In the previous section we have seen that IPHDhas been a very effective program in many ways. It can get things done, even things that areonly very tangentially connected to school feeding and things like textbook distribution thatwere absent from the original program design. The present section deals with the cost-effectiveness of the program. While it is customary to express costs in monetary terms wecannot ignore other costs of certain activities. The most obvious example of this is thatmassive imports of subsidized foods can disrupt local food production on markets, a cost thatis often borne by small producers. Another example is that the competent administrativeactions of expatriate personnel can limit the development of local institutional capacity.These two examples are not random choices. They exemplify efficiency issues that must beaddressed by the program and shall be addressed in the following sections of this evaluation.

5.1 Cost-effectiveness of inputs

Since the cost of the program’s inputs (some $18 M for the last two-year budget) is borne byUSDA it cannot be the focus of this evaluation. The resources are a gift from the Americanpeople; whether they were produced and shipped a bit more or less efficiently is of noconcern here.

But, as the saying goes, there is no free luncheon. McGovern-Dole forces its programs toconsider the issue of market distortion coming with the “free luncheon”. This is the subject ofthese paragraphs. The resources come in the form of agricultural commodities, specificallysome commodities that have traditionally been produced locally in GB. It is easy to see theneed for food imports. Take the example of rice, the most important local staple and one ofthe four commodities imported by IPHD. GB rice production has declined drastically over thepast few years, form a 2009-2013 average of 194,000 MT to a 2014 estimate of 111,000 MT.Some of this is no doubt normal fluctuation due to meteorological conditions but the factremains that for 2014 GB imported 150,000 MT of rice, much more than were producedlocally.17 Three decades ago GB was a net exporter of rice; now it has to import rice as wellas other staples.

Is IPHD to blame for the decline in GB’s rice production? Definitely not, is the clearanswer. It is true that this decline of local agricultural production is due to a classic case of“Dutch disease”,18 with a combination of (a) market distortion, i.e., declining competitivenessof the rice sector compared to the cashew export sector and (b) availability of a “free”resource of foreign aid. But – importantly - this decline predates the arrival on IPHD andis due to the over-specialization in cashew exports more than to any other factor. At present

17 All figures come originally from FAO, as reported by Kyle (2015) and various news agencies and internetsites.18 In economics, the “Dutch disease” is the apparent relationship between the increase in the economicdevelopment of natural resources (or foreign aid) and a decline in the manufacturing sector (or agriculture).

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time, 90 percent of GB farmers produce cashew nuts for export, and this product aloneaccounts for 98 percent of the country’s export earnings.19 The program may havecontributed in some degree to making local rice production less competitive for a few yearsbut it had nothing to do with the major forces causing its decline. It appears that IPHD hasfully lived up to the “Bellmon rule” required by McGovern-Dole.20 Its 1,900 MT per annumof imported rice over the 2011 Agreement amounted to no more than 0.7% of the estimated2014 rice consumption in the country – hardly deserving the term “disruptive impact”. (Formore discussion of the macroeconomic effects of cashew specialization see Annex 7).

5.2 Cost-effectiveness of outputs

The program does not keep detailed accounts of the cost of every activity. Estimates forinfrastructure work are $5,000 per 2-classroom school, $5,000 per water well, and $2500 toequip one classroom with furniture. In most cases such figures do not reflect total cost sincelocal contributions of labor, land, building materials, administrative oversight and the like arenot included. Also excluded are contributions from other donors such as UNESCO, WFP,some bilateral agencies, individual benefactors and, of course, the GB MOE. Given all theseuncertainties we can only state that the program appears to make efficient use of its resources.

If it were possible to estimate the average per capita cost of in-school meals in the IPHDprogram, net of all program costs not immediately connect to school lunches, one might wellfind the figure to be similar to the average of $40 per year found in the World Bank study(Bundy, 2009: xviii), suggesting that the program’s efficiency is on par with many otherprograms.

More importantly, there are other, non-monetary aspects of efficiency at which the programexcels, such as:

Using schools as conduits for health interventions. As the distribution of foodcommodities necessitates a considerable network of logistics, contacts, transportequipment, etc., it was an excellent move to make these available for health-relatedpurposes.

The micronutrient study is a similar case in point. Though financed independently,this study made use of some program personnel such as trained monitors as well asthe cumulated knowledge and logistics capacity of IPHD. It further built capacity ofIPHD staff and local health workers to be experts in Randomized Control Trials(RCTs).

