EFFECT OF SCHOOL GARDEN FOOD PRODUCTION ON NUTRIENT
ADEQUACY AND NUTRITION STATUS OF CHILDREN IN NAMASAGALI
PRIMARY SCHOOL IN RURAL KAMULI DISTRICT, UGANDA
LAURA AGABA BYARUHANGA (BSc. FST)
H60/12931105
A RESEARCH THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE
REQUIREMENTS FOR THE AWARD OF THE DEGREE OF MASTER
OF SCIENCE (FOOD, NU1;'RITION AND DIETETICS) IN THE SCHOOL
OF APPLIED HUMAN SCIENCES, KENYA TT A UNIVERSITY
OCTOBER 2016
KENYATTAUNiVtHSrrV llBHARY
11
DECLARATION
This thesis is my original work and has not been presented to any University for the
award of a degree or any other purposes.
Date .. :2g / r.o./::mth.Signature .. "~ '..•.•",../VV1.A/,...v"'--'1
Byaruhanga Laura Agaba
Department of Food, Nutrition & Dietetics
H60/12931/2005
SUPERVISORS:
This thesis was submitted with our approval as University Supervisors:
Signature ~ Date .?X;1.(jI.2P./r
Prof. Judith Kimiywe
Department of Foods Nutrition and Dietetics
Kenyatta University
Signature .. ~ Date ~%.'.ll.()..!..~.()[.~ .
Dorothy Mukudi Masinde (ph. D.)
Global Resource Systems
Iowa State University
III
DEDICATION
1 dedicate this work to my late mum Karen Byaruhanga, my beloved daughter Carren
Sayuri, my dad Prof. John Byaruhanga and Papa Gaetano Bahemuka.
IV
ACKNOWLEDGEMENT
The success of this study was a combined effort of many individuals. It would be
impossible to mention all of them. However, several people deserve special recognition;
first and foremost am very grateful to my supervisors; Prof. Judith Kimiywe and Dr.
Dorothy Mukudi Masinde for their capable and experienced professional guidance that
strengthened and enhanced the quality of this thesis. I would like to acknowledge and
thank all the pupils, teachers and parents of Namasagali Primary School, without them
this work would not be possible. Many thanks to Dr. Mark Westgate, former Director of
the Centre for Sustainable Rural Livelihoods (CSRL) for giving me the opportunity to
conduct this research through the CSRL program in Uganda. I wish to sincerely thank
Prof. Gail Nonnecke, Global Professor in Global Resource Systems and Professor of
Horticulture Iowa State University (ISU) and Prof. David Acker the Associate Dean for
Academics and Global programs ISU: for providing me with the financial,moral support
and access to the ISU library to finish my writing. I appreciate the assistance from Dr.
Dorothy Nakimbugwe and the technical staff at the School of Food Science and
Biotechnology Laboratory at Makerere University for the support they accorded to me.
Special thanks go to my friends Sernbera. Kato, Sharon, Mudhasi, Denis. Arthur Koobe.
Nelly. Alex. Daudi and Cousin Ashley for their support and help during data collection.
entry and analysis. Thanks dad for financing my education.
vTABLE OF CONTENTS
DECLARATION .ii
DEDICATION iii
ACKNOWLEDGEMENT .iv
TABLE OF CONTENTS v
LIST OF TABLES xi
LIST OF FIGURES xii
OPERATIONAL DEFINITION OF TERMS xiii
ABBREVIATIONS/ACRONYMS xv
ABSTRACT xvi
CHAPTER ONE: INTRODUCTION 1
1.1 Background to the Study 1
1.2 Problem Statement. 3
1.3 Purpose of Study 6
1.4 Specific Object ive """"""""" ~ 6
1.5 Study Questions 7
1.6 Hypotheses 7
1.7 Significance and Anticipated Outputs 7
1.8 Justification of Study 8
1.9 Limitation and Delimitation of the Study 9
1.10 Conceptual Framework 10
CHAPTER TWO: LITERATURE REVIEW 13
2.1 -lntroduction __._ 13
2.2 Overview of School Feeding Programs 13
VI
2.3 Benefits of School Feeding Program ]4
2.3.1 Alleviate Short-term Hunger, Improve Learning and Cognitive Function 14
2.3.2 Increase Enrolment and Attendance 15
2.3.3 Improve Nutrition and Health Status 15
2.4 Nutrient Adequacy of School Meals 16
2.5 Sustaining School Feeding Through Agriculture (School Gardening) ] 9
2.6 Costing a School Feeding Program 21
2.7 School Gardening and Feeding Programme at NPS 22
2.8 Summary 24
CHAPTER THREE: METHODOLOGY 26
3.] Research Design 26
3.2 Study Site 26
3.3 Target Population 27
3.3.] Inclusion Criteria 28
3.3.2 Exclusion Criteria 28
3.4 Sampling Technique 28
3.4.1 Purposive sampling 28
3.4.2 Sample Selection 28
3.5 Sample Determination 29
3.6 Study Variables 29
3.6.1. Independent Variables 29
3.6.2 Dependent Variables 29
3.6.2.1. The School MeaJ... 29
3.6.2.2. Collection and Preparation of the Sample 30
VII
3.6.2.3. The Moisture Content 31
3.6.2.4. Crude Protein 32
3.6.2.5. Crude Fat Content. 33
3.6.2.6. Ash Content 33
3.6.2.7. Iodine Content 34
3.6.2.8. Iron Content. 35
3.6.2.9. Vitamin A Content 35
3.6.2.10. Energy Content (Bomb Calorimeter) 36
3.6.3 Cost Description of Producing Crops from the School Garden 37
3.6.4 Socio-economic Factors 37
3.6.5 Dependent Variable 38
3.6.5.1 Anthropometric Measurements · 38
3.6.5.1.1 Weight Measurements 38
3.6.5.1.2 Measuring of Height 39
3.6.5.2 Dietary intake 39
3.6.5.3 Cost Description of School Lunch Sustained by School Garden 39
3.7 Data Collection Technique 40
3.7.1 Socio-Dernographic Data 40
3.7.2 Dietary Intake 40
·3.7.3 Anthropometric Data .42
3.8 Data Quality Control Assurance 42
3.8.1 Training of Enumerators .42
3.8.2 Pretesting of Study Instruments .42
3.8.3 Validity 43
VIII
3.8.4 Reliability 43
3.9 Data Analysis 44
3.10 Ethical and Logistical Consideration .45
CHAPTER FOUR: RESULTS 47
4.1 Introduction 47
4.2 Demographic and Social Economic Characteristics of Pupils and Caregivers .47
4.2.1. Distribution of the Caregivers by Marital Status .48
4.2.2. Distribution of the Caregivers by Age .48
4.2.3 Dist~ibution of the Caregivers by Level Education .49
4.2.4 Social Economic Characteristics of the Caregivers at NPS Participating in the Study
........................................................................................................................................... 50
4.2.4.1 Type of Occupation of Care givers of Children at NPS 50
4.2.4.2 Housing Characteristics and Fuel Use by Households of Children at NPS 52
4.2.4.3 Ownership of Land and Household Durable Consumer Goods 55
4.2.4.4 Water, Hygiene and Sanitation Characteristics of the Households of Children at
NPS 56
4.3 Nutritional Content of the Meals Taken at NPS under the School Feeding Program. 57
4.4 Dietary Intake of the Children in Namasagali Primary School 57
4.4.1 Dietary Intake as Reported by the Food Frequency Questionnaire 58
4.4.2 Macro and Micronutrient Intake by the Pupils in the Preceding 24-hour 60
4.5 Nutritional Status of the Children in Namasagali Primary SchooL.. 61
4.6 Morbidity and Illness among the Pupils 62
4.7 Costing of the School Feeding Program at NPS 64
4.7.1 Costing Meal per Term 64
4.7.2 Contribution made to the SLP by the Stakeholders 65
IX
4.7.3 Food Production in the School Gardens 69
4.8 Relationship between Factors (Demographic and Socio-economic Characteristics,
Dietary Intake, Nutrient Composition of School Meals) and Nutritional Status of Children
attending NPS 70
4.8.1 Nutritional Status about Demographic and Socio-Economic Characteristic 71
4.8.2 Nutritional Status in Relation to Dietary Intake 72
CHAPTER FIVE: DISCUSSION 73
5.1 Demographic and Social Economic Characteristics Households of Children in NPS 73
5.2 Dietary Intake of the Children in NPS 74
5.3 The Nutrient Quality and Quantity of the Meal Served at NPS 75
5.4 Nutrition Status of Children at NPS 76
5.5 Relationship between Factors (Demographic and Socio-economic Characteristics,
Dietary Intake, Nutrient Composition of School Meals) and Nutritional Status of Children
attending NPS 78
5.5.1 Correlation between Nutrition Status. Demographic and Socio-Economic
Characteristics 78
5.5.2 Nutrition Status in Relation to Dietary Intake 79
5.5.3 Correlaton between Nutrition Status and Nutrient Composition of School Meals .. 80
5.6 Cost of School Feeding at NPS Before and After the Introduction of School
Gardening 80
CHAPTER SIX: SUMMARY, CONCLUSION, AND RECOMMENDATION 82
6.1 Summary 82
6.1.1 Purpose of study 82
6.1.2 Results and Implication 83
6.2 Conclusion 83
6.3 Recommendations 85
x6.3.1 Recommendation for Policy 85
6.3.2 Recommendations for Practice 86
6.3.3 Recommendation for Research 86
REFERENCES 88
APPENDICES 102
APPENDIX A: INTRODUCTION LETTER 102
APPENDIX B: INFORMED CONSENT FORM ENGLISH VERSION 103
APPENDIX C: INFORMED CONSENT FORM IN LUSOGA VERSION 105
APPENDIX D: CHILD ASSENT FORM IN ENGLISH 107
APPENDIX E: CHILD'S ASSENT FORM IN LUSOGA ]08
APPENDIX F: RESEARCH AUTHORIZATION FROM KENYATTA UNIVERSITY
......................................................................................................................................... 109
APPENDIX G: ETHICAL CLEARANCE 110
APPENDIX H: UGANDA NATIONAL COUNCIL OF SCIENCE AND
TECHNOLOGY APPROVAL 112
APPENDIX 1: LETTER TO RESIDENT DISTRICT COMMISSIONER, KAMULl
DISTRICT 113
APPENDIX J: VEDCO ENDORSEMENT OF RESEARCH APPLlCATION 114
APPENDIX K: QUESTIONNAlRE 115
APPENDIX l: LABORATORY ANALYSIS OF SCHOOL MEAL J24
Xl
LIST OF TABLES
Table 2.4a: Mean Daily per Capita Energy Requirement and Safe Protein Intake for
Primary and Pre-Primary Children 17
Table 2.4b: Recommended Nutritive Values of Rations for Primary Schools (WFP Data) 18
Table 2.4c: Recommended Mean Daily Intakes for Vitamin A, Iron and Iodine 19
Table 4.1: Mean, Mode and Median Age in Years for Pupils at NPS .47
Table 4.2: Frequency Distribution of Participating Pupils by Class and by Gender.. 48
Table 4.3: Demographic Characteristics of the Principal Caregiver .49
Table 4.4: General Characteristics of the Study Household 54
Table 4.5: Water, Hygiene and Sanitation Characteristics of the Households of Children
at NPS 56
Table 4.6: Nutrient Content of School Lunch at NPS (Maize, Beans and Collard Kale
"Sukumawiki") 57
Table 4.7: Frequency of Consumption (%) of Selected Foods by Households in the
Preceding 7 days 59
Table 4.8: Consumption of Nutrients at Home and SchooL 60
Table 4.9: Prevalence for BMl-for-age, Height-for-age z scores in 2012. Sex
disaggregates data "'" 62
Table 4.10: Health Seeking Behaviour by the Caregivers when the Child falls Sick 63
Table 4.11: Total Cost of providing NPS with Lunch of Maize, Beans and Kales (Sukurna
wiki) for 226 Pupils for 89 Days (One Term) 65
Table 4.12: Contribution made by the different Stakeholders towards the SFP in 2011 in
NPS 67
Table 4.13: Acreage Planted per Enterprise and the Input and Output obtained from the
School Garden 70
Table 4.14. Chi square test for selected socio-economic characteristics and nutrient intake
in re lat ion to nutritional status 71
XII
LIST OF FIGURES
Figure 1.9: Contribution oflocally grown and sourced school feeding program to
improve dietary adequacy and reduce short term hunger ] ]
Figure 4.]: Percentage of Household Growing Crops 5]
Figure 4.2: Percentage of Households Rearing Animals 52
Figure 4.5: Percentage of Pupils Sick in the Last 2 Weeks 63
Figure 4.6: Percentage Contribution made by Program, Parents, and School Gardens in
20 10 and 20 11 : 68
XIII
OPERA TIONAL DEFINITION OF TERMS
Primary School Child: A child between ages 6-] 8 years attending school at Namasagali
Primary School
School meal: A hot lunch (maize and beans, vegetables, oils and iodized salt) provided to
pupils during school days
Nutritional Status: The current body status of a person related to their state of
nourishment (consumption and utilization of nutrients). In this study it was measured in
terms of BM 1-for-Age and stunting.
Nutrient adequacy: nutrient composition of the meal based on macro and
micronutrients with the ability to meet the individual requirement for that nutrient based
on age/gender. The nutrients analyzed in this study-included energy (kcal), protein,
lipids, iron, vitamin A and iodine.
Recommended Dietary Allowance(RDA): the intake levels for nutrients that meet the
needs of nearly all (97+98% ) of healthy individuals that make up a certain group at the
given life-stage
Stunting: it indicates the attained growth in height of the child. This indicator is used to
assess whether a child has normal height (> I to <2 SD). is moderately stunted (>-3 to -,
<2SD) or severely stunted «-3 SD). It can help identify children who are stunted due to
prolonged under nutrition or repeated illness (WHO. 2008).
BMI-for-Age: Is measured by dividing weight (kg) by the height (m) of an individual. It
is age (2-20) and gender specific. BMl-for-age cut off: ::; 951h percentile-overweight
851h_951h percentile-risk of overweight ::;51h percentile underweight.
XIV
Cost Description: The required payments, expenditures and cash in kind necessary to
provide lunch for pupils at NPS.
Index Child: The pupil anending NPS and taking part in the study
Estimated Average Requirement (EAR) - intake levels for nutrients estimated to meet
the needs of half of the healthy individual in a particular group.
