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The Impact of DepED’S School-Based Feeding Program.pptx

  1. The Impact of DepED’S School- Based Feeding Program 1 Philippine Institute for Development Studies Surian sa mga Pag-aaral Pangkaunlaran ng Pilipinas www.pids.gov.ph Jose Ramon Albert, Ph.D. , Senior Research Fellow, PIDS Ana Maria L. Tabunda, Ph.D. , UPSS & Pulse Asia Imelda Angeles-Agdeppa, FNRI 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  2. Outline 1. Introduction : The School Based Feeding Program (SBFP) and the PIDS Study Evaluating the SBFP 2. Methodology & Results 3. Ways Forward 2 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  3. 1. INTRODUCTION 3 www.pids.gov.ph 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  4. DepED’s in-school feeding program, initially called the Breakfast Feeding program, was first launched in 1997 to address short-term hunger among public school children. ◦ After SY 2008-2009, program shifted to addressing undernutrition or malnutrition among elementary children enrolled in public schools. ◦ Starting SY 2012-2013, the program was called School Based Feeding Program (SBFP) so as not limit the feeding to breakfast only. ◦ The SBFP provides food to severely wasted (SW) children (weight-for-height of child is below minus 3 standard deviation cut-off established by WHO for well- nourished populations) . The SBFP is conducted in schools over a period of 100 to 120 feeding days for a given batch of program beneficiaries. 4 1.1. The SBFP 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  5. Goals of the SBFP are : 1. To rehabilitate at least 70% of severely wasted beneficiaries to normal nutritional status at end of 100 to 120 feeding days; 2. To increase classroom attendance by 85% to 100% 3. To improve the children's health and nutrition values and behavior. To ensure effectiveness and sustainability of SBFP, complementary activities are undertaken ◦ Deworming of beneficiary children ◦ Program implementers undertake waste segregation, management and composting; and integrate the Essential Health Care Program (EHCP) in SBFP ◦ Schools grow vegetable gardens under Gulayan sa Paaralan Project (GPP) 5 1.1. The SBFP 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  6. ◦ The SBFP involves feeding primary pupils for 100–120 feeding days, using a 20-day cycle of standardized recipes with malunggay.  SBFP’s feeding days are fewer compared to an average of 180 feeding days in other developing countries (Bundy et al. 2009) ◦ Each meal has at least 300 calories.  This is lower compared to other feeding programs that provide 876 calories per meal (Adelman et al. 2008). ◦ To implement SBFP, each school head establishes its SBFP core group (CG) and involves volunteer parents in preparation of meals and in feeding the children. 6 1.1. The SBFP 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  7. ◦ In SY 2013–2014, the daily feeding budget for SBFP was PHP 16 per beneficiary, covering both the food (PHP 15 per beneficiary) and the admin and monitoring expenses (PHP 1 per participant). ◦ In the same SY, DepED’s SBFP had a total budget of PHP 77.5 million to feed a fraction of the SW pupils in public primary schools. The number of SBFP beneficiaries (40,361) was only 7.2 percent of the more than half a million (562,262) SW primary school students across the Philippines  In SY 2014-2015, SBFP was given a budget of over PHP 1B to target all severely wasted students in this schoolyear. For SY 2015–2016, budget was further increased to more PHP 2B, with the program targeting 532,752 severely wasted pupils, as well as about half (627,403) of the total number (1,312,935) of wasted pupils in public primary schools 7 1.1. The SBFP 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  8. Objectives of Impact Evaluation of SBFP: 1. assess the outcomes and impact of the 2013-2014 SBFP in terms of its stated educational and nutritional objectives; and 2. assess the complementary activities of 2013-2014 SBFP namely, the GPP and integration of the EHCP in implementation of the 2013-2014 SBFP. 3. identify changes needed, if any, to improve the design and management of the program. Significance: An IE of SBFP and complementary activities would serve to determine whether SBFP is achieving its goals and may provide useful insights to DepED that would help serve to strengthen future strategy or improve the design of the program. 8 1.2. Impact Evaluation of SBFP 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  9. ◦ In SY 2013-2014, DepED allocated funds for school-feeding of 40,361 SW pupils in 814 schools across the country ◦ Distribution of program beneficiaries was uneven across regions  CAR, Region XII, Caraga and ARMM each had at most 600 beneficiaries  Region IV-A had 8,893 beneficiaries. ◦ The distribution of program beneficiaries was also uneven across schools.  