The textbook distribution is another example of an efficiency gain by making theprogram’s institutional capacity available for a variety of uses.

Ensuring meaningful participation of local communities in infrastructure work. Thisraises the level of local ownership of schools and protects schools from neglect andpredation.

19 Data from WFP (2015). Africancashewalliance (April, 2015) gives slightly lower figures of 85% and 90%.20 “A plan that shows how the requested commodities could be imported and distributed without a disruptiveimpact upon production, prices and marketing of the same or like products in the country.” (USDA 2015, n.d.,as cited in the 2011 Agreement)

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Engaging MOE officials in the administration and monitoring of school lunches. Suchgradual transfer of experience and administrative capability is a necessary first steptowards an eventual transfer of the whole school feeding into governmental hands andbudgets.

5.3 Cost-effectiveness results at household and school levels

At the household level, school feeding undoubtedly adds to total income (in kind) even afterdiscounting for payments made for tuition and other expenses. For a rural family with onechild in a modest community school the situation can be estimated in the following way:

Table 2 Estimated costs and benefits of participating in school feeding for a ruralhousehold, in $US, per child (without PPP adjustments)

Factors Benefit CostNet

benefit CommentsAll direct costs (mainlytuition at CFA350/month and clothes)

10 7.5% of a total rural householdincome of $132.

Value of food at $0.20per portion

30 The average SF program operatesabout 150 school days.

Obligatory beneficiary’scontribution

0 School lunch is usually includedin tuition of $0.70 per month

Opportunity cost 4 Economic contribution of childrenat 10% of adults

Net benefit of attendingschool to the household

16 This brings total householdincome up to $148.

Net benefit of attendingschool as proportion ofhousehold income

10.8% ($16/$148)

Data sources: FHI360 (2015); calculations by the author.

The figures in the above table are no more than rough estimates but they do substantiate theimpression that the great demand for school feeding is founded on rational considerations onthe part of parents. School feeding has considerable short term benefits that more than makeup for the costs of enrolling at least some of the household’s children in school. By sendingtheir children to a school offering free lunches, households can improve their economicsituation and food security considerably. 21

The distance between home and school can change the calculation. Applying estimates of thecalories contained in an average school lunch (822 kcals) and needed for a walk to school (70kcals/hour) it is clear that if the school is located at a distance of more than 10 km (2.5 hours

21The key figure in Table 2 is obviously the value of food, set at $0.20 per meal. The cost to the US taxpayer is

much higher, in the neighborhood of $0.30. In a regular year the program fed 145,000 children some 27,000,000meals at a total cost of $6 M. We estimate that about 25% went to costs not related to school lunches.

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one way) from the home the walk consumes close to one half the calories provided by theschool lunch. In this case, the short-term economic benefit of schooling virtually disappearsand the opportunity cost of work not performed at home weighs even more heavily.

Also, opportunity costs vary with the seasons which explains the reduced attendance duringthe cashew harvest. It varies as well with the age of children which helps to explain why girlsfrom about age 10 attend school much less.

At the school level, it is important to distinguish the types of costs and benefits, and thelocations at which they occur. In terms of financial considerations there is no doubt thatschool feeding boosts enrolment and makes schools more profitable, at least for directors andsome teachers. On the other hand, school feeding carries a high cost in time-on-task lost,making schools less effective for learning and reducing their internal efficiency. The profitstend to accrue to the school owner and/or director while the efficiency loss victimizes parentsand children.

Potentially the greatest cost of school feeding is the loss in teaching effectiveness. Most GBchildren spend no more than 4 hours at school per day.22 According to anecdotal evidenceand the observations of team members, feeding a hot meal at 10:30 reduces time on task byan estimated one hour or 25% of total time in school. Most of this time is lost not by eatingbut by waiting. Schools can feed no more than one or two classes at a time but the logistics,waiting time, noise and smell affect all children simultaneously.

5.4 Program efficiency and impact

Does a healthy meal served at school improve learning and performance levels? It isfrequently assumed that feeding children at school constitutes a net addition to their dailyfood intake, to household income (in kind), and to school resources and effectiveness. Theseassumptions deserve a few comments.