Offline menu planner- It is a tool used to measure the nutritional value of a meal and
provides a gentle introduction to the HGSFP web application. This tool can be used
without an Internet connection. The tool should run on most versions of Microsoft Excel
for Windows
AOAC
BCG
BMI
CSRL
FAO
HGSF
ISU
MDG
MUK
NEPAD
NPS
PEM
RDA
SDG
SFP
SPSS
UBOS
UNICEF
UNHTF
UPE
UN
UNCST
VEDCO
WHO
WFP·
xv
ABBREVIA nONS/ACRONYMS
Analysis of the Association of Official Analytical Chemists
Boston Consulting Group
Body Mass Index
Centre for Sustainable Rural Livelihood
Food and Agriculture Organization
Home Grown School Feeding
Iowa State University
Millennium Development Goals
Makerere University Kampala
New Partnership for Africa's Development
Namasagali Primary School
Protein Energy Malnutrition
Recommended Dietary Allowance
Sustainable Development Goals
School Feeding Program
Statistical Package for Social Sciences
Uganda Bureau of Statistics
United Nations Children's Fund
United Nations Hunger Task Force
Universal Primary Education
United Nations
Uganda National Council of Science and Technology
Volunteer Efforts for Development Concerns
World Health Organization
World Food Program
XVI
ABSTRACT
Proper nutrition is critical for optimal growth, cognitive development, general well being
and academic performance among school going children. Access to good nutrition either
at home or at school can contribute to the elimination of malnutrition and its associated
health and developmental problems among this age group. Developing countries still
remain within reach of halving the proportion of hungry people. Gains of the second
Millennium Development Goal (MDG) (Sustainable Development Goal-SDG 4) are
being threatened by several factors that including short term hunger. A cross sectional
study with an analytical design and laboratory analysis was used. Data was collected on
socio economic and demographic factors of the pupils, dietary intake patterns of the
pupils , anthropometric measurements were collected from 226 pupils. The meal was
analysed in the laboratory for nutrients: energy, protein, fats,vitamin A, iodine and iron.
Both inputs and output from the school garden were recorded and these computed in
monetary terms. Data was analysed using SPSS version 17, Anthro-plus version 1.0.2 and
Nutri-survey. Descriptive statistics such as inean, frequencies and percentages were used
to describe the data. A higher level of cross tabulation and correlation test of the three
hypothesis was done and P<0.05 was used to determine statistical significance. From the
study 50.4% were male pupils while 49.6% were females. About 5]% of the caregivers
had attained at least level of primary education with 89% of them being peasant farmers.
The most grown crops were maize (97%) and sweet potatoes (87%). The school meal
provided a significant amount of calories (853kcal±178) and all other major nutrients as
compared to what the pupils received from home. Stunting and BMJ-for -age levels did
not change much after the program introduced the school feeding program, an indication
that there could be a spill over of malnutrition from childhood to school age. Regression
analysis showed that there exists a positive correlation between BMl for age and
education level of parent and a negative relationship between BM] for age and marital
status of parent exists. Further analysis showed a weak relationship between nutrition
status BMJ for age and number of meals consumed per day (r=0.120. p=0.021). The
study did not find any significant relationship between schools meals and nutritional
status. Contribution from the stakeholders-program-28%, parents-14% and school
garden-57% indicated a reduction on the cost incurred by the program to sustain the SFP.
This study recommends that a longitudinal study comparing schools that employ gardens
and those that do not should be conducted to examine the difference in nutritional status
and the cost implications.
CHAPTER ONE: INTRODUCTION
1.1 Background to the Study
The creation of the Millennium Development Goals (MDGs) in the year 2000 and
Sustainable Development Goals [SDGs] in 2015 resulted from the determination of all
countries in the United Nations (UN) to address challenges resulting from advancing
globalization. Attention was paid to hunger and poverty which was stated in MDG one
(SDG 1&2), as "eradicate extreme hunger and poverty (Murray, 2015)," specifically
expressed in the sub-goal formulated" by the year 2015 the proportion of people who
suffer from hunger is halved as compared to 1990" (UN, 2005). The State of Food
Insecurity in the World 2013 presented updates showing that further progress has been
made towards the 2015 MDG target (halving the proportion of hungry people), this
remains within reach for the developing countries collectively (FAO. 20] 3).
Globally, it is estimated that every six seconds a child dies from hunger-related causes
(FAO, 2007) and in developing countries one out of four children are stunted (WFP.
2009;UNJCEF, 2007). Across the developing continents. 66 million primary school aged
children attend classes hungry, 23 million being in Africa (Badri. 2014). Of the 72
million primary school-age children worldwide, who are not in school. 95 percent are in
developing countries: 57 percent are girls; 48-56 percent are stunted and up to 62 percent
are underweight. More than half of the 72 million suffer from iron deficiency anaemia. 5
percent from iodine deficiency and 7 percent from vitamin A deficiencies (WFP. 2009).
2The target of the second MDG was to ensure that all boys and girls complete primary
schooling through achieving Universal Primary Education (UPE). Developing countries
have made great strides in reaching this goal but these gains are threatened by several
factors that include short term hunger due to lack of proper meals at school, insufficient
school supplies and lack of enough teachers in the schools (Muntenyo, 2010). Other
reasons stem from responsibilities at home and pressure to earn additional income.
In Uganda children belonging to poor and food insecure regions/households have been
forced to contribute to household chores rather than go to school (WFP, 2011). The
policy on school feeding is that parents who can afford to pay are ailowed to make
feeding arrangements with the school management. and those parents who cannot afford
the cost of a school meal, provide food for their children to carry to school (Uganda
Budget, 2007/2008 in Kibwika et al., 2010). In Kamuli District Eastern region poverty
and lack of school feeding programs (SFPs) have severely crippled the children's ability
to learn because most of the time they are hungry (Kirabo. 2011 & UBOS, 2012).
SFPs have been reported to improve children' s cognitive outcomes and nutritional status
depending on the design of the program (Kristjansson. 2007). School gardens have been
'used as a source of locally grown products for SFPs (Mwangi et al .. 20 I0). Foods from
~
school gardens are more appropriate, cost-effective and contribute to the sustainability of
the SFPs (Lawson, 2012). The New Partnership for Africa's Development (NEPAD)
teamed up with World Food Program (WFP) and other partners to create the Home
Grown School Feeding Program (HGSF). a program that provides nutritionally adequate
3meals for learners and improving enrolment and retention in schools while addressing the
needs and growth of the local small farmers (NEPAD, 2007; Mutenyo 2010; UNHTF
2003). One of the NEPAD's recommendations is that food must be produced in the
locality of the school (Tomlison, 2007).
Iowa State University's-Centre for Sustainable Rural Livelihoods (CSRL) in partnership
with Volunteer Efforts for Development Concerns (VEDCO), a local non-governmental
organization in Uganda and Makerere University; are implementing a sustainable rural
livelihood program to ensure that rural people of Kamuli District have access to sufficient
food, sustainable incomes and livelihoods that result in good health and well-being. The
program set up a school garden/feeding project at Namasagali Primary School (NPS)
with a goal of providing a hot, solid and nutritious lunch to the children. Produce from
the gardens are used in the SFP or sold to provide ingredients for the meal. The aim of
linking the garden to the feeding was to make the SFP cost-effective, improve its
efficiency and overall contribution and make it self-sustaining (CSRL, 2012).
1.2 Problem Statement
Malnutrition and hunger among children in developing countries contribute to poor
health and low quality of life. The economic costs of malnutrition are very high in terms
of higher budget outlays as well as lost gross domestic product (Lopez, 2006). School-
age children are more vulnerable to under nutrition because they are not a priority for
nutrition interventions. which often focuses on preventing malnutrition during fetal
development and the early years of life. Evidence-based research is beginning to show
4that school-age children may not. in fact. be healthier than younger children. The
developing world and the development community are starting to acknowledge this
problem of malnutrition and health among this age group and more importantly the need
of addressing it. SFPs and other food-based strategies are among the range of nutrition
interventions aimed at improving school -age children's nutritional status (Hall, 2007 &
Bennett, 2003; Alien, 200 I).
Uganda's launch of the Universal Primary Education (UPE) in 1997 was a landmark
towards meeting MDG two (SDG 4). However, short-term hunger in schools has become
a threat (Kibwika et al., 2010) to the realization of this goal. Under the UPE program,
parents are taxed with the responsibility of providing meals among other materials to
their children. In most rural schools in Uganda, school administrations make
arrangements with parents to provide the children with a cup of porridge for lunch.
Parents contribute in kind or cash towards this lunch. The school administration in NPS,
Namasagali Sub-County of Kamuli District is one of the schools that had this
arrangement. However. providing one-cup (250 ml) of maize meal porridge for lunches,
which is grossly inadequate (50kcal) in terms of quality and quantity, is never guaranteed
due to poverty and poor agricultural productivity in the area (CSRL Report, 2011).
Furthermore, the govemment also announced that parents should not be forced to
contribute towards feeding their children in schools (ACT. 2008). Due to these
pronouncements. rural Kam uIi District parents are reluctant to contribute maize and
money to facilitate the feeding in schools (Kirabo. 201 I).
5In 2006, the CSRL Program introduced a school gardening and feeding program in NPS
to enhance the quality and quantity of the school lunch. Through the school gardens,
grain amaranth (a protein-rich cereal) and occasionally eggs were added to the porridge.
Although the additional of the macro and micro nutrients in the grain amaranth
marginally improved the quality of the porridge; the quantity served (one 250 ml cup)
was still inadequate in terms of kcal (from 50kcal to 80kcal) for a primary school going
child. In 2010, CSRL introduced a solid meal with an intention of increasing the caloric
intake and provide the much-needed macro and micronutrients. The dish consisted of
whole maize, beans, vegetables, iodized salt and vegetable oil; also, eggs were added to
the meal once a week to provide animal source protein.
No study has been conducted to find out the exact nutrient content in the meal,and the
effect it has on the pupils at the school. This study, therefore, set out to establish the
adequacy of the solid meal served and its contribution to the children's daily dietary
intake based on the Recommended Dietary Allowance (RDA) for their ages and
nutritional status. It further sought to establish the cost implication of linking a school
garden to the feeding program at a rural primary school. The study formed part of the
evaluation of the CSRL' s school garden and lunch project. Also, the over-reliance of the
schools on donations to run school feeding programs is an awful idea because of lack of
sustainability. It is hoped that school gardening, though expensive in short run. it will
prove to be a viable option over donations. thereby fostering the need for scaling up of
the program to the neighbouring schools and later the entire country.
KENYATTAUN\\IERSii'i UBRARY,
61.3 Purpose of Study
The purpose of this study was to determine the nutritional adequacy of the meal served at
NPS, its contribution to the children's daily dietary intake based on the RDA for the age
group. The study also assessed the contribution of the lunches on the nutritional status of
the target group and outlined the cost of providing lunch to the pupils from the school
gardens. The study is also supposed to carry out cost comparison of feeding programme
with the school gardening programme in place and when out of the picture.
lA Specific Objective
l . To determine the demographic and socio-economic characteristics of the households of
the index child in Namasagali Primary School
2. To determine the dietary intake of the children in Narnasagali Primary School
3. To establish the nutritional content of the meals taken at school under the school-
feeding program
4. To determine the nutritional status of the children in Namasagali Primary School
5. To compare the cost of school gardening with the cost incurred by the donors to run
the school-feeding program.
71.5 Study Questions
I. In one month prior to the study, what are some of the illnesses the index child suffered
from?
2. Does the school meal provide one-third of the nutrients required by the children?
3. Does the school garden lower the cost of providing meals for the pupils at school?
1.6 Hypotheses
HOI The school meal (maize, beans, and vegetables) introduced by the program did not
significantly contribute to daily dietary needs of calories, proteins and micronutrients for
the primary school children (6-18years) based on their RDA.
Hoz Introduction of the school meal of maize, beans. and vegetables did not significantly
change the nutritional status ofNPS children.
Ht>;Supporting the school feeding program with the school garden produce did not have
any effect on the cost of providing lunch to the pupils.
J.7 Significance and Anticipated Outputs
Although the provision of lunch to school-aged children is important. it rernams a
challenge for poor rural farmers experiencing hunger and poverty. Poor rural farmers
. have to choose between providing meals for the whole family at home or giving the
produce to children to take to school. Most of the times the families will choose to forego
8giving the children lunch at school. It is widely acknowledged that an integrated approach
to problem solving is more likely to produce sustainable results. Extensive research has
shown that the potential for school gardens in providing a nutritious meal and sustaining
a SFP is possible, but this has to be affordable. Jntroducing and sustaining a SFP is in the
interest of CSRL, and providing this information on the school lunch linked to the school
garden is expected to inform the program on the decisions to be taken when scaling up to
other primary schools. The findings of the current study are critical in filling this gap.
Most central to this study was to assert the importance of providing a nutritious lunch to
the beneficiaries and the cost implication involved. This study also sought to add to the
call for introducing such programs in rural public schools and hopes to convince the
leadership to rethink the school feeding policy. For policy makers' results are important
in making informed economic decisions on school lunches. This study has demonstrated
that growing of high value crops for sale has been an effective way of funding the SFP
but this has to be supported through contributions from the parents. The nutrient
adequacy of the lunch has also improved noted in the high caloric intake on the meal
consumed.
1.8 Justification of Study
The SFP is part of the nutrition component of the CSRL program. through which it IS
enhancing the nutritional status of school children. improving their school performance.
attendance, enrolment and increasing production and sustainabiliry of the school gardens.
An extensive evaluation of the program is yet to be carried out since the inception of the
school garden and feeding program in 2006. CSRL and its partners are in the process of
9scaling up the feeding and nutritious lunch project to other schools in which they are
operating. This study provided information on the efficiency and cost of providing this
meal, which is necessary for making decisions to provide adequate nutritional meals for
other schools using locally available foods. Results of this study also informed other
stakeholders and policy makers in Kamuli District on the benefits and cost implication of
linking school gardens to SFP with the goal of providing nutritious meals to school-going
children.
In a similar study done in an Australian context, Geissman et al. (2005) found out that
adequate vegetable and fruit intake in young children (in the school set up) has a positive
effect on developing healthier food preferences later in life. Mosie (2004) suggested that
the reduction of the prevalence of deficiencies should entail encouraging the growing of
fresh vegetables in school gardens and educating the public on the value of including
them in the diet.
1.9 Limitation and Delimitation of the Study
The CSRL program is implementing the school garden and feeding project in 5 schools,
however, the study was limited to NPS because this is the school where the solid
nutritious lunch has been introduced. Nutritional status of the children was a variable of
interest in this study. However. the children spent 88 days in school and food consumed
on school days and at home might have confounded the results of this study. The
methodology applied in data collection and analysis took care of these factors. When
costing the meal the study only considered the ingredients in the food assuming all other
10
costs remain constant whether the produce is from the school gardens or provided
otherwise by the parents. school or donor (Gelli et al., 20 10).
1.10 Conceptual Framework
The study adopted the Home Grown School Feeding (HGSF) conceptual framework
developed by NEPAD and WFP (Martens, 2007; NEPAD 2007). NEPAD has urged
African governments to support SFP using as much as possible locally produced
foodstuffs (NEPAD 2005). NEPAD's framework focuses on food purchased or produced
by the local small-scale farmers. In the case of CSRL's SFP, the food is produced in the
school garden and also by the parents who are small-scale fanners in the area. Apart from
promoting local agricultural production, NEPAD's HGSF aims at promoting the
children's wellbeing (Espejo. Burbano, and Galliano, 2009), which is in line with
CSRL's objective of the SFP.
The goal of CSRL's SFP is to provide a nutrient dense school lunch in a cost-effective
and sustainable way to ensure the well-being of the children in NPS. By consuming the
meal, the children received part of their caloric. protein and micronutrient daily intake.
Consuming the meal eventually reduces the short-term hunger and improves the
children's nutritional status while increasing enrolment at the school, attendance and
cognitive outcomes. The use of food from the school garden results in increased demand
and diversity for the produce from the school garden and coupled with food contributed
by parents which leads to an increase in local agricultural production (Figure 1.1).