In NCR and Region IV-A, no school had fewer than 20 beneficiaries. ◦ Most of SY 2013-2014 beneficiaries were from rural areas (65.7%). ◦ Nearly half of the SBFP beneficiary schools in SY 2013-2014 were located in first-class cities or municipalities. 9 1.3. SBFP for SY 2013-2014 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  10. 2. Methodology & Results 10 www.pids.gov.ph 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  11. ◦ The best approach for an impact evaluation is to conduct a randomized controlled trial (RCT), which involves having a targeted set of beneficiaries, and randomly assigned them into the program. In practice, this is challenging to implement, so other approaches are used, including matching beneficiaries with non-beneficiaries meant to perform a counterfactual analysis and measure impact. 11 2.1. Study Design Impact of SBFP Outcome with SBFP Outcome without SBFP 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  12. ◦In practice, a RCT is challenging to implement, so other approaches are used, including matching beneficiaries with non-beneficiaries meant to perform a counterfactual analysis. The design for the IE of SBFP involved a mixed methods approach. ◦Quantitative surveys of program beneficiary pupils and their parents, as well as matched non-program beneficiary children and their parents (to generate a counterfactual analysis) ◦Key Informant Interviews (KIIs) of school-heads and SBFP implementors, as well as Focus Group Discussions (FGDs) with parents during process evaluation (initial phase of IE), and main phase of the study. 12 2.1. Study Design 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  13. ◦ A multi-stage stratified random sample with a target sample size of 1,210 SBFP beneficiaries was to be drawn from 44 randomly sampled beneficiary schools in Northern and Central Luzon (CAR, Regions I to III) NCR and Region IV-A Regions IV-B and V ◦ The schools were initially stratified into stratum 1 : N ≤ 19 SW stratum 2 : 20 ≤ N ≤ 29 ◦ Samples of 15, 25 and 35 SW pupils were to be drawn from collapsed strata 1-and-2, stratum 3 and stratum 4, respectively. Allocation of the 44 beneficiary schools and target number of SW beneficiaries per school was done in a manner that will yield an approximately proportional sample. 13 2.1. Study Design Visayas Mindanao stratum 3 : 30 ≤ N ≤ 99 stratum 4 : N ≥ 100 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  14. ◦A sample of 1,210 (target sample size) SW non-beneficiary (NB) pupils was to be selected from schools that were not included in the SY 13-14 implementation of the SBFP. NB pupils were to be matched to randomly selected beneficiary pupils in terms of Nutrition Status (NS), Age in years, and Sex of pupil ◦Interviews of Parent / guardian of sampled beneficiary pupils Parent / guardian of sampled NB pupils School Heads of 44 Beneficiary Schools School Heads of NB Schools An SBFP Core Group member per sampled beneficiary school Teachers of sampled beneficiary pupils ◦FGDs involving Parents (beneficiary and NB), Teachers, Core Group members 14 2.1. Study Design 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  15. 1. The survey was conducted about a year after the implementation of the SY 2013-2014 SBFP, the focus of the study. Survey responses may be subject to recall bias. 2. Info needed for verifying nutrition status and school attendance of beneficiary and NB children is missing or incomplete for many of the sampled beneficiary children and NB children. 3. The expanded implementation of the SY 2014-2015 SBFP, which was ongoing at the time of the survey, constrained the selection of non- beneficiary SW children (counterfactual sample). 4. The analysis presented is an unweighted analysis. 5. Validation of information regarding list of beneficiary schools (as stated in DepED Memo No. 74 s. 2013) was conducted during the field work. 15 2.2. Limitations of Study 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  16. ◦Field work dates: 16 Feb to 27 Mar 2015 ◦12 of the 44 beneficiary schools in the original sample had to be replaced ◦Because of a lower number of SW pupils in many of the sampled schools, only 1,151 beneficiary children (some of whom are siblings) were interviewed. ◦Identifying 1 NB school per beneficiary school prior to field work proved insufficient. Some NB schools • did not have SW pupils • or did not have enough SW pupils • or enough SW pupils that matched the sampled beneficiaries. ◦1,107 NB pupils (some of whom are siblings) from 119 NB schools were interviewed. 