At the child’s level, a meal served at school will add to total food intake in many cases. Itmay also add variety and key nutrients to the diet. However, the interviews, focus groups,observations and formal studies accumulated in this area suggest that children fed at schoolfrequently have to forego meals at home and/or share food portions diverted and broughthome from the school meal, leaving them at a roughly equal overall food intake. In addition,the performance of school kitchens is sometimes quite unpredictable, resulting possibly ingreater irregularity of the child’s meals. Furthermore, it is reasonable to assume a negativecorrelation between net food addition through school feeding on the one hand and socio-economic status on the other hand. It is often precisely the neediest children that do not profitfrom school feeding programs (more on this in the equity section below). 23

22 Of 18 schools visited by one evaluator only one kept children for the whole 7-hour day – a school funded by aSaudi benefactor that taught the regular curriculum in the morning and functioned as a Madrasa in the afternoon.The same teacher taught mathematics and the Koran.23 The poorest children are not in school and the poorest schools do not fulfill the minimum qualifications toparticipate in school feeding programs as practiced by the largest donor agencies dominating the market.

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An argument could be made that children learn more and achieve more thanks to schoolfeeding programs. Intuitively, this makes sense on an individual level and for those childrenwho come to school with nothing in their bellies. But overall there is virtually no empiricalsupport for this argument. Comparative international evidence consistently ranks schoolfeeding as such with the least cost-effective ways of improving schools and learningoutcomes (Schiefelbein et al., 1998; Jomaa et al., 2011; Kazianga et al., 2009). This is not todeny the value school feeding programs; in many circumstances they are necessary. But somepoints are repeated in study after study:

If carried out as a stand-alone activity school feeding produces little more thantemporary enrolment increases. It generally does not improve learning outcomes.

Well-designed school feeding programs, which include micronutrient fortification anddeworming, can provide significant nutrition and health benefits.

If donors use school feeding as leverage for school quality improvements, thepotential for achieving better educational outcomes is considerable.

The educational value of school feeding is not inherent; it comes with combining nutritionaland pedagogical improvements. This needs careful planning and implementation (see Annex4 for more discussion of cost-effective interventions that boost learning).

There are several factors that can contribute to making schools ineffective. School feedingsometimes helps to keep ineffective schools in operation. 24 School directors make short termprofits from enrolment increases but parents pay a heavy price in years of sacrifice wasted onfrequently worthless activities which hardly deserve the term of education. There is everyjustification to provide school feeding on a conditional base: schools which fulfill minimumquality requirements get food, others do not get food. Such a harsh rule should obviously beapplied with the intention of nudging schools along to a status where every child has a bench,a textbook and a qualified teacher. Foreign donors have the means and the political muscle toenforce such rules and, while providing the funding, force school quality improvements.

5.5 Summary of program efficiency

The internal efficiency of the program has been quite remarkable. The cost-effectivenessof the operations of storage, handling and distribution of the commodities has never beenquestioned in a serious way. While the cost per meal ($0.41 in our estimate, if counting allexpenses rather than only food) is higher than the international average ($0.27, based on theannual cost of $41 reported by Bundy, 2009), the difference in all likelihood is due to theprogram having allocated considerable resources to activities that are peripheral to schoollunches. International evidence suggests that these peripheral activities may well be preciselywhat is needed. School feeding results in increased student learning only thanks to itscombination with other school quality factors such as adequate infrastructure, teachertraining, textbook availability and so on. IPHD has done well to invest in such activities.

24 I have heard of cases (not in GB) where teaching starts at 10 am, lunch is served at 10:30, and children returnhome right after the meal. On some occasions teachers appear only to eat, not to teach. In GB we have heard ofcases where children come to school only for the meal.

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Non-monetary aspects of efficiency are a highlight of the program. Of particular value areactivities which result in the development of intermediary institutions such as PTA andNPTA which broaden the networks lobbying for education and increase local ownership ofschools and schooling.

The external efficiency of the program – the increase of human capital leading to a moreproductive society – cannot be measured at the present time. What can be said in the absenceof appropriate studies is that there are now more children attending school, more childrengraduating from the primary school cycle and more parents, teachers and communityrepresentatives lobbying for better access and better school quality.

Development of PYAs and community organizations

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6 Equity considerations

Equity refers to understanding and providing people with what they need to enjoy full,healthy lives. Unlike equality, the concept assumes that not everyone has the same startingpoint, needs and capacities and that to be fair and just is to take these differences intoaccount. To be equitable is to be selective and efficient, and occasionally to attract criticismfrom those left out. Sometimes it is more practical to be simply egalitarian and less efficient.School feeding is a case in point. To feed only the neediest students in a class would makethe food go farther and the program to be more cost-effective. But the practical difficulty ofassessing and monitoring this need of some students, the penalty for those labeled as thepoorest and the clamor of the others for equality make selective feeding impractical in mostcases. A few instances of positive discrimination can be found in GB and elsewhere, mainlyconsisting of take-home rations for girls (within WFP), but by and large, non-selective schoolfeeding is the rule (like in IPHD); anything else, in Guinea-Bissau, would be culturallyunacceptable..