11
Children participating in the SFP receive a portion size of 250g of the maize, beans, and
vegetable meal ("nvoyo "), which directly contributes to their dietary intake. A school
lunch meal usually provides from one-third to one-half of the RDA for energy and
protein. According to Bennet, 2003, school feeding programs have three major impacts
that are an improvement in the school-going children's nutritional status and reduction of
malnutrition rates: increasing school enrolment; attendance and cognitive performance;
and finally to increase the demand for locally produced foods as shown in Figure 1.1.
Reduced Cost of providing school meal
Reduction
of Short
Term
Provision of
60-75%
Energy. 70-
90%of Protein,
and I 0% Energy
from Fat and
Increased % of
Micronutrients
Improved
dietary intake
and adequacy
Increased
school
garden food
production
Increased
enrollment
and
Reduced Cost on providing school meal
Figure] .9: Contribution of locally grown and sourced school feeding program to
improve dietary adequacy and reduce short term hunger
Source: Adapted from Tineke Martens, 2007
Iron deficiency (anaemia). vitamin A deficiency. and iodine deficiency among other
deficiencies have been shown to affect school attendance and performance. Food rations
12
for schools should supply energy, protein and fat in the following ratios: Energy should
be 1200-1500 kcal, protein 28-36 g , and fat should be 13-17 g . Food for the school
lunch at NPS is obtained locally from the school garden and community.
Growing or rearing food through school-gardens and raising animals has been one of the
most successful ways of providing additional food for the SFP in some schools around
the world (Bundy, 2009). It will, however, require adequate tools and trained staff to
maintain the gardens. The food that is obtained from the garden can either be used
directly in the SFP, or a portion of the harvest is sold and the funds obtained saved for
future expenses required for sustainability (Briggs et al., 2008). At NPS food grown in
the school garden is used directly in the school lunch, vegetables, eggs and other high-
value crops e.g. grain amaranth are sold to purchase ingredients and pay for other costs
related 10 feeding the children. With many parents especially in the rural areas unable to
afford school lunches for their children, school farming can play a vital role in reducing
the costs involved in providing nutritious meals for pupils (Mwangi et al., 20 10).
13
CHAPTER TWO: LITERATURE REVIEW
2.1 Introduction
There are over 350 million hungry children in the world. Of the over 115 million children
that are out of school, 96% are from developing countries. Short-term hunger is one of
the contributors of failure to attend school. A lot needs to be done to reverse the long-
term effects of hunger and lack of education for children, their families and societies
(WFP, 2012, WFP, 2006, FAO, 2005). Providing meals at school has the potential to
mitigate this challenge. School Feeding Programs (SFP) have the potential to break the
vicious cycle of hunger, poverty and poor education, which are interdependent (WFP.
1006). Studies have shown that inadequate access to nutritious food causes a significant
setback in a child's learning ability and contributes a high economic cost to the nation
(WFP, 2009). SFPs are interventions that alleviate hunger while supporting education,
health and community development (WFP, 2009). School feeding can be broadly defined
as the provision offood to children during the school days
2.2 Overview of School Feeding Programs
School feeding programs can take different forms. The common ones include in-school
meals (children are fed breakfast, lunch or both at school) or take-home rations (THR)
(transfer of food resources to entire families' conditional upon school enrolment and
regular attendance of children). The latter targets a particular group of vulnerable
children such as orphans or older girls who are provided with THR at certain times of the
14
school year (WFP, 2009). The success of a sustainable SFP relies on the active
participation of the parents, teachers, pupils and the communities (WFP and BCG, 2011).
2.3 Benefits of School Feeding Program
Research and literature continue to demonstrate that SFP has benefits as follows:
2.3.1Alleviate Short-term Hunger, Improve Learning and Cognitive Function
Across the developing world, 66 million pnmary school-age children anend classes
hungry with 23 million in Africa alone (WFP, 2012). The potential of a child to
concentrate and learn is reduced with hunger due to skipped meals and much activity.
Many children, especially in rural areas, leave home on an empty stomach, take long
walks to school and, as a result, begin school hungry and unable to concentrate (Briggs et
al., 2008). Much research has shown that providing school meals. especially breakfasts.
can play a critical role in alleviating short-term hunger and ensuring that children learn.
Other studies (Benin, Jamaica, and North America) have shown that learning
achievement is higher for children receiving SFP especially to those who missed
breakfast (Bennett, 2003). Introducing a small snack at the beginning of the day or mid-
morning can relieve the short-term hunger. increase activity levels and learning capacity.
15
2.3.2 Increase Enrolment and Attendance
The enrolment and. attendance of children coming to school is one of the most direct
effects of SFP (Andrews et 01., 2011). A study done in Bangladesh by Ahmed 2004
showed a considerable impact on school participation by increasing the enrolment and
attendance by 14% and 6% respectively. This is more prevalent among the girls than
boys; food is a strong incentive for children to attend school on a regular basis and keeps
them there. Female learners especially benefit from this, as parents may feel that there are
sufficient income-transfer benefits. Research has shown that enrolment for girls increased
by 247% in Pakistan and 197% in another province as a result of School Feeding
Program. Similar results were echoed in the extreme Northern Province of Cameroon
where the program increased girls' enrolment by 313% (Briggs et 01., 2008). Introducing
school garden program can increase enrolment and school attendance in rural areas.
2.3.3 Improve Nutrition and Health Status
Research shows that undernourished young children do benefit from SFPs, though they
cannot reverse the consequences of earl ier malnutrition (Bundy et 01., 2009, Krisjansson,
2007,Bundy et 01., 2006). Studies have indicated that an increase in micronutrient and
macronutrient intake leads to enhanced nutrition and child health. increased learning and
decreased morbidity for the pupils. Furthermore. Bundy(2006) and Krisjansson (2007)
have further demonstrated that providing meals at school can have a significant
contribution to the nutritional status and educational outcomes in children (Bundy et 01.,
2009, Krisjansson, 2007 Bundy et al.. 2006).
16
A study in Kenya by Meme et al., 1998, concluded that the SFP did not improve the
nutrition status and children's school attendance. One of the studies by Krisjansson
(2007) showed an improvement of Body Mass Index (BMI for age) in primary school
children participating in breakfast supplementation programs. Good evidence suggests
that SFP, when designed with micronutrients in mind, can significantly improve the
effects of 'hidden hunger'. The three top macronutrients linked to learning capacity that
SFPs can impact on are iron, Vitamin A and iodine. Increased cognitive performance and
development (particularly in female children) has been linked to micronutrient
supplementation especially of iodine and iron (Leslie & Jamison, 1990; Tomilnson,
2007). An increase in micronutrient and macronutrient intake can lead to enhanced
nutrition and child health, increased learning and decreased morbidity for the pupils.
2.4 Nutrient Adequacy of School Meals
School meal programs should be well designed. to provide adequate macro and micro
nutrients content. The average school meal should offer a third of the RDA for calories,
proteins, fats, vitamins and minerals given their role in ensuring good nutrition and health
for the child. Lunch is one of the three primary meals that a person is required to eat in a
day (Musamali. 2007).
When designing a meal for the SFP it is imponant to take into consideration the type of
ration and if the size will vary according to the age of the child, modality or delivery
format of the food (Mosie. 2004). Some of the common means include snacks, in school.
meals or take-home rations. The best food sources and such meat or dairy products will
t-
17
be included. Some guidelines do exist, and they guide nutritional requirements and
recommended daily allowance. The tables below provide guidelines derived from WFP.
WHO and USAID data.
Table 2.4a: Mean Daily per Capita Energy Requirement and Safe Protein Intake for
Primary and Pre-Prirnary Children
Pre -Primary
School Children
3-5 years
Primary
School
Children
6-12 vears
2000
Adolescent
11-14 years *
Adolescent / Teen
15-18 years**
Energy 1600-1800
(Kcal~ ~ ~ -+ -+ ~ L- __ ~
Protein 24-32
(grams~~ __ -L J- ~ ~ __ ~ L- ~
* USAID and WHO data only
* * USAID data only
Source: Bundy cl al., 2009
2200 - 2350
28-40 45-46
World Food Programme recommends that during meal distribution, serving portions
should be adapted to the consumer's ages with younger children receiving smaller
portions than their older counterparts. Calories. protein and fat content are availed to
children up to age 12 (Bundy et al., 2009). WFP recommends that for day school, feeding
programmes supply two meals: a light meal and lunch. The light meal can be served at
the start of classes or mid-morning and should supply approximately between 400-
600kcal. As for the lunch. it should provide 700-900kcal.
JJ8
The total number of kilocalories supplied by both meals should be between 1200-1500
refer to Table 2.4b (Finan, 2010) the meal should also supply protein between 28-36g and
fats between 14-17g. Adjusting portion sizes for older children (especially adolescent
girls) can help meet the increasing needs within the school set.
Table 2.4b: Recommended Nutritive Values of Rations for Primary Schools (WFP
Data)
School Type Acceptable range of rations nutritive value
Children 6-12 ears
Ener r (Kcal Protein ( ram Fat (gram
Half-Day School 600-900 ] 6-24 7-11
(30-45% (40-60% (40-60%
Day School 1200-1500 28-36 J4-J7
(60-75% (70-90% (46-56 %)
Boarding School Up to 2000 At least 40 >23
(u to J00%) (u to] 00% (76%)
Key: The figures in shown the brackets show the percentages of caloric provisions of
meals in different situations.
In addition to protein. calories and fat micronutrient deficiencies such as Iodine
deficiencies. iron deficiency anaemia and vitamin A deficiencies contribute significantly
to poor educational outcomes (Tomlinson, 2007). The WFP, WHO and USAID provide
guidelines to regulate the recommended daily intakes for Vitamin A. Iron and Iodine
Table 2.4c.
]9
Table 2.4c: Recommended Mean Daily Intakes for Vitamin A, Iron and Iodine
Age Group Vitamin A (ug retinol) Iron (mg) Iodine (Jlg)
Pre-Primary
(3-5 yrs WFP) 400 9-] 0 90
(1-6 yr WHO)
(4-6 yrs USAJD)
Primary
(6-12 yrs WFP) 400 (WHO)
(7 -10 yrs WHO & 500 (WFP) ] 0-] 6 ]20
USAJD)
Adolescents
(10-]5 yrs WHO) 500 (10-12 yrs) 12 (boys 11-14 yrs) 150
(1]- 14 yrs USAID) 600 (12-15 yrs) 15 (girls 11-]4 yrs)
(14-18 yrs JOM) 630(boys 14-18 yrs)
485(girls 14-18 yrs)
* Differences Exist Between WFP and WHO in Regards of Micro nutrients
When providing lunches to school children, care should be taken in making sure the meal
is nutritious and not too "heavy", to cause a temporal sedative effect on the children.
2.5 Sustaining School Feeding Through Agriculture (School Gardening).
One of the most probable means of ensuring sustainability ofa SFP and at the same time
empowering pupils to gain life skills in agriculture are through school gardens. A school
garden is considered an outdoor laboratory for teachingl1earning of farming by the
learners and a source to produce food for the SFP (Kibwiika et ut. 2010). In their aim to
restore agricultural growth, food security, adequate nutritional levels and rural
developments. African governments in 2003 endorsed the Home Grown School Feeding
Programme (HGSFP) under the Comprehensive Africa Agriculture Development
Programme (CAADP) initiative. In the same year, NEPAD identified HGSFP as having
an immediate influence on food insecurity in Africa with the prospective to contribute to
20
long-term development outcomes (NEPAD, 2007, Gelli et 01., 2010). HGSF is seen as a
tool to reach three different target groups: school children: small-scale farmers and
community groups involved in food preparation and other income generating activities
involved in school feeding service provision (Gelli et al.. 2010). The main objective of
HGSF programmes is to link a food-based programme, such as school feeding, with local
agricultural production (WFP, 2009). This creates ready markets for local farm produce,
supports primary education and builds community relationships leading to strong
community ownership and sustainability of the SFP (Loga, 2012). To avoid shocking the
already food insecure and at the neediest community, it is important that a right balance
be reached. The balance can be between programs that count on community participation
and ownership and those that seek to be largely funded by communities (Weru, 2011).
NEPAD through the CADDP and the Alliance for a Green Revolution in Africa, have
been actively supporting the connection between School Feeding and domestic
agricultural production. Food can be obtained within the boundaries of the village or
areas surrounding a single school, or within the national border of the country with which
the school sits (Sumberg, 20] I). The in-country demand for smallholder production for
local school meals has so far translated into sustainable. nationally owned. cost-effective
HGSF programs in Ethiopia, Mali, Kenya: Ghana. Nigeria and Tanzania. These countries
are less dependent on external sources of food by linking the program with local
agricultural production, which is the main drive behind HGSF (Gelli et 01..2010).
Kenya, Uganda. and Benin view this as a way to strengthen their SFP and make it more
sustainable. In Ghana, HGSFP forms the basis for Wl P's exit strategy (WFP, 2008). An
21
excellent example of a successful school farming and SFP is the Garden for life project
underway in the UK, India, Kenya as well as Gambia (Loga, 2012). These countries have
embraced school farming as a crucial factor for a successful SFP. In Kenya's Nakuru
town, a case study on improving school feeding through school farming was conducted
and African Studies Centre reported that school farming appeared to be common in both
secondary and primary schools with most of the produce destined for the SFP. This will
keep the cost of the feeding programme at a low, and more parents will be able to afford
school 'meals (Turkana & River, 2011). For schools to produce part of the ingredients
needed to support school feeding program some conditions must be met, including
adequate land, sufficient water, technical support and leadership
2.6 Costing a School Feeding Program
The cost and effects should be considered when designing school feeding interventions,
and several different factors come into play when costing. These factors include choice of
modality, composition and size of the rations. source of food (obtained locally or
imported), number of beneficiaries and school feeding days per year (Geli et al., 20 10).
Resource availability is naturally linked directly to the costs of operating and designing
the program and, therefore, it is important to obtain information on local produce and
other food sources to assist with meal planning and program implementation. Other
factors that need to be reviewed include seasonal fluctuations in food availability that
may influence the working of the program. transportation. and storage. It has also been
documented that preparation facilities and equipment and fuel (availing fuel in
abundance) will greatly affect the nature of the SFP.
22
It is pertinent to note that the sources of funds or resources for the program, duration of
funding and how costs will be divided amongst the school, parents, local sources,
government sources, partners and implementing agencies are outlined. Food for the
program can be acquired through donation, purchase of local food, growing/rearing own
food, local vendors or a combination of these. Parents, community members,
government, food agencies or NGO's can donate food. This food can be directly used or
sold (monetization) for the purchase of needed items. Purchase of local food will require
cash inputs, and this allows for greater control of the quality and quantity of items bought
and will contribute to the local economy (Weru, 2011). School gardening and livestock
rearing can provide many opportunities for learning and skill training for the pupils, in
addition to food production for the SfP. While costing, it is important to include
contributions made by the community in cash or kind such as labour or food (Rose,
2003). To maintain the garden and livestock at the school adequate tools and training
need be provided along with sufficient staffing.