16 2.3. Survey Implementation & Challenges 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  17. ◦ Of the 44 sampled beneficiary schools, 30 schools or 68% are located in rural barangays ◦ 68% implemented the SBFP for the first time in SY 13-14 ◦ Of the 14 schools that are repeat-implementers, 11 had repeat pupil beneficiaries Number of repeat beneficiaries ranged from 1 to 28 for 9 schools 1 school reported having 100 repeat beneficiaries, another reported 134 ◦ 12 School Heads said that they fed W pupils in SY 13-14. ◦ All but 5 of the schools had a school vegetable garden in SY 13-14. ◦ All but 2 schools implemented the Essential Health Care Program (EHCP) in SY 13-14. 17 2.4. Beneficiary Schools 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  18. Families ◦ About 67% of 1,081 beneficiary families reside in rural areas. ◦ Nearly half (49.4%) were CCT beneficiaries in SY 13-14. ◦ About 15% of the families have OFW relatives who send them money. ◦ Average family size of beneficiary families is 6, with size ranging from 2 to 16. Children ◦ More than half of the beneficiary pupils are male (56%). ◦ Recorded ages of children range from 4 to 16, with a mean and median age of about 10. ◦ About 1/3 of the children are below 8 years old. ◦ Nearly 39% of the children were repeat beneficiaries (acc. to parents). ◦ 36% were beneficiaries in SY 14-15 as well. 18 2.5. Beneficiary Families & Children 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  19. ◦ Some inconsistencies in the descriptor for nutrition status (e.g., SW, W, etc.) of beneficiary and NB children in SBFP forms and nutrition status reports and the verified nutrition status based on recorded birthdates and weight and height measurements in these same documents. 19 2.6. Main Findings (on Nutrition) Fig. 3. Verification of pre-feed nutrition status of SY 13-14 SBFP beneficiary pupils No Info / With Incomplete Info on Pre- Feed Date With Complete Info on Pre- Feed Date 1, 151 Beneficiary Children 394 pupils or 34% 757 pupils or 66% 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  20. ◦ Study was able to verify pre-feed and height of 753 beneficiary children. 20 2.6. Main Findings (on Nutrition) Verfied to be Severely Wasted 494 pupils or 43% Verfied to be Wasted 147 pupils or 13% Verfied to be Normal 111 pupils or 10% Complete Info on Pre- Feed Weight and / or Height 753 pupils or 66% With Complete Info on Pre- Feed Date No Info on Pre- Feed Weight and / or Height 757 pupils or 66% 4 pupils or 0.3% • Some 494 pupils, or about 66% of beneficiary children with complete information on NS variables were verified to be SW. • Majority of the verified wasted (W) beneficiaries may not be considered borderline SW. • In the case of NB children, 383 pupils or 61% of the 626 cases with complete information on NS variables were verified to be SW. 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  21. ◦ 62% of the 287 verified SW beneficiary children attain at least normal nutrition status at the end of the feeding program. 21 2.6. Main Findings (on Nutrition) But 10% of Normal regress to poorer nutrition status and 30% of Wasted pupils either remain Wasted or regress to SW. 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  22. ◦ A comparison of the NS of beneficiary and non-beneficiary pupils during the survey (Tables 2a and 2b) shows that more SBFP-fed severely wasted pupils attained and maintained a normal NS or better compared to non-beneficiary counterparts (48% vs 41%). 22 2.6. Main Findings (on Nutrition) 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  23. Attainment of Goal on School Attendance ◦ Of about 200 SBFP pupil beneficiaries verified to be severely wasted prior to the feeding, and who had school attendance data, only about 3 percent attended school for less than 85 percent of the total school days. The median percentage attendance for the severely wasted children is 97.5 percent. (School attendance of non-beneficiary pupils is comparable). Assessment of complementary programs ◦ Nearly all beneficiary schools implemented GPP and EHCP. Some parents mentioned that when school sometimes lacked food for SBFP, feeding implementors added vegetables from school garden to make up for the lack. ◦ Children were taught importance of good grooming, of washing hands before and after meals, of brushing their teeth, and of good nutrition. Nearly all children say that they continue to wash their hands before and after eating, both at school and at home. (But only 69 percent of the field interviewers found children to be well-groomed at the time of the interview.) 