There are clearly very large differences in socio-economic status between the country’sregions. The following graph captures one such difference – the rate of literacy of youngwomen. That rate in the capital city region, Cacheu, Bolama and Biombo is more than twicewhat it is in the poor regions of Gabu, Bafata, Oio, Quinara and Tombali. One of theexpected effects of raising female literacy is that educated women will have fewer andhealthier children.

Figure 10 Literacy rates of young women (15-24 years) and rates of young child(0-5 years) malnutrition,25 by region, 2014Source: MISC, 2015a

Figure 10 certainly confirms this expectation: all of the regions with low female literacy havehigh levels of malnutrition and all of the other regions have lower levels of malnutrition. Thegraph does not prove causality but it does contain powerful evidence that the IPHD program

25 Underweight or weight for age scores (WAZ).

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is generally on the right track. One can of course consider both illiteracy and malnutrition tobe expressions of one and the same thing, poverty. Regions of high poverty are legitimatetargets for relief measures of many kinds. Poverty relief comes with economic developmentand, according to some economists, the single most cost-effective intervention promotingdevelopment is educating girls. Programs would do well to make sure that girls who aredrawn to schools are actually getting educated there.

6.1 Equity in inputs

School feeding is available in primary schools and kindergartens throughout GB, without anyparticular selection by region, ethnicity or social stratification. Two large programs dominatethe market, IPHD and WFP (PAM); it is estimated that between them they cover 60 percentof children in the appropriate age groups.26 For practical reasons and reasons of efficiency,the two programs have worked out a geographic division of labor: WFP works mainly in theNorth-East regions of Bafata and Gabu while IPHD serves the rest of the country. Thisdivision is not absolute: we visited IPHD program schools sometimes in close proximity toWFP schools. There has also been a change over time: for the past year, due to limitedavailability of resources, the IPHD program has concentrated its efforts in the Tombali andQuinara regions, deemed to have the greatest needs.

26 WFP 2013b provides a very different number, 45%, without specifying either the data source or to whichschool levels or age groups the percentage the number applies.

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IPHD has taken care to spread its resources equitably among sub-regions. De facto this hasmeant that more program resources are going to poorer, more distant schools since it costsmuch more to service schools in distant locations than schools located in cities or on majorhighways.27 As schools are inevitably concentrated in accessible and urban areas, equality inschool feeding inevitably makes the activity inequitable. The IPHD program is right on targetsince the recent MICS study shows great rural-urban differences by using crude enrolmentrates: fully 91% of urban children start grade 1 while only 66% of rural children do (MICS,2015). Figure 10 shows the same rural disadvantage even more powerfully, using netenrolment rates.

Figure 11 Percent of students who start first grade at the appropriate age, byrural/urban residenceSource: MICS, 2015a

Since pre-school organizations generally control which ages they admit, children who havebeen to preschool have a much higher chance of both profiting from age-appropriate teachingin first grade and of having a long and successful educational career. The fact that fully threequarters of rural children start school late constitutes a serious disadvantage for them. Theyare less likely to complete primary school, become fully literate and move on to the nextlevels of schooling. Rural disadvantage is thus perpetuated.

6.2 Equity in outputs

One equity issue that is addressed in a more limited way by IPHD is girls’ education. Genderinequality is similar in GB (GER 91.6) to the average of Sub-Saharan Africa (GER 90.0),according to the Education For All monitoring system (FIH 360 GB, 2014) but suchcoefficients tend to hide more than they reveal, and besides, the data is for 2010. The realityis that the great educational progress of the 2000-2010 decade (in which IPHD played asignificant part) has come to a halt since then. This leaves girls at a continued disadvantage asexpressed in the following points:

83% of boys start school in grade 1 but only 75% of girls do.28

In grade 5, 74% of boys are still in school, compared to only 55% of girls. On the grade 2 exams girls performed much worse than boys in tests of Portuguese

(43.6 vs. 50.0) and Mathematics (46.2 vs. 56.4).