2.7 School Gardening and Feeding Programme at NPS
The school gardening program in NPS began in 2006 with an active partnership between
ISU College of Agriculture and environmental sciences and VEDCO a local NGO in
Uganda. The main intention of setting up these gardens was to provide an outdoor
learning laboratory for the pupi Is. produce supplemental food for the SFP and generate
planting materials for the pupils to rake home. The gardens also serve as demonstration
sites for modem agricultural practices aimed at teachers. parents and community. Some
of the crops grown included fruits. collards. maize. grain amaranth, soybean, and orange-
23
fleshed sweet potatoes (CSRL Report, 2011). The SFP launched in 2010 was met with
enthusiasm from the pupils. Prior to initiation of this program, the students at NPS were
served a lunch that consisted of a cup of maize meal porridge that provided 50kcalories
or equivalent to medium-sized apple. "Nyoyo", a famous Kenyan dish was introduced in
20] 0 with an aim of providing a more filling and high caloric meal for the children
(CSRL Report, 2011).
The program has been in place for two years with funding and contributions from the
donor community, but CSRL is working to make itself sustaining through the school
gardens with support and donation from the teachers, parents pupils and community. The
school garden produces most of the food that is used in school lunches or sells part of it
to purchase other items (salt. oil) needed for the meal. A successful chicken-rearing
project in the school is providing eggs for the students' meal plus additional income. The
idea of a school lunch program has been accepted, and parents in the community are now
willing to contribute. At the beginning of every term, they contribute 3kg of maize and 2
kg of beans (that they once refused) to ensure that their children get the benefits of a
midday meal (CSRL Report. 20 J 2). The continued success and impact of our School
Lunch Program at Namasagali reflects a collective effort and support by the parents.
teachers. and pupils in that community (CSRL Report, 2011). Jt is important that the
program be informed of the contribution of this SFP on the pupils' nutrition and health
status. This is because good nutrition is one of the indicators of the meals' adequacy
about the needs of children of primary school age and cost implication of the program.
This study was conducted with an intention of providing answers to these important
24
questions.
2.8 Summary
The literature reviewed shows that there is a clear indication that a lot needs to be done to
address the long-term implications of hunger and lack of education for our children, their
families and societies (WFP 2012, WFP 2006 & FAO, 2005). School meals are seen as a
tool that will address short-term hunger, supporting education, nutrition and encourage
community development (WFP, 2006). SFP is also viewed as one of the ways of
encouraging families to send girls to school instead of staying home to do household
chores (WFP. 2009). A well-designed school meal should provide adequate nutrients for
a school going child normally a third of the RDA for both macro and micronutrients
(Musamali. 2007). The modality of the meal, composition and size of the ration. age and
sex of the child. number of beneficiaries, school feeding days per year and source of food
should always be used as guide when planning for a design of a SFP (Weru. 20] l ).
Central to this study is to provide a cost description of having a school garden fit into an
SFP. School farm ing. is considered as one of the ways of keeping the cost of the program
.at a minimum. Also. linking the SFP to local agriculture is a sure way to reduce donor
dependency while encouraging community ownership and sustainability especially
through the HGSFP model that NEPAD and CAADP are actively advocating for (WFP
and BCG. 20 11: Gelli er al. 20] 0). Some fundamental conditions to be met to ensure a
successful gardening program include sufficient land. sufficient water. professional
support and leadership. Many schools could reap more benefits from the positive
25
experiences of schools in the garden for life project and also the success story of a school
in Nakuru Kenya (Turkana & River, 2011). NPS in Kamuli district has a school garden
that is supplementing the SFP as highlighted in the literature. However, the program
needs answers on how successful this project has been and this study sought to provide
that information especially to the nutrition and health of the children, adequacy of the
meal served and cost implications.
26
CHAPTER THREE: METHODOLOGY
3.1 Research Design
This study was cross sectional study with an analytical design and had a laboratory
analysis that was done on the "new" school meal. This study was conducted at one point
in time and no follow up was done. The study employed both quantitative and qualitative
methodologies in data collection and analysis. Anthropometric measurements, dietary
intake, and socioeconomic data were obtained horn the respondents using questionnaires.
Proximate and micronutrient analysis of the meal was done at Makerere University
Department of Food Science and Technology using Official Methods of Analysis of
Association of Official Analytical Chemists (AOAC). The researcher opted to perform
an analysis of samples of food from the NPS kitchen as opposed to using offline menu
planners because 1) she had the means to access the laboratory and 2) to minimize errors
due a possible variation of nutrient composition of food crops from region to region. TIle
use of laboratory results is one of the major strengths of this study.
3.2 Study Site
This study was conducted at NPS, which is located in Kabanyoro village in Namasagali
Parish. Namasagali Sub County of Kamuli District. The district is one of the most food-
insecure parts of the country with at least 50% of the population food insecure throughout
the year (KDA, 2004) and high malnutrition rates (79%) (UBOS, 2012). NPS IS a
missionary founded a school of the church of Uganda that began way back in 1932.
27
It is located a kilometre from the river Nile. Secondary data obtained from the school
indicated that in the year 2010 the average enrollement was 285 pupils (l48 girls and
137 boys), while in 2011 the average enrollment was 726 pupils ( 358 girls and 368
boys).
3.3 Target Population
The target population was the pupils attending NPS. The class register was used to obtain
the total attendance from which the study sample was drawn. It is important to note that
being a rural school the attendance by the pupils was low though the enrolment rate are
recorded as being high. The common anecdotal evidence from an annual Parent Teacher
Association (PTA) meeting held at the school on 24th March 2011 included statements
such as:
Parents in Namasagali are not interested in taking their children to school. The
child has the right to decide when to go to school ...
.. .Girls have become a major source of income for the households through early
marriages while boys spend most of their time fishing to raise money to look after
themselves ...
.. .Namasagali Sub County has the highest number of school dropout. The parents
will hold their children at home especially during. planting and harvesting time.
Chores such as guarding the rice fields against birds. walking cattle to greener
pastures, fetching water and cooking are mostly done by children. This
contributes to high rates of absenteeism ...
28
3.3.1 Inclusion Criteria
The study sample included pupils aged between 6-18 years of age whose
parents/guardian gave consent and pupils provided assent.
3.3.2 Exclusion Criteria
Pupils who were involved in pretesting were excluded from the study sample. Children
suffering from chronic conditions such as diabetes and HIV /AIDS were excluded from
the study.
3.4 Sampling Technique
3.4.1 Purposive sampling
Namasagali Primary School Vias purposively selected because it is the school that CSRL
program introduced a School Feeding Program (solid meal) that is directly benefiting
from the school gardens. NPS is the piloting school; if the cost of school gardening
proves to be lower than the cost incurred by the CSRL donors, scaling up of the program
will be justifiable. Pupils enrolled in the school during the 2012 school year and attended
on a daily basis were selected to participate in the study.
3.4.2 Sample Selection
All pupils in the school during the year 2012 from grade one to grade seven participated
in th is study.
29
3.5 Sample Determination
The total daily attendance in the whole school was 226 at the time of data collection and,
therefore, the whole school population was included in the study. Total comprehensive
sampling was used to examine the entire student population at NPS.
3.6 Study Variables
3.6.1. Independent Variables
The independent variables were the school meal.. composed of whole maize, beans,
collard kales, iodized salt and oil, and the cost of feeding the entire school with produce
from the school garden. Socio-economic factors were considered as extraneous variables
that were controlled during analysis.
3.6.2 Dependent Variables
The dependent variables (outcome variable) in this study were nutritional status stated in
terms of anthropometric indicators like body mass index (BMI) for age and sex. stunting;
dietary intake. morbidity and illness, and the cost of providing lunch to school children at
NPS.
3.6.2.1. The School Meal
The meal composed of whole maize, beans, collard kaJes, iodized salt and oil, and was
prepared and served at school. Each pupil received a portion size of 2S0g of the meal
daily for lunch (Monday to Friday). The portion size of250g (maize to beans ratio of2: I)
yielded 765 kilocalories (amine menu planner). According to the offline menu planner.
30
children aged 6-12 years will require 1850 Kcal per day. During the lunch hour, they will
require one-third (616 Kcal). However, the children attending NPS came from low-
socioeconomic households and the likelihood that meals served at home met the two-
thirds of their caloric needs was very low. Thus, the school meal provided slightly more
than the required one-third to compensate for any inadequacies at home. An analysis of
the meal served at NPS was done to establish its nutrient composition and 24hour recall
was used to establish what the children had eaten at home.
To determine the impact of the meal on nutritional status and dietary intake, the school
meal was analysed for nutrient composition. A sample of the meal was analysed at
Makerere Universitys Department of Food Science and Technology Laboratory using
Association of Official Analytical Chemist (AOAC) methods (2005).
3.6.2.2. Collection and Preparation of the Sample
All ingredients for the meal were transported from the school to the laboratory in their
raw and dry form to protect the sample from the changes in composition, possible loss of
nutrients and contamination. The school meal was prepared in the Makerere University's
Department of Food Science and Technology Laboratory using the same procedures as
on site. Maize and beans in the ratio of 2: J (200g and IOOg respectively) were soaked
separately overnight and then boiled the next day for a period 3 hours. The maize was
boiled first until soft and then the beans were added. Once cooked, vegetable oil (20g).
iodized salt (4g) and collardlkales (20g) were added, and the mixture cooked for a :2
31
minutes. The mixture was then left to cool and then grounded using a blender into a fine
uniform consistency. The blended sample was then analysed for moisture, protein. energy
fat, ash, vitamin A, iron and iodine. The ground paste was then used to determine the
proximate analysis of the meal and the micronutrient content using the AOAC method
(2005). All proximate components were analyzed in triplicate and reported as mean on %
wet weight basis.
3.6.2.3. The Moisture Content
Moisture content was determined usmg the oven drying method. Five grams of
homogenized sample were accurately weighed out in triplicate in a clean. dried crucible
(WJ). The crucible was allowed in the oven at lO5°C for 3 hours until a constant weight
was obtained and to avoid the loses of volatile components. After 3 hours of drying the
crucibles were placed in a desiccator for 30 minutes to cool. After cooling it was weighed
again (W2) the percentage moisture content was calculated using the formula:
%Moisture content= (WJ -Wz)x 100
Wt. Sample
Where:
W1= Initial weight of crucible + sample
w2= Final weight of crucible + sample
Note: Moisture free samples were used for further analysis of crude protein. Ash.
fats/oils. iodine. vitamin A and iron.
32
3.6.2.4. Crude Protein
Protein in the sample was determined by Kjeldahl method. The samples were digested by
heating with concentrated Sulphuric acid (H2S04) in the presence of a digestion mixture.
The mixture was then made alkaline. Ammonium sulphate thus formed, releasing
ammonia that was collected in 2% boric acid solution and titrated against standard 0.05M
Hydrochloric Acid. Methylene blue and methyl red was used as indicator. Total protein
was calculated by multiplying the amount of nitrogen with appropriate conversion factor
(6.25).
Percentage crude protein content of the sample was calculated using the following
formula:
% Crude protein =6.25*x %N (Correction factor)
%N= (S-B) xNxO.OI 4xDxl 00
Wt. of Sample x V
Where:
S=Sample titration reading
B= Blank titration reading
N= Normality ofHCL
D= Dilution of sample after digestion
V= Volume taken for distillation
0.0 14=Milli equivalent of weight Nitrogen
33
3.6.2.5. Crude Fat Content
Crude fat content was determined according to the soxhlet method (AOAC, 2005).
Triplicate weights of 5g sample were accurately weighed into a thimble. 1-1.5g of sand
was added to the sample and mixed using a glass rod. The glass rod was then wiped with
a cotton wool and the cotton placed on the top of the thimble. The thimble was then
inserted in a soxhlet liquid/solid extractor and was exhaustively extracted for 6 hours in
Soxhtec systems apparatus using petroleum ether (b.p. 40-60 "C) as the extractant. The
extractant in the flask was then placed in an oven at 102°c and the contents dried for 1-2
hours until a constant weight was reached. After 2 hour the contents in the flask were
cooled in a desiccator and contents weighed after. The % crude fat was calculated using
the formula:
% Crude Fat= (W2-WI) xl 00
S
Where:
WI= weight of empty flask
W2= weight of flask and extracted fat (g)
S=Weight of Sample.
3.6.2.6. Ash Content
Ash content was determined by incinerating the sample for 12hours in a furnace at
550°C. 2g of dry sample was weighed in triplicates in pre-weighed crucibles. The
34
crucible was then placed in a muffle furnace set at 550°c for 8 hours until sample became
completely free from carbon and appeared as light gray or white.
The furnace was then turned off to allow the sample to cool. The partially cooled crucible
was then transferred into a desiccator and allowed to cool at room temperature. The
percentage ash was then calculated using the formula below:
% Ash Content= Weight of residue xl 00
Weight of Sample
3.6.2.7. Iodine Content
The iodine content of the sample was determined using the Iodometric titration method.
Ten grams of sample was weighed in triplicates into 250ml flasks with a stopper. 30 ml
of water was added and flask swirled to dissolve the sample. Water was then added to
make volume up to 50 ml. afterwards; lrnl of 2N Sulphuric acid (H2S04) was pipetted
into the solution. Five milliliters of 10% potassium iodide (KI) was then added into the
solution. The solution should turn pale yellow in the presence of iodine. The flask was
then stoppered and put in the dark (cupboard or drawer) for 10 minutes. After 10 minutes
the solution was then titrated against 0.005M sodium thiosulphate until the solution
turned pale yellow. 2ml of starch indicator solution (solution should turn dark purple)
was added and titration continued until the solution becomes pink and finally colorless.
The level of sodium thiosulphate in the burette was recorded and converted to parts per
million (ppm) equivalents to the content of iodine at that level.
35
3.6.2.8. Iron Content
Iron content of the sample was determined usmg the atomic absorption
spectrophotometer. The food sample (2.5g) was weighed and placed in a crucible. The
crucible was heated for about 20 minutes with a hot burner flame until the food sample
was well charred and stopped smoking. The sample was then ashed in a furnace at a
temperature of 550°C until ash turned white. The crucible was then allowed to cool and
the contents transferred to a small beaker. 10 ml of 2.0 M hydrochloric acid was added
into the. sample and stirred for one minute. Ten milliliters of distilled water was also
added and stirred well to mix. The mixture was then filtered and 2.5mls of O.IM
potassium thiosulphate added to the filtrate. Using a spectrophotometer (Shimadzu AAS,
AA-6300) at a wavelength of 458 nrn, each standard solution and the sample was placed
into a separate cuvette and the absorbance of each solution measured. A standard curve
constructed by plotting concentration of standard solutions vs. absorbance was used to
determine the iron OH) concentration of the samples.
3.6.2.9. Vitamin A Content
Vitamin A content was determined by a photometer using light emitting diode (LED)
technology. 5g of the previously crushed sample was weighed into a I litre flask. 20ml of
50% NaOH solution was added to the sample and the mixture warmed in a water bath at
90°C. 100ml diethyl alcohol and 2ml of hydroquinone solution was also added and the
water bath maintained at 90°C for 30minutes. The contents were then poured into a
decanting vial and lOOmls of water added followed by 50mls of ethylic ether and content
mixed uniformly by shaking. 50mls of petroleum ether was added to the mixture and
36
allowed to decant. Extraction was done twice with 50mls of petroleum ether. The ether
phase was then washed three times with lOOmls of water. The mixture was then filtered,
evaporated and concentrated until lml was obtained. Total carotenoids content was
determined using the Harvest Plus method and using the Spectrophotometer (Shimadzu
AAS, Model AA-6300) to read of the absorbance of the Carotenoid at the wavelength
450nm this value was then converted to Vitamin A by dividing withl2 conversion factor.