23 2.7. Other Findings 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  24. Sustaining Nutritional Gains ◦ There are challenges sustaining nutritional gains in the case of many severely wasted beneficiaries a year or more after the feeding. In particular, of the 179 severely wasted beneficiaries whose nutrition status had improved to normal at the end of feeding, and who had consistent height measurements for pre-feeding and survey periods, about half (48%) remained normal by the time of the survey, but some regressed to wasted or severely wasted a year or more later. ◦ This suggests the need to continue feeding most of the severely wasted beneficiaries beyond the 100- to 120-day feeding cycle, while simultaneously introducing government interventions (not necessarily DepED-administered) other than feeding programs to address the capacity of disadvantaged families to provide for the nutritional needs of their members 24 2.7. Other Findings 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  25. Positive Feedback from Stakeholders ◦ Field interviews and FGDs suggest that the SY 2013–2014 SBFP was generally implemented well, with majority of school heads, teachers, and parents expressing appreciation for the program and with sizeable percentages of heads and teachers expressing a desire to continue and expand it. The SBFP also promoted a culture of care and active participation among stakeholders ◦ The SBFP also helped improve attentiveness and sociability of the beneficiary pupils. Teachers reported that most of the beneficiaries enrolled in their classes improved their level of attentiveness during (96%) and after (95%) the feeding. The children also became more sociable during the feeding (97%)—a development that was sustained after the feeding (96%). ◦ Improvement in class attendance was also reported by teachers for 94 percent of the beneficiaries; 92 percent of the children sustained good attendance. 25 2.7. Other Findings 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  26. 3. Ways Forward 26 www.pids.gov.ph 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  27. ◦ Inaccuracies in recorded ages (to nearest month), and height and weight measurements (recorded in school documents as well as those obtained during the survey) constrain proper assessment of initial nutrition status of would-be program beneficiaries, as well as improvement in such status. RECOMMENDATION: DepED should provide all schools with standardized equipment for weighing and height-measurement. (Nonbeneficiary schools also need to submit accurate nutrition status reports, which serve as basis for determining beneficiary schools).  School heads, school nurses, and class advisers, if not all teachers, should be trained on the proper use of such scales and on the importance of proper documentation of pre- feeding, feeding, and post-feeding phases of SBFP to help in the proper selection of beneficiary schools and beneficiary pupils, and in monitoring and evaluating program outcomes 27 3. Ways Forward 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  28. ◦ The target goal of having at least 70% of SW beneficiaries attain normal nutrition status by the end of a 100 to 120-day one-meal feeding program may have not been attained in SY 2013-2014.  This may be due to ◦ problems in administration of program in some schools ◦ various factors beyond the control of program implementers RECOMMENDATION: DepED should revisit targets. Note that new (higher) nutrition targets have been set in the SBFP for SY 2014-2015 and 2015-2016 due to higher budgets. 28 3. Ways Forward 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  29. ◦ Nutritional gains of the program are not sustained in the case of many of the SW beneficiaries 12 months or more after the feeding program. RECOMMENDATION: DepED should revisit implementation processes, e.g., 100-120 days (why not whole SY???). It will help also to increase the food budget allocation, and allow for inflation-adjusted increases in both program administration and food budgets as warranted. ◦ The feeding program appears to have been implemented well. It also help improve attentiveness in class and sociability of beneficiary pupils. The goal of at least 85% school attendance is attained by the program beneficiaries for entire SY (though even the NB children have good school attendance). RECOMMENDATION: DepED needs to continue monitoring program, and learn lessons from M&E, make adjustments as need be. 29 3. Ways Forward 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
  30. PhilippineInstituteforDevelopmentStudies Surian samga Pag-aaral Pangkaunlaran ng Pilipinas Service through policy research 30 EMAIL: jalbert@mail.pids.gov.ph Thank you Special thanks to Sonny Domingo, Beverly Lumbera, Martin Joseph Raymundo, Winnie Gerio and other PIDS staff who helped us conduct some fieldwork (FGDs & KIIs), troubleshoot, and encode data during the course of this project. Thanks also to DepED for the cooperation, and DBM for financial support. /PIDS.PH @PIDS_PH http://www.pids.gov.ph 13th National Convention on Statistics October 3-4, 2016, EDSA Shangri-La Hotel, Mandaluyong City
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