27 The concentration of foreign aid resources in “convenient” regions is a well known problem. IPHD staff isaware of this and appears to counteract it successfully. We have no data indicating that WFP is acting similarly.28 These seem to be net enrolment rates but we shall have to wait for the definitive publication of the study toclarify this point.

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By grade 5 the gender differences in test scores are reduced by half but by that timemany of the girls have already dropped out.

As a result of several such factors, young women in GB (15 – 24 years old) are muchless literate (50.5%) than young men (70.4%). (MICS, 2014)

IPHD has been a factor in the general enrolment increases that have brought many more girlsinto schools over the past few years, but it’s targeting of girls has been limited to payment ofschool fees for 2,900 girls. Given the context described above, many programs have started tooffer special incentives to bring girls into schools, either with cash stipends or with take-home rations conditional on school attendance. (For more on girls’ education, see Annex 6).

6.3 Equity in results

The program has been successful in obtaining an equitable distribution of its results in thoseareas where it strives for equity, basically in terms of geography and rural-urban distribution.There is no evidence that girls obtain their just share of educational resources in GB and theprogram has addressed that, at least through some enrolment increases. Unfortunately, thereis no evidence that those newly enrolled girls learn as much in schools as boys do; quite tothe contrary: they learn less. In this respect the 2014 MICS study confirmed what older MICSdata had already shown.

Equity in international aid can only be achieved where the targeted beneficiaries havechannels to voice their needs and get them satisfied. Central governments and distantplanners can rarely be equitable. Foreign donors can act more equitably but their programsneed input and feedback from all stakeholders and in particular from those ultimatebeneficiaries who are the only justification for having programs in the first place. This is,again, an area where IPHD excels.

Community participation in IPHD is quite remarkable. The program has made PTAs intoreal partners and continues to listen to them. Interventions are always planned together andthe part of community members in infrastructure work and in running the school feedingactivities is significant. Even the construction of water wells, a highly technical piece of workusually reserved for experts, involves community members to a certain extent.

Distant rural communities are invariably neglected by centralized, urban-basedgovernments. The IPHD program is one of a very few organizations in GB which gives thema voice and promotes their solidarity and empowerment.

6.4 Is the program impact equitable?

The measurement of impact ordinarily requires a longer timeframe than what is offered by aprogram still in operation. The benefits from education in GB are distributed in highlyinequitable ways along the divides of economic class, gender and residential milieu. It willtake much more than one program and eight years to bring movement into such well-established structures and make education into more than a social filter serving theperpetuation of class divisions.

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For what it did do, however, the IPHD program has been remarkably successful in channelingresources to some of the most vulnerable populations. By all accounts the actions of theprogram were more geographically and socially equitable than those of the main competitor,WFP. Also, the choice of not just delivering services but embedding them into nascentcommunity institutions like PTAs, AMICA and local school committees was excellent. Suchorganizations function as lobbies staking claims on national as well as internationalresources.

6.5 Summary concerning equality and equity

The promise of education is to offer equal life chances to all citizens. GB and GB educationare far from such a lofty goal. By increasing access to primary education IPHD has made acontribution to equalizing chances for all. Even more, by emphasizing work in distant ruralcommunities the program has achieved a more equitable impact than many other programs inGB and elsewhere.

The next frontiers in working for equity in education will be school quality – qualityschooling for all – and a fair deal for girls. In both of these areas the program lacks expertiseand experience but it has opportunities to stimulate and collaborate with programs morequalified.

The problem of overaged girls: 15 year olds in second grade

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7 Sustainability

One of the most common definitions of sustainable development refers to “development thatmeets the needs of the present without compromising the ability of future generations to meettheir own needs.” Applied to school feeding programs, the second half of the definition is thecritical one. The current IPHD program is not sustainable because it (1) creates aiddependency, (2) tolerates continued under-financing of education and (3) undermines localinstitutional development by concentrating power and resources in the hands of foreigners.

Given these undesirable aspects of FFE programs, the GB government and its major donorshave a choice of two options. The first is to declare victory and terminate the program. “Somehuman capital gains have been made. Now let’s turn our attention to other factors ineconomic development.” This is the “exit strategy” nobody seems to want because (a)decision makers like the continued inflow of foreign resources and (b) the country is notready for an exit.

The second option is to “transition” school feeding into government administration and untogovernment budgets. This would solve the three principal problems. (1) It would curtail aiddependency and the “Dutch disease” that comes with it. (2) It would add resources and de-facto-lobbyists to the MOE and thereby increase the ministry’s share of overall budgets andinfluence. (3) It would add administrative capacity and institutional development where theyare needed.