3.6.2.10. Energy Content (Bomb Calorimeter)
The energy content was determined using the bomb calorimeter method. About ] g of
dried sample was weighed in a crucible with a piece of cotton wool and then placed
inside a stainless steel vessel (decomposing vessellbomb) filled with 30atm of oxygen.
The bomb was then placed in a calorimeter bucket containing 1.2litres of water. The
sample was then ignited through the cotton thread connected to an ignition wire inside the
bomb and was burned (combusted) at JOOODc.The heat created during the burning
process was recorded using a thermometer in the calorimeter at intervals of 3minutes
until a stable maximum temperature was reached. After calibrating the bomb with the
sample of a known heat, then the amount of energy needed to heat up the water by 1 DC
was known and this unit displayed the amount of energy inside the sample in units of
joules or BTU per gram. This was the physical calorific value.
37
3.6.3 Cost Description of Producing Crops from the School Garden
The produce from the garden consisted of collards (kales) that were added to the meal. In
addition a high-value crop, grain amaranth and tomatoes were produced throughout the
year and sold to purchase maize and beans from the local farmers and oil and salt from
the local market. These food products were prepared at the school as part of the school
meal. The cost of producing these crops was determined by taking the costs of inputs and
outputs from the school garden. The cost of all inputs and outputs were determined
through recording during the actual crop production process. Costs were standardized to
an acre for purposes of analysis. The costs were then calculated in terms of cost of the
each food crop grown and the total cost determined and separately the cost of running the
SFP before the introduction of school gardening programme to make it easier to draw
comparisons.
3.6.4 Socio-economic Factors
Other variables of interest including household characteristics like socio-economic
factors associated with the caregiver were also included in the study and controlled for
during analysis. Variables of gender. the age of the caregiver, education. household
income, proxies of wealth in terms of household assets, land size, were obtained through
the questionnaire.
38
3.6.5 Dependent Variable
The dependent variables (outcome variable) in this study were nutritional status stated in
terms of anthropometric indicators like Body Mass Index (BMI) for age and sex,
stunting; dietary intake, morbidity and illness, and the cost of providing lunch to school
children at NPS.
3.6.5.1 Anthropometric Measurements
Indicators such as BMI-for-age and stunting ratios were used to assess the child's
nutritional status. Anthropometric measurements of weight, height and age in months and
sex for each child were obtained. These indices were compared to WHO (2006) reference
standard for stunting, wasting and underweight for a child at that particular age.
Household factors likely to influence nutritional status were obtained through interviews
and controlled for in the analysis.
3.6.5.1.1 Weight Measurements
Weight measurements were obtained using the method described by Lee and Nieman
(2013). A platform beam balance scale accurate to O. J kg was used 10 obtain the pupils'
weights. The pupil stood in the middle of the scale. which was placed on a flat surface
and their weight taken barefoot but with the school uniform. To check for accuracy and
reliability. three consecutive and independent readings were taken. The school uniform
was then weighed. and the weight deducted from the readings.
39
3.6.5.1.2 Measuring of Height
Standing height of the pupils was recorded to the nearest 0.1 centimetre (cm), with the use
of a stadiometer. The individual to be measured stood bare feet or in thin socks with the
body leaning against a vertical board (WHO, 1995). The individual was required to stand
heels together, arms hanging freely at the sides, and head. back, buttock, heels in contact
with the vertical board and the head positioned so that the eyes were looking parallel to
the headboard to avoid parallax error. The horizontal headboard was then brought into
contact with the uppermost point on the individual's head. To check for accuracy and
reliability, three consecutive and independent readings were taken.
3.6.5.2 Dietary intake
The adequacy of nutrient and caloric intake for children between 6-18 years was
expressed as the proportion of the Dietary Reference Intakes (DRIs) according to the
National Academy of Sciences (2002). The dietary intake at home was determined by
food frequency questionnaires and 24-hour recall. Local compositions tables were
incorporated during analysis.
3.6.5.3 Cost Description of School Lunch Sustained by School Garden
Cost Description of the school lunch in terms of feeding was provided in two ways. The
total cost of feeding using harvest from the garden and the total cost of feeding the entire
school using food purchased from the local market by the program.
KENYATTA U~JlVERSJTY LIBRARY
40
The initial price of all inputs for the school gardens was obtained. This included the
seedlings, fertilizer, herbicides, organic manure and labour used for cultivation. This was
compared with prices for all the ingredients if purchased and supplied to the school by
. the program. The cost of producing in the school and purchase of food items by the
program was obtained and compared in this study.
3.7 Data Collection Technique
3.7.1 Socio-Demographic Data
A semi-structured questionnaire was used to obtain demographic and sociai-economic
information of the pupils' ages 6-18 years old. The pupils gave directions to their homes
and the research assistants administered the questionnaire (Appendix JI) to their
mothers/caregivers. Socioeconomic and demographic information, such as age, sex, and
class of the child and parents/guardians information such as marital status, educational
level, age, occupation was collected. Data on type of house, fuel used for cooking and
lighting and assets at home was also collected during the home visitations by research
assistants. Anthropometric data on weight. height and age in months was obtained from
the study population.
3.7.2 Dietary Intake
A food frequency questionnaire was also administered to determine the consumption
frequency of each type of food based on the num ber of times it is eaten per day in a week.
Also. a 24-hour recall was used to capture the daily food consumptions of the index
41
children from home and out of school. In the 24-hour recall method, subjects (aided by
the care givers/parents) were asked by the dietitian, trained in interviewing techniques, to
recall the subject's exact food intake during the previous 24- hour period or preceding
. day. The respondents were given the opportunity, without suggestion, to provide detailed
descriptions of all foods and beverages consumed, including cooking methods and brand
names. Twenty-four-hour recalls can be obtained on single or multiple occasions. Recalls
of actual food consumption during the previous 24 to 48 hours are the most reliable, with
the maximum period thought to be a month. The 24-hour recall method is easy to
administer, economical, and is not dependent on the literacy of the respondent. Other
advantages include: the time required to administer is short, respondent burden is low so
compliance is generally high: data obtained can be repeated with reasonable accuracy.
Limitations include the following: Individual diets vary daily, so a single day's intake
may not be representative: an experienced interviewer is required; selective forgetting of
foods such as liquids, high calorie snacks, and fat occurs; reported intake may not be
actual but what the interviewer wants to hear; and the tendency to over-report intake at
low levels and underreport intake at high levels of consumption, leading to "flat slope
syndrome" with reports of group intakes. A single 24-hour recall was most appropriate
for assessing average intakes of foods and nutrients because of the large group (226).
42
3.7.3 Anthropometric Data
Anthropometry information of interest in this study included weight and height for the
index children. TIle tools used to collect the data included bathroom scale (weight) and
height board/stadiometer for taking height. Height of the children was taken while
standing on a horizontal ground and without shoes, then the measurement were read out
and recorded by the assistant in meters to the nearest 0.1 cm. The weight of children was
taken with the participant standing upright on a weighing bathroom scale. While taking
the weight, the children were also asked to remove excess clothing. The weight taken was
recorded to the nearest 0.1 kg.
3.8 Data Quality Control Assurance
To ensure the quality of data collected, the researcher took some steps including training
data enumerators and pretesting of the questionnaires.
3.8.1 Training of Enumerators
Two research assistants were trained for one day on how to conduct the face-to-face
interviews at household level and also how to obtain anthropometric data. The purpose
and objectives of the study were also explained to them.
, 3.8.2 Pretesting of Study Instruments
The instrument was pre-tested at NPS with a small sample of the children. A pilot study
using 10% (n=25) of the respondents was identified and followed to their homes, where
43
their parents were interviewed. The results were analyzed, and the few defects that were
observed in the instrument were corrected and changes implemented before the actual
data collection exercise. The result of analysis of the pre-testing sample was excluded
from those ofthe main study. The researcher did not select a subset of the pretesting
study population from a different school because NPS is a piloting school into the school
gardening program, and, therefore, the characteristics of its pupils are dissimilar to those
of any other neighbouring schools.
3.8.3 Validity
Two nutrition specialists examined the questionnaires for the study; feedback provided
and this was integrated into the final questionnaire.
3.8.4 Reliability
The test re-test method was used to check for consistency in producing the same results.
Twenty pupils comprising the pretest sample were randomly selected from a neighboring
school and interviewed at the household level. After a week. the same respondents were
visited and interviewed again to establish whether the responses obtained each time by
the same tool were similar. The responses from the first interview and the second
interview were then compared and areas of the tool found to have discrepancies were
adjusted accordingly.
44
3.9 Data Analysis
Raw data was crosschecked for completeness and correct labeling daily. Data was then
entered in an excel spread sheet and exported to SPSS and Nutri survey where subsequent
descriptive and statistical analyzes were done on dietary and anthropometric data. Local
food composition tables were used when analysing data using Nutri Survey. Local foods
with their nutrient composition were added to the list provided in Nutri Survey software.
The prevalence of stunting and wasting was statistically obtained using the World Health
Organization's Anthro Plus version 1.0.2 statistical software (WHO, 2012). Analyzes of
the social demographic data were performed using SPSS version 17 and descriptive and
inferential statistical analysis of the data was computed. Variables including distribution
of pupils per class and by gender, demographic characteristics of principal caregiver, crop
and animal enterprise distribution per household, housing characteristics and hygiene and
sanitation were analyzed.
Laboratory analysis of the school meal was also determined and macro and
micronutrients analysed included: calories, proteins, lipids, vitamin A, iron and iodine.
Cost of producing and providing the meal at school was also computed and a comparison
done on different levels of contributions towards the SFP: including parents. school
garden and program contributions. A higher level of cross tabulations and correlation test
on the three hypotheses was done for further analysis and P<0.05 was used to determine
statistical significance.
45
3.10 Ethical and Logistical Consideration
Approval to conduct this research was obtained from the Graduate school Kenyatta
University, Nairobi. Ethical clearance was sought from the Ethical Board at the College
of Health Sciences Makerere University ~Kampala. Permission to conduct the study was
also obtained from the Uganda National Council of Science and Technology (UNCSD.
In addition permission to conduct the study was obtained from the Resident District
Commissioner ofKamuli District who is a representative of the Office of the President in
the district. Local authorities that govern the community in which the school is situated
gave a written consent for the study to be conducted at the school.
A written consent from the school administration was obtained after all relevant
documents from the district, and the UNCST were presented to the school head teacher.
The parent! guardian signed a written consent form while the pupils gave their assent to
take part following a meeting where the purpose and objectives of the study were
explained to them. Participants were informed that there would be no risk if they took
part in this study and that their participation is entirely voluntary, and they could
withdraw from the study at any time if they wished. The participants were also made
aware that all their responses were to be kept confidential and only accessible to the
researcher. Any names on the interviewing 1O01 were not made public and were not
included in the data entry and analysis. The participants were also assured that refusal to
take part in the study will not affect the usual services that the child receives at school.
Records identifying the participants have been kept in a secure location and confidential
46
to the extent permined by applicable Jaws and regulations and will not be made publicly
available.
47
CHAPTER FOUR: RESULTS
4.1 Introduction
Results of the descriptive and inferential statistical analysis of the data and their
interpretation as per the objectives are presented in this chapter. Results are reported and
discussed in six sections: demographic and socio-economic characteristics of the
respondents; dietary intake of the of the children in NPS, nutrient composition of the
school meal (nyoyo), nutritional status of the children in NPS, and comparisons of the
costs incurred by donors in running the school feeding before and after the
implementation of school feeding program and finally multivariate analysis to show
correlation between different variables ofthe study.
4.2 Demographic and Social Economic Characteristics of Pupils and Caregivers
A total of226 pupils with their parents took part in this study and data analysis was done
on 226 respondents. Out of all the pupils assessed, J 14 (50.4%) were boys, and 112
(49.6%) were girls. The mean. mode and the median age for the pupils' were 10.7± 2.4
years, 12.9 years and 10.9 years respectively as shown in Table 4.1.
Table 4.]; Mean, Mode and Median Age in Years for Pupils at NPS
N=226 Age in years
Mean
Median
Mode
Maximum Age
Minimum Age
10.7±2.4
12.9
10.9
18
5.4
48
The frequency of distribution of the pupils by percentage per class is shown in Table 4.2.
According to Table 4.2, Grade five had the highest number of pupils 20.4% (46)
participating in the study while grade seven had the least number of pupils 8.4% (19)
taking part in the study.
Table 4.2: Frequency Distribution of Participating Pupils by Class and by Gender
Class Frequency Frequency distribution by Percentage
(n) Sex (%)
Male Female
Grade 1 36 21 15 15.9
Grade 2 36 16 20 15.9
Grade 3 26 13 13 11.5
Grade 4 36 24 12 15.9
Grade 5 46 25 21 20.4
Grade 6 27 8 19 11.9
Grade 7 19 7 12 8.4
4.2.1. Distribution of the Caregivers by Marital Status
The majority of the pupils came from male-headed households 187 (82.7%) with most
principal caregivers being the mothers 193(85.4%) (Table 4.3)
4.2.2. Distribution of the Caregivers by Age
Most of the pupils came from homes where the parents were married (86.3%) with the
majority of the caregivers being in the age group of 31-45 (54.0%) as indicated in Table
4.3.
49
4.2.3 Distribution of the Caregivers by Level Education
In regard to education, slightly more than half (59%) of the caregivers at NPS had
attended school, of whom, the majority (58.1 %) were male. Findings of study found out
that of the respondents who had attended school, most (50.4%) of them had attended
primary school education as indicated in Table 4.3.
Table 4.3: Demographic Characteristics of the Principal Caregiver
Variable Frequency Percentage
Principal care giver
Mother 193 85.4
Grandmother 18 8.0
Aunt 5 2.2
Others (F ather) 10 4.4
Occupation
Casual Labourer 7 3.1
Housewife 15 6.6
Fanner 200 88.5
Others 7 1.8
Marital Status
Single 18 8.0
Married 195 86.3
Separated 10 4.4
Divorced 3 1.3
Education Level
None ] 8 8
Primary ] ] 5 50.8
Secondary 93 41.2
Age
20-30 vear 36 38.0
31-45 years ]22 54.0
46-55 years J3 5.8
Above 55 years 5 2.2
Sex of household head
Male ]87 82.7
Female 39 17.3
50
4.2.4 Social Economic Characteristics of the Caregivers at NPS Participating in the
Study
The study examined the socioeconomic characteristics of pupils' households such as
occupation of caregiver, housing characteristics, ownership of consumer goods and the
source of cooking fuel.