The transition from externally supported projects to national programs is not a new idea. Bythe publication of the World Bank study (Bundy, 2009), 28 school feeding programs hadalready made the transition from WFP to national institutions. Several more must havefollowed since then. What are the principal lessons learned from these examples? They arethree: 29

1. “School feeding programs in low-income countries exhibit large variation in cost,with concomitant opportunities for cost containment.” Practically speaking, the per-student cost of a meal in GB could be a fraction of the $0.41 of PhD’s total operationin GB and of the $0.22 reported by IPHD for SF alone.30

2. “As countries get richer, school feeding becomes a much smaller proportion of theinvestment in education.” Needless to add that as governmental budgets grow there ismuch fighting about access to the new budgetary resources. It is by no means certainthat education will be the winner, but a stronger education lobby will help.

3. Successful transition requires “the mainstreaming of school feeding in nationalpolicies and plans, identifying national sources of financing and expanding nationalimplementation capacity.” With the mainstreaming there comes the opportunity of

29 Adapted form Bundy et al. (2009). Other WFP studies contain different lists.30 Savings can come from many budget lines but vary by country. Bundy et al. provide examples but no generalrule.

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obtaining foreign financing and of tying school feeding to pedagogical priorities ofthe national education sector plan.31

Some promising first steps in the direction of a transition have already been taken by GB andIPHD (see the document in Annex 16). They show a certain awareness of the need to“mainstream” mentioned in the previous paragraph. However, they are still a long way fromany implementation of such plans; it will take much more than non-binding commitments tomake it happen and additional time is essential to ensure that this happens. In particular, it isnot clear where the MOE would find the necessary resources when so many other needs arepressing and competing with school feeding. Nor is it clear whether the MOE at this time hasthe institutional capacity to truly profit from the experiences made elsewhere and therebyavoid costly mistakes.

7.1 Sustainability of inputs

Can the resource flow from USDA to GB schools be maintained? The answer is yes,provided such support fits into the strategic priorities of the U.S. government. But if thequestion is whether the school feeding activity will likely continue once support throughIPHD is withdrawn the answer is certainly no, unless a new donor can be found. The reasonsare economic and political. At present only 10% of the education budget goes to non-salaryexpenses, and education gets only 14% of total government expenditures. Primary educationgets 55% of that number (Republica de Guiné-Bissau, 2013:20). By comparison, even at halfof the IPHD cost of $0.22 per meal (counting food only), providing meals for all childrencurrently fed by IPHD and WFP would add $4.1 M to the non-salary-one-tenth of an alreadyminute education budget – a political impossibility.

The present program is sustainable with donor funds, unsustainable with GB public fundsalone. This is not the place to draft a new program and specify the use of any future donorfunds. However, a short summary sketch may be allowed. Ideally, any program extensionshould:

Formalize targets, schedules and institutional responsabilities for the transition ofschool feeding to the GB government. Significant steps in this direction have alreadybeen taken. (see Annex 16)

Tie all school feeding to school quality improvements and a schedule for reachingminimum targets in terms of infrastructure, teacher training and textbook use. Somerecent working documents are promising in this respect, especially those concerningschool management, the school environment, textbooks, “incomplete schools” and thesupervision of private schools. UNESCO Dakar is currently evaluating theseproposals.

Expand and coordinate the school feeding activities of the major organizationsinvolved (IPHD, WFP, ADPP and others).

31 The first candidate among the usual donors is, of course, the U.N. through its WFP but there is no reason theWorld Bank, the African Development Bank, the European Union and several bilateral agencies could notparticipate. The forum currently preparing the 10-year education plan contains a wealth of contacts andexperience in this respect.

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Generally speaking, such a conditional extension and refocussing will move the programaway from school feeding towards the human capital formation which is the true focus ofMcGovern-Dole.

7.2 Sustainability of outputs

A different program of much smaller size could possibly be financed by parental, PTA orcommunity contributions, however it is likely that such programs would fail because theyhave not yet been established for long-enough to make them resilient. Furthermore, whethertransitioning to a program financed by parents at this time is desirable must remain open.What would be ideal is 3-5 years of additional funding for the school program with built-inbenchmarks for transitioning programs and control to local government so that by the end ofthe period all aspects of IPHD work will be self-sustaining. During this time, educationalenhancements would be tested for adoption by the whole country in parallel withmaintenance of the school meal program.

Most of the program’s outputs were part of the budget and as such will not be continuedshould that budget disappear. This is especially true of the school meals and most of the itemson the list given in chapter 4.2. The exceptions are:

PTAs with their local, regional and national organizations have reached a certain levelof legitimacy in the public eye and autonomy of function. Some of that institutionalnetwork might well be able to function with local resources constituted by localfundraising and government transfers.

Local school committees do not depend on foreign donors. Following their pastexperience with contributing to school renovation, provision of supplementary fooditems, monitoring of commodity arrivals and more, it is conceivable that they couldcontinue to function and take a close interest in school matters. Still, at present theyappear so totally oriented towards school feeding that it is not evident how they wouldfind a new field of activity.

7.3 Sustainability of results

Community participation in many forms has been one of the hallmarks of the IPHD program.Many of the results achieved so far would have been impossible, or would have requiredmuch larger resources, had it not been for the committee and PTA structures. There is nopoint in speculating about the future, but some anecdotal evidence suggests that thecommunity network could be sustainable, under the condition that the flow of commoditiesdid not come to a complete halt. The program has fostered a level of community ownershipthat is comparatively impressive.32

32 Program staff has pointed repeatedly to WFP as an operation that has been less successful in fosteringcommunity participation. We have no way of verifying this claim.

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7.4 Sustainability of impact

Will the program’s impact be sustained after termination of donor-financed operations? On afirst level – often omitted in evaluations – the answer is a resounding yes. More than 300,000children – taking account of successive cohorts - have eaten more and better food for at leasta fraction of their upbringing. Their health has been improved at least for some time. Theyattended school more than would otherwise have been the case. All these gains stay withthem. Even in the worst-case scenario of dropping out of school and sliding back into a stateof malnutrition, their overall development and life chances will have improved.

Beyond this there is not likely to be much sustained impact, should the program beterminated. The government has expressed the intention of taking over school feedingactivities in the long run but, absent massive donor resources, has no reasonable chance ofdoing this in the near future.

The single most notable education impact of the program has been the enrolment increase ithas provoked. Will enrolments revert to previous levels should the program be closed? Thisis what previous experiences suggest. WFP has addressed this question in several of itsschool feeding operations and found that the reversal can be very rapid. It observed in Niger,a country somewhat similar to GB, that “wherever school canteens are closed, evenprovisionally, immediate and high absenteeism follows and children are withdrawn fromschool” (Cham, 2009:10). There are also examples where enrolment increase provedunsustainable even within continued of school feeding.

7.5 Summary concerning sustainability

Some elements of the program contain the promise of sustainability but they are still fragile,subject to contextual forces beyond their control and dependent on foreign donor support.The same must be said about governmental commitment as expressed in the creation of aschool feeding office and the tentative transition schedule covering the next four years.

Planning for true sustainability requires integrating an exit strategy into the very design andoperation of a program. McGovern-Dole programs lack any serious attention to exit andsustainability even though they clearly aim at sustainable impact. It is not too late to correctthis omission, in new or extended programs. A number of elements could be built intoongoing programs. In the case of a next phase of IPHD this would likely include

setting realistic milestones for achievement in terms of results and impacts; striving for a high level of government commitment expressed in budgetary

allocations; continued work in structuring community participation; technical support in all areas of management and logistics; broad communication will direct stakeholders and the public alike; systematic involvement of the private sector.33

33 Adapted from WFP, 2003:6.

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8. List of key findings

Process and program theories The IPHD process theory is confirmed. The team has been highly successful in all

aspects of program implementation, providing a very impressive record ofachievement that ideally can be exported to other less successful programs. It set inmotion processes of commodity distribution, of community organization and oforganizing peripheral activities in response to emerging needs and opportunities, all ofwhich were successfully accomplished. It never lost control of its resources andoperations, despite much political adversity. It established effective networks ofcommunication and collaboration on individual and institutional levels which areessential for short-term success as well as longer-term sustainability.

The McGovern-Dole impact theory linking school feeding with human capitalformation is not confirmed. There is no proof that the school feeding program as suchhas achieved the increased learning outcomes and human capital formation that arecritical to economic development. In fact, solid empirical studies from other nationspoint to the contrary: school feeding alone is neither effective nor cost-effective inreaching those objectives. It becomes effective only if combined with school qualityimprovements. IPHD is correct where it attempts to link school feeding with schoolquality improvements.