4.2.4.1 Type of Occupation of Caregivers of Children at NPS
Majority (88.5%) of the caregivers of children at NPS were small-scale farmers
(peasants), 6.6% house wives, and 3.1% casual laborers. The peasants group mainly grew
crops and reared animals. The study found that there was an emphasis on food crops,
cash crops. and vegetables, though in small scale. The three predominant food crops
grown by the household of the NPS pupils was mainly maize (97%), sweet potato (8]%)
and cassava (75%). "Posho" (maize meal stiff porridge) and sweet potatoes were the
main traditional staples/food crops consumed by predominant ethnic group Basoga
residents in Kamuli District as shown in Figure 4.] . These findings are in agreement with
those of the Uganda Bureau of Statistics that indicated that major crops grown in rural
Uganda are maize, cassava (Uganda Bureau of Statistics. 2009).
5]
Percentage of households growing crops
ID Rice,5%
ill Simsim, 10%
!\i Banana. 12%
i!I Groundnuts, 17%
g Soy bean, 24%
li'j Millet,36%
m Beans. 64%
IT Cassava. 75%
m Swcetpotato, 81%
~~~~~@~t~~~~~~~~~W~~_~~F£0~~~~~mlfWM~~~~~~~j~~~'~"".e,97%
Figure 4.1: Percentage of Household Growing Crops
With respect to animal rearing, the investigator found out that most commonly reared
animals by the households were poultry (65%), goats (54%) and cattle (49%). These were
mostly local breeds domesticated by the household. This observation agree with Uganda
Census of Agriculture 2008/2009 Volume iv which indicated that local poultry, goats and
cattle breeds were mostly reared in Kamuli District and other rural areas of Uganda
(Ministry of Agriculture, Animal Industry & Fisheries. 2008). Figure 4.2 shows the
percentages of household. which reared animals.
52
Percentage of Households Rearing Animals
Ill! Poultry. 65%
III Goats, 54%
III Cattle, 49%
I
\..... ..•......._ _ .........................•..... _ ......•..................•..•...........•..
u Pigs, 9% III Sh 70/eep, /0
tilt Others, 1%
Figure 4.2: Percentage of Households Rearing Animals
4.2.4.2 Housing Characteristics and Fuel Use by Households of Children at NPS
The housing characteristics of the pupils' dwellings were established as a proxy indicator
•
of their wealth and socio-economic status (Table 4.4). This was hoped to have
implications on the capacity of the household to provide the basic needs for the pupils.
Temporary structures such as mud houses are an indicator of low standards of living.
Some of the indicators included in this study were: house ownership. the type of material
used to build the house. number of rooms in the house, number of household members
living in the house. fuel used for cooking. source of water. type and ownership of toilet
and bathroom. The majority of the pupils lived in houses owned by their parents 218
(96.9%), with most of the houses having two rooms and shared by an average of 7
members. These findings are in agreement with the Uganda Bureau of Statistics (2014).
which revealed that housing in the rural areas. is a problem characterized by
overcrowding to an average of six or more people per room. The predominant floor type
53
in the houses was mud 177 (78.3%) while the most common roofing material used was
grass as reported by 147 (65.0%) of the respondents. Firewood 2] I (93.4%) was the most
common type of fuel used for cooking while kerosene was the main source of lighting
used 2] 8 (96.4%) as shown in Table 4.4.
54
Table 4.4: General Characteristics of the Study Household
Variable Frequency (n=226) Percentages (%)
Type of Household
Rented 4 1.8
Owned 2]8 96.9
Others (staff housing) 8 1.3
Type of Roof:
Iron sheet 79 35.0
Grass-thatched ]47 65.0
Disposable material 0 0.0
Others 0 0.0
Type of Floor:
Cement 17 7.5
Mud floor 177 78.3
Mud floor with dung 28 12.4
Earth 4 1.8
Others 0 0.0
Cooking fuel
Kerosene 3 2.2
Electricity 0 0.0
Charcoal ]0 4.4
Firewood 211 93.4
Others 0 0.0
Source of lighting
Electric 0 0.0
Kerosene 218 96.9
Solar 4 1.8
Candle wax -, 1.3-'
Others 0 0.0
Number of rooms:
1 room 40 17.7
2 rooms J04 46.0
3 rooms 44 19.4
4 rooms 35 15.5
Number of household
members
4-5 members 63 27.8
6-7 members 78 34.5
8-10 members 62 27.4
11-16 members 14 6.2
55
4.2.4.3 Ownership of Land and Household Durable Consumer Goods
Generally, income is not a reliable estimate for economic status in developing countries
(Howe et al., 2008). As such, the researcher sought to establish ownership of household
goods and assets as an indicator of economic status of the households in the study. The
most valued asset in this community was land because farming was the main activity
practiced at the pupils' homes; land is an essential asset supporting any form of farming.
The study results revealed that the majority (96.5%) of the respondents owned land.
Ownership of household durable consumer goods among the caregivers in the study was
as follows: bicycle (95.1 %), radio (94.7%) and mobile phone (82.7%). These
observations are in agreement with those by Uganda Bureau of Statistics (20]4)
provisional results that cited land, bicycles, radio and cell phones as the most popularly
owned assets in Uganda. The bicycles are used by most of the household as a mode of
transport and a means of ferrying/carrying goods. The radio is also seen as the media to
receive information.
Percentage ownership of Assest at household level
v Land.96.5% "i Bicycle. 95.1%" Radio. 94.7% I!! Mobile phone.
82.7%
" Motorcycle.
12.-1°;',
Figure 4.3: Percentage Ownership of Assets in the home
56
4.2.4.4 Water, Hygiene and Sanitation Characteristics of the Households of Children
atNPS
Provision of safe water and sanitation is very crucial for improving the quality of life of
any community. The source of water, presence of pit latrines and bathroom coverage
were some of the factors taken into consideration in this study. These will have an effect
on the health and nutrition status of a person. The major source of safe water supply in
Namasagali was the boreholes and the majority (88.9%) of the pupils used borehole
water, for home consumption. Most of the households owned pit latrines (92%) with the
traditional pit latrine being the most common toilet (95.1 %) used by the pupils at home.
The use of bathrooms was also very high with 91.2% of the households having
bathrooms as indicated in Table 4.5.
Table 4.5: Water, Hygiene and Sanitation Characteristics of the Households of
Children at NPS
Variable Frequency Percentage
Source, of water
River/spring/swamp 14 6.2
Borehole/well 20] 88.9
Rain/tank 7 3.1
Tap 4 1.8
Others 0 0
Toilet
Traditional pit 2]5 95.1
Ventilated Improved Pit 5
(VIP) 6 2.2
No pit 2.7
Ownership of toilet 209
Own use ] ] 92.5
Communal use 6 4.8
Not applicable 2.7
Bathroom
Yes 206 91.2
No 20 8.8
57
4.3 Nutritional Content of the Meals Taken at NPS under the School Feeding
Program
The nutrient content of the meal consumed at the school was determined through a
laboratory analysis at the Makerere University Department of Food Science. From the
analysis the energy content of the school meal was 341kcaL Protein was 12g, Fat was
0.8g, Iron was 0.0195ug, Vitamin A was] 6.7] 5ug Retinol Activity Equivalent (RAE)
and the Iodine content was 0.0037ug. Laboratory results after analysis on the school
lunch are as presented in Table 4.6.
Table 4.6: Nutrient Content of School Lunch at NPS (Maize, Beans and Collard
Kale "Sukumawiki")
Parameter measured Unit
(100g)
measure Results Sample Content
Energy
Protein
Fat/oil
Vitamin A
Iron
Iodine
Kcal
G
G
flgRAE
flg
gg
341
12
0.8
16.715
0.0195
0.0037
This results are similar (with the exception of Vit A and iron) when the composition of
the school meal is estimated using the online menu planner: it yields 306 Kcls, 1] .666
grams of protein, 3.3 grams of fat, I.083ugRAE of Vit A. Fe 3.97 I1g.
4.4 Dietary Intake of the Children in Namasagali Primary School
The type of food consumed by the respondent in the past 7 days was obtained using a
food frequency questionnaire while the 24 hour recall was used to obtain information on
58
the quantity of all foods and drinks consumed by the respondent in the last 24hours of the
previous day.
4.4.1Dietary Intake as Reported by the Food Frequency Questionnaire
The researcher visited the homes of each child and during the interview in the presence of
the caregiver different foods from the various food groups were read to the pupil who in
turn had to respond by stating the number of times he/she consumed that food in a week.
Results indicated that groundnuts (42.8%), beans (35.4%), soybeans (30.2%) and silver
fish (50.0%) were the main source of protein among pupils in the household. The
households consumed more plant protein sources compared to protein from animals and
animal products. The most common animal source protein was silver fish, which was
consumed at least 3days in a week by most households. The most common cereal
consumed was 'pasha' (maize flour) 62. J % and the most common root tuber among the
household was white sweet potatoes (65.3%). Fruits were consumed mostly on seasonal
basis and mangoes (22.5%), jackfruit (19.7%). papaya (J 9.1%) and oranges (13.8%) were
the most common fruits eaten by the pupils. The most common vegetables (greens) eaten
by the pupils at home were the eggplant (24.1 %). tomatoes (27.9%). and leaf amaranth-
(26.3%) Table 4.7.
59
Table 4.7: Frequency of Consumption (%) of Selected Foods by Households in the
Preceding 7 days
Food Group Frequency of consumption
as percentage (n=226)
Cereals roots and tubers
Sweet potato
Maize
Cassava
Millet
Rice
65.3
62.1
31.9
25.0
13.4
Animal source protein
Meat (Beef)
Silverfish
Fish
Eggs
Milk
Plant source protein
Soy bean
Beans
Groundnuts
Mushroom
Vegetables
Leafamaranth (do do)
Tomatoes
Eggplant
Cabbage
Fruits
Mangoes
Oranges
Pawpaw
Jackfruit
7.0
50.0
22.4
4.9
9.0
30.2
35.4
42.8
1.3
26.3
27.9
24.1
9.0
22.5
\3.8
19.1
19.7
60
4.4.2 Macro and Micronutrient Intake by the Pupils in the Preceding 24-hour
From the 24hour recall data the study indicated that the mean average consumption of
energy, protein, fats, vitamin A, Iron and Iodine was 218 ± 133 kcal, 3.79 ± 3.77 g, 1.54
± 1.55g, 43.75 ± 35.33ugRAE, 0.1 54±0.110ug, 0.0088 ± 0.0050 ug respectively (Table
4.8). Table 4.8 also shows the total consumption per day for the pupils from school and
home in terms of energy, protein, fats, vitamin A, iodine, and iron was 1071kcal, 33.79g,
3.54g, 85.54 ug retinol, O.Ol78ug and 0.6415 ug respectively. This represent % of the
RDA; the pupils did not meeting their Recommended Dietary Allowance (RDA) for
energy and protein.
Table 4.8: Consumption of Nutrients at Home and School
Nutrient Home School Lunch Mean RDA
consumption Intake/day
Energy kcal 218±133 853±178 ]o7l 2000-2200
Protein (g) 3.79±3.77 30±14 33.79 40-46
Fats (g) 1.54±1.55 2±0.5 3.54 >23
VitaminA 43.75±35.33 41.787±25.3 85.54 400-600
(ugIRAE)
Iodine (ug) 0.008±0.005 0.0098±0.003 0.0178 120-150
Iron (ug) 0.154±0.110 0.0488+0.07 0.6415 10-15
RDAs were adopted from WHO 2006/2007
The percentage contribution of lunch from school and at least two meals from home
(breakfast and supper) for a particular nutrient according to age category are as indicated
in Table 4.8. The lunch at school significantly contributed to the pupils RDA as seen
from the table 4.4.2. At home, the pupils received less of the nutrient for their age with a
large percentage of nutrient consumed being obtained from the school lunch. Most pupils
61
came to school without taking breakfast, and this would have an impact on their RDA
and overall nutritional status.
The meal served at the school contributes 853kcal for the pupils per day. The school
feeding program at NPS provides one meal in the form of a solid lunch to the 226 pupils.
According to WFP, for a day school, school-feeding lunch should provide between 30-
45% of energy for the pupil per day (WFP, 20] 0).
4.5 Nutritional Status of the Children in NamasagaJi Primary School
The prevalence for the respective anthropometric measurements taken Body Mass Index
for age and the stunting at baseline indicated that 1.5% and 13.4% of the pupils had a low
Body Mass Index for Age and stunted respectively. After introducing the SFP. the
prevalence for chronic malnutrition among the pupils did not change much. BMl-for-age
and stunting ratios were reported as 1.8 % and 13.4 % respectively. indicating that the
SFP did not have much of an impact on the pupils' nutrition status. The proportion of
stunting (height-for-age) and BMl-for- age are as shown in Table 4.9:
62
Table 4.9: Prevalence for BMI-for-age, Height-for-age z scores in 2012. Sex
disaggregates data
Female Male Total
(n=l 12) 95% Cl (n=114) 95% Cl (n=226) 95% Cl
Stunting (Height- 13.3 (7.6-20.9)
for-age)
Low BMI-for-age 0 (0-3.2)
(thinness)
] 3.5 (4.5-28.8) 13.4 (6.3-24.0)
3.5 (1.0-8.8) 1.8 (0.5-4.5)
4.6 Morbidity and Illness among the Pupils
Forty-one percent of the pupils reported falling sick in the previous two weeks prior to
data collection. The most common illness reported were malaria (48%), acute respiratory
infections (23%), diarrhoea (12%), stomach ache (6%) and skin infections (12%) (Figure
4.5).
KENYATTA UNIVERSITY LIBRARY
63
Malaria
ART!
48%
Diarrhoea
Skin Infection
0% 10% 20% 30% 40% 50%
Stomach ache •• 6%
60%
Figure 4.5: Percentage of Pupils Sick in the Last 2 Weeks
When the pupils fell sick, the majority of the caregivers 200 (88%) took them to the
health Centre (average distance of 2km from the home) to seek medical attention (Table
4.10).
Table 4.10: Health Seeking Behaviour by the Caregivers when the Child falls Sick
Frequency Percentage
Steps took when child falls
sick
• Rush to health 200 88.5
Centre
• Self-medication 24 10.6
• Did not seek
treatment 2 0.8
• Others 0 0
64
4.7 Costing of the School Feeding Program at NPS
The cost of providing the School Feeding Program (SFP) at the NPS depended on several
factors, including the choice of modality, the composition and size of the rations, whether
the food was purchased locally or is shipped in, and the number of beneficiaries and
school feeding days per term (Machocho, 2011). Parents and community members
contributed food to the lunch program and also donated food was considered coming
from parents, NGOs or other benefactors. Food contributed towards the SFP can be
directly used or sold (monetization) for the purchase of needed items. All these factors
were taken into consideration when costing the SFP at NPS. The cost difference of
having an SFP supported by the program verses the parents and the school gardens
supporting SFP were both taken and comparison done on the two modalities.
4.7.1 Costing Meal per Term
The meal at NPS consisted of maize, bean. vegetables (mostly collard kales), oil and
iodized salt. The meal was designed to feed 226 Children. Maize and beans were mixed
at a ratio of 2:], and then collard kale. oil. and iodized salt added based on the quantities
cooked, Each child consumes 26g of beans and 52g of maize, approximately 20g of kale,
0.6g of oil and 2.2g of iodized salt of raw food products (dry weight) in 100 grams. This
is cooked and is measured using a 250gm cup and served on a plate or any container that
the child brings to school. Food products or ingredients are obtained from the parents.
school garden, and the CSRL program. They are either consumed directly or monetized
to purchase additional ingredients and pay other costs. Stakeholders contributions were
65
monitored closely to determine how much they contributed towards the SfP. The total
estimated cost of feeding 226 pupils for 89 days (1 term) was UShs.