By shifting focus and some resources to factors that actively enhance learning IPHDnow has the potential of effecting substantial impact in human capital formation. Theprogram has established solid institutional bases and exceptional expertise in workingwith schools which can be leveraged to make this possible. It should be emphasizedthat, without the work IPHD has accomplished to date, these next steps would not bepossible.

School feeding operations School feeding was carried out in competent, responsible and honest ways. Rarely

have SF programs been associated with so little controversy, corruption and waste,which is an impressive achievement and, again, a valuable base on which to buildnext-generation educational opportunities.

The program has shown exceptional resilience during politically challenging times. Ithas continued when many other service providers simply ceased operation, mostnotably government schools. As political instability is the rule rather than theexception in SSA, IPHD can be a model of how things should be done.

Health and nutrition Through an exceptional distribution system and thorough field monitoring, IPHD

school meals are contributing to the caloric, macronutrient and micronutrient intakesof the school going child, an important achievement for a food insecure population.

The rations however are currently not tailored to accommodate the increase inenrolment over a window of 3 months.

Along with complementary activities such as deworming, specific micronutrientsupplementation and the anti malaria campaign, the program is helping to create a

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healthy environment for the school going child. As noted above, such activitiesprovide a very effective base to use with greater educational engagement in futurework here.

PTAs and community organizations Embedding school feeding in a network of functioning community organization has

been a hallmark of IPHD. Impressively, PTAs with their local, regional and national organizations have reached

a certain level of legitimacy in the public eye and autonomy of function. Local school committees have experience with contributing to school renovation,

provision of supplementary food items and monitoring of commodity arrivals. Effective and charismatic leaders make a difference in the political weight and the

sustainability of community organizations. The National PTA is led by an exceptionalindividual of considerable influence.

Education context The internal efficiency of most schools in GB is very low because of school quality

factors that limit learning, prevent promotion and result in repetition and dropout. The FFE approach is effective in improving enrolments, retention, attendance and

graduation rates. There is no causal connection between school feeding and improved cognitive results. Many low-to-medium cost interventions practiced elsewhere have a proven high

impact on student learning. IPHD could leverage food for such promisinginterventions.

Most IPHD resources are still concentrated on school feeding activities, i.e., theycombine high cost with low learning impact. Now that the program is firmlyestablished, this can be changed.

Girls’ education IPHD has succeeded in improving enrolment, retention, attendance and promotion

rates for girls in its schools. This is true in both the rural schools as well as the urbanones, and in Moslem communities as well as Christian

One limited but particularly successful activity deserves additional mention – thepayment of tuition fees and provision of some school supplies by the program,conditional on school attendance by the selected girls.

School infrastructure: buildings, water wells, furniture and supplies, kitchens, gardens Costs were well contained. Community participation served more as a means to

promote local ownership and empowerment than to reduce cost to the program. The need is very great. Not a single school visited was fully equipped with complete

and satisfactory infrastructure, trained teachers and full school supplies. The IPHDwork undoubtedly made things much better than they would otherwise have been, butadditional resources are needed to provide facilities at a level that would be expectedto enhance education.

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Key recommendations

IPHD has interpreted its mandate primarily as a school feeding mandate and all otheractivities are currently tied to school feeding by taking advantage of the presence of childrenin school. However, the McGovern-Dole objective of a more productive and prosperoussociety cannot be met by distributing food alone.

1. Schools should not be used for large-scale food distribution unless school qualityleverage can be achieved.

2. IPHD should phase out support for inadequate schools that will not be capable ofmaking educational improvements.

3. IPHD should expand its support for PTAs by rewarding those that provide an activesupport in terms of monitoring and material contributions.

4. IPHD should target additional support at the PTA efforts in radio-education.5. IPHD should accommodate the changing numbers of enrolment in the 2nd and 3rd

trimesters for food ration calculations.6. IPHD should take the lead in elaborating a standard package of interventions aimed at

filling the needs of all participating schools. The package might combine schoolmonitoring, textbooks, teacher’s manuals, classroom supplies, PTA support, selectedhealth interventions and micronutrient-fortified school lunches. Using existingchannels, a partnership with MOE, MOH, UNESCO, UNICEF and WFP could resultin the definition of the package.

7. IPHD should seek formal association with initiatives to assess the impacts of its foodaid. The aim is to draw profit from the large number of studies done in this area. Suchan association could take the form of retaining the services of an outside researcher,part time, or to allocate some local research capacity. The objective is to refocus theprogram from food aid to human capital formation, in accordance with McGovern-Dole.