2,288,785 ($915.5) (Table 4.] J)
Table 4.11: Total Cost of providing NPS with Lunch of Maize, Beans and Kales
(Sukuma wiki) for 226 Pupils for 89 Days (One Term).
.Item child/d 226pupils/89 Unit cost Total Total cost
Cost (USD)
(UShs)
Maize 52g 1046 (kg) 600 627,600 251.04
Beans 26g 523 (kg) 2000 1,046,000 4] 8.37
Collards 109 201 (kg) 1000 201,140 80.46
Cooking Oil 0.6mls ] 2 (litres) 6500 78,445 31.38
Salt 2.2lg 89 (pkts) 400 35,600 14.24
firewood ] truck 150,000 150,000 60
Labour 50,000/month 3 150,000 60
Total 2,288,785 915.49
4.7.2 Contribution made to the SLP by the Stakeholders
When the solid high nutrient meal (whole maize and beans mix meal) for SFP was
introduced at the NPS in 2010. the CSRL program was providing all the ingredients for
the meal. In addition. the program paid the cook who was preparing the meal. The
children brought the firewood that was used to cook the meal. At that time, the program
as spending about UShs. 2.288.785 ($915.5) per school term to feed the 226 children who
were eating the lunch (Table -L 11).
66
However, the goal of the CSRL program was to make the SFP lunch sustainable by
linking it to the school gardens and also encourage the parents and the local community
to contribute towards feeding the children. The plan was to have the program continue
when the CSRL program exits from the community. The CSRL program worked with the
parents and the school community to start including parents' contribution and produce
from the garden to provide the meal. Over time, the school has faced a big challenge
obtaining beans from the school garden. Producing beans in the school garden at NPS
remain a challenge because of the poor soil types and climatic conditions related issues
like insufficient rainfall; this is a problem that affects the whole of Namasagali Parish.
Previous attempts to produce beans as an enterprise from NPS garden led to either total
crop failure or very low yields, which resulted in financial losses. Hence, the program
realized producing beans from the school gardens was not a viable venture. Alternative
crops that could be sold to purchase beans had to be identified for cultivation.
Maize can be produced at the gardens, but the yields are still below the expected output
resulting in less than the break-even point. This has been attributed to poor soils and pests
mainly mobile termites that are a problem at the school. The program is working with
other researchers to adopt and adapt technologies that will enhance the maize yield to
make it viable for school gardens. At the moment high-value crops mainly bananas.
vegetables and grain amaranth are the main enterprises being practiced at the school
garden. These crops once harvested are sold, and the funds used to purchase food items
for the SFP. Initially. the program purchased all the ingredients and with little suppon
from the parents and the school community. However. this has since changed, and the
67
gardens are now being used to supplement the SFP, with support from the parents who
are contributing part of the maize used in the school lunch. Table 4.12 and figure 4.6.
show how the SFP was sustained with support from the program in 2010 and 20]] with
parents. program and the school.
Table 4.12: Contribution made by the different Stakeholders towards the SFP in
20)) in NPS
Stakeholders Contributions Amount (Ushs) Amount (US) 0/0
Contribution
Program Garden inputs, 1,435,000 574 27.8%
cook salary
cooking oil,
beans, labour,
land hire.
Parents Maize 766,800 306.72 14.9%
School Garden Grain 2,950,000 1] 80 57.3%
amaranth,
Collards,
Tomatoes
Total 5,152,500 2060.72 lOO
Contribution
68
120% -
100%
100%
80%
60%
40%
20%
0%
Year2011
,.----~A'--_-.,
{ 57% \
28%
Parents GardenProgram 2010 Program
Figure 4.6: Percentage Contribution made by Program, Parents, and School
Gardens in 2010 and 2011
In 20] 0, the program would contribute all food items towards the SFP and spend an
equivalent ofUShs. 2,288,785 ($9] 5.5). In 201 L the program started including proceeds
from the school gardens as a way to supplement the SFP. Parents contributions in kind
(maize) was also received and supplemented in the lunches. The program invested
1.435,000 Uganda shillings (574 US Dollars) in the school gardens in the form of seed,
labor, fertilizer, herbicides and land preparation. This same year the program paid for the
cooks wages and purchased a few kilograms of beans to support the lunch program. The
parents contributed ]278 kg of maize equivalent to 766.800 Uganda Shillings (306.72 US
Dollars). This was more than enough maize needed to feed the entire school. The school
gardens in the end produced an equivalent of 2.9500.000 Uganda shillings (1180 US
dollars) in the form of tomatoes, grain amaranth. and collards. Some of these was directly
used in the lunches of the pupils. and part of it sold to purchase beans.
69
When the nutrient-dense lunch was introduced in 20 J 0, it was supported ] 00% by the
CSRL program. Today, through garden outputs and parents' contributions, the CSRL
program contribution is 27.8 %, with outputs from the gardens at 57.3 % and parents'
contributions at 14.9%. As garden productivity increases through improved horticultural
and pest management practices, the CSRL program contribution toward the cost of the
lunch will continue to decrease. Since part of the output from the garden is reinvested
into the gardens, the overall cost of the school lunch program will be less for the CSRL
·program. The school gardens and the parents' contribution have greatly reduced the cost
of the SLP to CSRL program. These have also improved the quality and diversity of the
school children's diet.
4.7.3 Food Production in the School Gardens
One acre of school land was used to produce three crops each (tomatoes, grain amaranth
and collards). The program invested UShs. I, 107500 ($443) and harvested produce worth
UShs. 2,950, 000 ($1180). which were more than half of the initial capital (Table 4.13).
Collards are the most yielding crop from the school gardens followed by grain amaranth
and tomatoes, 40.7%, 33.9% and 25.4% respectively.
70
Table 4.13: Acreage Planted per Enterprise and the Input and Output obtained
from the School Garden
Enterprise Acreage
planted
Input cost Output
Tomatoes
Grain amaranth
Collards
UShs.387, 500 ($155)
UShs. 432,500 ($] 73)
UShs. 287,500 ($] 15)
UShs.750, 000 ($ 300)
UShs.l, 000,000($400)
UShs.l, 200,000($480)
Total UShs.1, 107,500 ($443) UShs.2, 950,000($1180)
From proceeds of the school garden, UShs. 5,152,500 ($ 206]), the school is able to to
pay for maize ($25]), beans ($4]8), ka1es ($ 80), iodized salt ($]4), firewood ,cooking
oil,and labour ($ 100) and still remain with a balance of $ 978 which can be reinvested to
ensure sustainability of the program. If the school garden must feed the entire school,
then it is important that production areas is expanded to at least two acres and also
improve the productivity. The yield of all the crops produced were below optimum,
which was attributed to poor rainfall, poor soils (CSRL Report, 20] I). The CSRL
program is working with VEDCO and JSU Service Learning program to introduce
technologies likes irrigation. soil fertility improvement and disease tolerant/resistant
varieties to increase productivity. The gardens are therefore a cost effective way of
supplementing the SFP especially if they are expanded in relations to the number of
pupils at the school.
4.8 Relationship between Factors (Demographic and Socio-economic
Characteristics, Dietary Intake, Nutrient Composition of School Meals) and
Nutritional Status of Children attending NPS
Analysis of nutrition status nutrition status (BMJ for age) was done with respect to
demographic and socio-economic. dietary intake, nutrient composition of school meals.
71
4.8.1 Nutritional Status about Demographic and Socio-Economic Characteristic
Table 4.14. Chi square test for selected socio-economic characteristics and nutrient
intake in relation to nutritional status
df P Value
Level of education vs. nutritional status
BMI-for-age 27.25]
Stunting 16.952
Occupation vs. nutritional status
BMI-for-age 44.551
Stunting 42.86
Level of education of parents vs. nutritional status
BMI-for-age 30.931
Stunting 38.928
Marital status of the parent vs. nutritional status
BMI-for-age 9.26
Stunting 29.269
Macronutrient intake vs. nutritional status
BMI-for-age 44.643
Stunting 56.902
No. of rooms for sleeping vs. nutritional status
BMI-for-age 32.094
Stunting 13.982
Main fuel for cooking vs. nutritional status
BMI-for-age 41.911 16 0.001
Stunting 33.065 8 0.001
A significant positive relationship was found in education. occupation and macronutrient
intake
20
10
0.128
0.075
28
12
0.024
0.001
20
6
0.056
0.001
8
4
0.321
0.001
14
20
0.001
0.001
12
4
0.001
0.007
Regression analysis. which was performed to determine the relation between BM] for age
(dependent variable) and demographic characteristics (Table 4.14). yielded the following
equation.
Regression equation: y = 11.294+0.12 J XI + 1.341x~-O.378x3; here XI = Education Status
of parents. x:=occupation of the parents/caregivers. X3= marital status of the parent.
72
The level of BM] age is J] .294 when all other variables are zero. From the equation, it
can be deciphered there exists positive correlation between BMI for age and education
level of the parents such that an increase education level by one unit results in an increase
in BM] for age by 0.12] . If the respondent islhas employed parents, the BM] for age is
likely to increase by ] .34] unlike when the respondent has parents who are not employed.
There was a negative relationship between BM] for age and marital status of the
parents/caregivers of the study participants in which an increase from one category to the
other led to a decrease in BM] for age by 0.378.
4.8.2 Nutritional Status in Relation to Dietary Intake
The researcher sought to determine the association between nutrition status of children at
NPS and dietary intake such as food. There was weak relationship between BMI for age
and number of meals consumed per day (r= -0. 120; p=0.02]). A negative significant
correlation was recorded for the dietary composition of the school meal and nutrition
status (r= -0.0056. p=0.087). This was translated to mean that despite the adequacy of the
school meal it did not still reflect a better nutrition status because of the various other
variables involved.
A chi-square analysis between macronutrient intake and nutrition status revealed a
significant positive relationship between nutrition status (BM] of age and Height for age).
Children who had taken average macronutrients were more likely have better nutrition
status.
73
CHAPTER FIVE: DISCUSSION
5.1 Demographic and Social Economic Characteristics Households of Children in
NPS
This study recruited nearly an equal number of male and female children attending NPS
with a mean age of 10.7±2.4 years. These findings are in agreement with the study by
Wells (2009), which showed that Uganda is rapidly closing its gender parity gap in
primary school enrollment. Age and sex are important determinants of an individual's
nutrition status (Ogden, Carroll & Flegal, 2008). These parameters were instrumental in
the determination of BM I for the age of the study participants.
Demographic characteristics such as age and marital status of parents and/or caregivers
are known to contribute to child wellbeing because such parameters are known to
influence the socio-economic profiles of households. For example, it is expected that
moderately to highly educated household heads hold high paying jobs (better occupation)
having better purchasing power of the basic needs such as shelter, food and medication;
all which can have a positive effect on the childrens nutrition and health status. Contrary
to this households whose heads are poorly educated are likely to engage in subsistence
farming. In this study, the majority were subsistence farmers growing food crops and
rearing a few animals. These findings are in agreement to those of Uganda Bureau of
Statistics in which it was revealed that rural dwellers in Uganda engage in small-scale
farming (Uganda Bureau of Statistics, 2009).
74
Parents/caregiver 's level of education influences their food choices as well as their
economic status occupation. Studies by Miller et al., (2009) and Bradley et 01., (2002)
have shown that educational attainment has a strong effect on health behaviors and
attitudes and thus affecting the nutrition status of the people. This socioeconomic status is
associated with a wide array of health, cognitive and socioemotional outcomes in
children, with effects beginning prior to birth and continuing into adulthood. Mother's
education is strongly inversely associated with stunting (Bradley et al., 2002 and Miller
et al., 2009).
A Study by Faith et al., (2004) revealed that knowledge is a significant factor affecting
dietary practices. This study agreed with those of Faith et al., (2004) assertions because
many parents and caregivers had not attended school. and of those who had only
completed primary school level, a situation that can be attributed to lack of knowledge
among the participants in respect to high stunting levels witnessed among the children at
NPS. Lack of education and therefore knowledge of disease prevention and nutrition
management in the study participants is likely to be one of the chief contributors to poor
nutrition status among children attending NPS.
5.2 Dietary Intake of the Children in NPS
It was hypothesised that the school meal served at NPS consisiting of whole grain cereal;
legume, collards. vegetable oil and salt did not significantly contribute to the daily dietary
intake of caloric and nutrient intake. for the child of between 6-18 years based on the·
RDA. Results from the laboratory indicated that the meal provided a significant amount.
75
of calories (853kcal) and all the other major nutrients (proteins, fats, iron, vitamin A and
iodine; 30g of proteins which is about 68% of the RDA, 2 g of fats, 0.0488ug of iron,
and 0.0098ug of iodine). One of the main meaJs that a person eats in the day is lunch;
and this should provide at least a third of the RDA given their role in ensuring good
nutrition and health for the child (Musamali, 2007). According to the WFP, (2010) a
primary day school feeding programs should supply two meals, a light meal at the start of
the day supplying approximately 400-600kcal and lunch supplying 700-900kcaJ.
Namasagali Primary School provides only lunch with no light meallbreakfast in the
morning. From the study, the amount of calories and nutrients received by the children
from the school lunch is much higher than what the children receive from home. This
may be attributed to the fact that most of the families consume one meal at home (supper)
as coping mechanisms of saving food for later use. TIle school lunch plays a significant
role in its contribution to the overall diet adequacy of the pupils as it contributes more
than a third of the RDA of the nutrients. It is also vital in ensuring good nutrition, which
is important in mental development and consequently good academic performance.
5.3 The Nutrient Quality and Quantity of the Meal Served at NPS
Nutrients of interest in this study were energy. protein. fats. vitamin A, iron, and iodine.
In the analysis. 100 grams of the food for the NPS kitchen yielded. 341 calories, 12
grams of protein, 0.8 of fat. vitamin A 16.71 5ug. 0.0195ug of iron and 0.0037ug of
iodine. This translated to 853 calories. 30 grams of protein, 2 g of fat, vitamin A
4] .787ug. 0.0488ug of iron and 0.00488ug of iodine in servings of 250 grams of the
'riyoyo". Essentiaily. lunch should provide if3 of i850 Kal (616 kcal). In the NPS's case.
KENYATT~~UNI 'ERSllY LIBRARY
76
it provided slightly more than enough. The servings were slightly elevated because these
children come from poverty-stricken households, and there is a very high possibility that
the breakfasts and dinners at home combined Jtlay not meet the remaining 2/3 of the daily
servmgs.
5.4 Nutrition Status of Children at NPS
It was hypothesized that the school meal did not significantly change the nutritional
status of pupils at Namasagali Primary School (NPS). From the results obtained the
stunting and BMJ-for -age levels in this study did not change much after intervention of a
School Feeding Program; an indication that there could have been a spill-over of
malnutrition from childhood to school age. The null hypothesis was therefore accepted.
The majority of the pupils were stunted an indication that the pupils could have suffered
long-term deprivation of food shortage. Lunch contributed significantly to the total daily
caloric and nutrient intake, and this should have translated to an improvement of the
nutritional and health status for the pupils. However from this study the nutritional status
did not change much even after introducing a solid meal at the school that is high in
. caloric and nutrient intake as compared to what they initially consumed (Maize meal
porridge 50kcal). This could also be explained by the fact that most of the pupils who are
receiving lunches at school and also contributing a higher amount of grain towards the
feeding program. were not given enough to eat at home (Personal Communication, 2012).
The parents are normally left in a dilemma of whether to contribute food for the SFP or
use it at home. Normally when the child is given grain to take to school. then his portion
77
is at school and sometimes this child is left to go hungry at home. A higher level of
analysis showed that the girls had a low BMI-for-age compared to the boys while the
boys are much more likely to become stunted compared to their female counterparts. This
can be explained by the fact that girls normally begin puberty at an early age (8-13 years)
as compared to the boys (9-14 years), therefore the physiological changes occurring
"late" in the boys could be a contributor to the possibility of them being stunted more as
compared to the girls. Literature continues to demonstrate that in sub-Saharan Africa, the
male children under five years of age are more likely to become stunted. than females,
which might suggest that boys are more vulnerable to health inequalities than their
female counterparts of the same age groups (Wamani et al., 2007).
The results of this study are in agreement with a similar study conducted in Kenya's
Nyambene District where the SFP did not have any significant impact on the nutritional
status of the pupils (Meerne et al., 20 10). Though there was an improvement in the
nutrient quality of the meal served at lunchtime, this made little or no effect to the
nutritional status of the children at NPS. According to Musamali, 20lO, wasting in school
children can be corrected through SFP and can also prevent severe cases among the
pupils. From this study. we can conclude that the amount of calories and nutrients
consumed by the pupils from the school lunches is much higher compared to what they
receive at home.
78
5.5 Relationship between Factors (Demographic and Socio-economic
Characteristics, Dietary Intake, Nutrient Composition of School Meals) and
Nutritional Status of Children attending NPS
5.5.1 Correlation between Nutrition Status, Demographic and Socio-Economic
Characteristics
The significant positive correlation witnessed between education level and occupation
with BMI for age and height for age points out to the fact that individual demographic
characteristics influence the people nutrition status in different ways. The children whose
parents were educated and had better occupation had a better nutrition status. This was
attributed to the fact that educated parents and employed had higher purchasing powers
of the basic amenities including food, shelter and healthcare. Similar results were
obtained in a study done in Kenya, which indicated that the demographic characteristics
of the parents (higher employment status and higher levels of education) were positively
correlated to children's nutrition status (Mwangi et 01.,2002).
Results from this study indicate that malaria (48%) is the most common illness that the
pupils have been suffering from while attending school. From literature. malaria has been
known to contribute for up to 20% of deaths among the pupils in primary schools and has
remained the leading cause of absenteeism in Uganda (Acham. 20J 0). Diarrhea
incidences among the school going children are much higher among households that have
a traditional pit (95%), and this can be attributed to poor hygiene and sanitation in the
household (Bosch et al. 2002& Quinn. 2009). Diarrhea is one of the common illnesses
that can cause malnutrition among children: because much of the food consumed is lost.
and very little is absorbed. Underweight children are seen to have higher incidences of
79
diarrhea compared to those with normal weights. There is a weak negative correlation
between BMI for age and incidences of diarrhea(R=- 0.123), children with a high number
of incidences of diarrhea have a low BM} for age. Stunting is evenly distributed among
those having diarrhea and those without. Stunting being an indicator of chronic food
insecurity and malnutrition over a long period may not be influenced much by diarrheal
incidences, because it is an indicator of chronic malnutrition over long periods of time
(Kandala et al., 201 n.
5.5.2 Nutrition Status in Relation to Dietary Intake
Adequacy of food for school going children is very critical in the determination of their
nutritional status. However, inadequacies were revealed from the 24hr recalls and food
frequency questionnaires among children attending NPS. Most of the children had little
control of the food they consumed; the decisions regarding food are bestowed on the
school and/or the parents. The results revealed a positive correlation between the number
of food groups chosen and the nutrition status of the respondents. This study finding
agrees with another study done by Mirmiran, Azadbakht and Azizi (2006) in which it was
revealed that people who consumed diversified diets are likely to have a better nutritional
status.
80
5.5.3 Correlaton between Nutrition Status and Nutrient Composition of School
Meals
The study did not find any significant relationship between schools meals and nutrition
status. Comparatively, the school meals provided slightly more than one-third of the
caloric requirements. However, from the 24hr recalls and food frequency questionnaires
done, it was revealed that most children could get the remaining two-thirds from the
meals taken at home.
5.6 Cost of School Feeding at NPS Before and After the Introduction of School
Gardening
The third hypothesis of this study stated that supporting the school-feeding program with
school garden produce did not reduce the cost of providing lunch to the pupils. This
hypothesis was rejected because from the study the cost of feeding was reduced with the
introduction of a school gardening program. The initial costs for the SFP in Namasagali
Primary School were entirely made by the CSRL program. The program had to absorb
all the cost involved in setting up a school garden and feeding program. The program also
purchased all ingredients and supplies required for the feeding of the pupils and also paid
for the cook's labour. The results obtained from this study indicate that the initial cost
spent by the program to sustain the feeding program in 20 I0 was 915.5 dollars per term.
The decision by the program to produce its own food for the school lunch at NPS has
been the cheaper option for the program and also as a way la sustain the program and
encourage rural agricultural production and economic growth at community level.
81
The produce from the school was partly used in the lunch while some were sold, and the
money used to purchase ingredients for the lunch. From the result presented the cost of
feeding the pupils from the gardens was reduce with supplementation from the gardens
and contribution from the parents. If we compared what the program spent on purchasing
of ingredients from the market, which was 9]5.5 dollars in 20]0, and how much it spent
to produce the food and from parents contribute in kind it is much less ($ 574 and $
306.72 respectively). According to Mwangi et al.. (2010), school gardens play an
important role in sustain ability and success of a feeding program.
82
CHAPTER SIX: SUMMARY, CONCLUSION, AND RECOMMENDATION
6.1 Summary
This study mainly focused on the contributions of the SFP at a rural universal primary
education school in Eastern Uganda. It aimed at determining the nutrient quality of the
lunch served at. the school and the adequacy of foods served away from school, its
contribution to the nutrition and frequency of illness of the pupils as well as conducting a
cost analysis pre and post introduction of the school gardening program at NPS. Most
rural schools in Uganda provide inadequate meals -if at all any -and many parents are not
willing to contribute to or SUpp0l1 the feeding program. The majority of rural children
come from homes that are food insecure. and most of them report to school hungry. This
has a negative effect on the overall gains of UPE schools to have all children attend
primary school. Short-term hunger leaves pupils hungry at school, unable to concentrate
in class and constantly absent from school. School feeding programs reduce short-term
hunger, increases concentration and. therefore. overall performance.
6.1.1 Purpose of study
The central focus of this study \\3S to provide a cost description how HGSFP using
school garden and parents contributions can supplement on the SFP. Nutrient analysis on
the school meal was also done to provide further information on whether the caloric
content and nutrient content of selected nutrients of the meal has been improved and what
effect this had on the overall nutritional and health status of the pupils.
83
6.].2 Results and Implication
The nutrient value of the lunches served at the school had improved with the introduction
of a more nutritious meal. The school meal served at the school initially provided 50kcal
(CSRL Report, 2011), and the lunch introduced provided 854 Kcal as reported by the
laboratory analysis. also the protein content and other nutrients had improved. Though
the meal did not improve the nutrition status of the pupils, it had a positive impact on
attendance, concentration and enrollment at the school. The lunch contributed a larger
percentage to the child's Recommended Daily Allowance as compared to the meals they
received from home. The study also reported that it is more cost effective to have a
school garden program supplement a school feeding program. The garden produce can
either be used directly in the SFP or can be sold to purchase other food items needed for
the feeding program. Support from the parents is also very necessary for the success of
the feeding program. This could be in cash or in kind.
6.2 Conclusion
This study found that the maize and beans diet served at the school for lunch had a high
caloric and protein intake as compared lO the maize meal porridge (50kcal) that the pupils
were initially consuming. The meal contributed a significant amount to the pupils RDA
between 28%-43% depending on the age group as compared to 7%- J 1% of the calls from
home. Though the nutrient content of the meal had improved. there was not much
improvement in the nutrition status of the pupils. The BMl-for -age and stunting ratios
during the baseline were J .5% (0-8.0) and 13.4% (6.3-24.0) as compared to the nutrition
status of the pupiis after two years being i .8% (0.5-4.5) and i 3.4% (6.3-24.0)
84
respectively. The majority of the pupils in this study could have suffered long-term
deprivation of food shortage, due to the high levels of stunting especiaIly among the male
pupils. The parents of the majority of these children are left in a dilemma of whether to
contribute food for the SFP or use it at home. Normally when the child is given grain to
take to school, then his potion is at school and sometimes this child is left to go hungry at
home. A higher level of analysis showed that the girls had a low BMl-for-age compared
to the boys while the boys are much more likely to become stunted compared to their
female counterparts.
Children from homes where parents were divorced are more likely to be malnourished,
and were also found to be more stunted than those from homes where either parent are
separated or married. The age of the mother is also one of the factors that influence the
nutritional status of their children moreover, we can conclude that children who have
been left under the care of young mothers and the elderly are seen to have a very high
prevalence of malnutrition.
Concerning illness: malaria. respiratory infections and diarrhoea are some of the most
common illness that the pupils have been suffering from while attending school leading
to high level of absenteeism. Underweight children are seen to have higher incidences of
diarrhea compared to those with normal weights (Sepulveda et al., 1988).
The study also concluded that supplementing an SFP from a school gardening program is
indeed cost effective wav of feeding pupils. Home Grown School Feed Program (HSFP)
85
concept is one perfect way to mitigate short-term hunger in the schools especially rural
schools where parents may not be able to afford to pay for feeding at school. CSRL
program initially provided 100% towards the school-feeding program at NPS. However,
with the introduction of school gardening and parents' contribution, the program only
spent/contributed 28% towards the SFP, the parents contributed 14%, and the gardens
contributed 57%. The harvest from the garden can also be sold to purchase any food
items needed for the school lunches. School pupils and teachers did the management of
the gardens with technical assistance from the agronomist and other staff of CSRL. It is
therefore very possible and cost effective to maintain a school-feeding program with
support from the school garden and the parents.
With regards to the age of the mother, the findings showed mixed outcomes due to
various other confounding variables. In some situations, there was better nutrition status
of children belonging to younger mothers while in some cases in older mothers. We
therefore conclude that confounding variables such as income and education status of the
mother play a critical role in influencing nutrition status of children.
6.3 Recommendations
6.3.1 Recommendation for policy
Home Grown School Feeding Program, use school gardens and parents support in
promoting School Feeding Program in the schools should be one of the practices the
Education Ministry should consider as a way of ensuring sustainable SFP. One of the
policies that the Ministry should revert is Parents should taking on the responsibility for
86
feeding their school children while at school The idea of UPE does not come with free
food and therefore they should contribute either in cash or kind towards the school-
feeding program. Practical agriculture integrated into the curriculum and use of outdoor
laboratory for both food production and learning could be a way of teaching pupils and
encouraging production of food. This should be empahised in the curriculum.
6.3.2 Recommendations for Practice
For the School Feeding Program to be sustainable Namasagali Primary School gardens
should be expanded to make them economically productive and viable as a source of
produce for the school lunch all year round. It is important to produce enough so that the
school can sell and have enough to feed the children. The parents and the community
should be involved and educated on the importance of SFP for their Children. Use of
locally sourced foods to support the SFP and encourage production as demand increases.
6.3.3 Recommendation for research
This research did not exhaustively explore the SFPs in urban and private owned schools.
Therefore further research should be done in urban and private schools and a comparison
made. This research study has addressed the possibilities of maintaining a feeding
program using fanning at school and parents' support and contributions in a rural sening.
The gap that this study has addressed is the possibility of having a rural school-feeding
program that is fining into a school gardening program. A more in-depth analysis should
be conducted to establish economic analysis of using school garden to support School
87
Lunch Programs. Longitudinal study comparing schools who employ gardens and those
who not to examine differences in nutritional status.
88
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New York: Oxford University Press. DOl: 10.] 596/978-0-821-36179-5/Chpt-58.
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http://aje.oxfordjournals.org/content/127/2/365.short
Sumberg, J., Sabates, R. (201l) Linking agricultural development to school feeding in
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04664.pdf
lOO
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J02
APPENDICES
APPENDIX A: INTRODUCTION LETTER
Greetings. My name is , and I am a master's
student at Department of Foods, Nutrition and Dietetics, Kenyatta University. I am
undertaking a study on the Effect of school garden food production on nutrient adequacy
and nutrition status of children in Namasagali primary school in rural Kamuli District,
Uganda
This letter is a request for you to participate in the study. My research assistants and I will
ask you questions about child's feedings practices and some information related to your
household. The session normally takes 45 minutes to one hour. Any information you
shall divulge will be kept treated with high confidentiality and will not be shared with
any other persons. Your participation is voluntary, and you can choose not to respond to
any individual question or all of the questions.
Researcher: Laura
Address: Kenyatta University
Dept. of Foods, Nutrition, and Dietetics
P.O Box 43843-00] 00,
Nairobi, Kenya
Mobile Phone: +2547257320991 +256757138255
Email: lauraagaba@gmail.com
I
11
103
APPENDIX B: INFORMED CONSENT FORM ENGLISH VERSION
TOPIC
Effect of school garden food production on nutrient adequacy and nutrition status of
children in Namasagali Primary school in Rural Kamuli District. Uganda
Principal Investigator: Laura Byaruhanga
This is a research study. Please take your time in deciding if you and your child would
like to participate. Feel free to ask questions at any time.
Introduction
Iowa State University (lSU) under the Centre for Sustainable Rural Livelihood (CSRL)
program introduced an SFP in Namasagali Primary School that is linked to the school
gardening program; with the aim of eliminating hunger, improving nutritional and health
status of the school aged, increasing enrollment, attendance and therefore academic
performance. We will require the participation of your child in this research to access
what effect the SFP has had on your child and the community.
Description of procedures
Upon enrollment, the index child will provide direction to his home so that a
questionnaire can be filled together with the mother or caregiver. Questions asked will
involve, foods the child has eaten at home throughout the day. socioeconomic data and
morbidity patterns of the child during the previous months. We may also ask for
permission to take a photograph of your child serving or taking her lunch. The photoaph
will be used for the purpose of the study.
Participant rights
You and your child's participation in this study are completely voluntary. You and your
child may refuse to participate or leave the study at any time. If you decide not to allow
your child to participate in this study or decide to end your childs participation early, it
will not result in any penalty or loss of benefits to which you and your child are otherwise
entitled. She /he will continue to receive the same services offered by the school as the
other children in the school.
Benefits for participating clients
If you allow your child to participate in this study. she/he will be entitled to lunch daily
during school hours for the entire term. Information obtained will be simplified and
disseminated to you. so that it may help in ensuring proper nutrition for your child. It is
hoped that this study will provide valuable information that will be used as a baseline for
the introducing this meal to the entire school and other primary schools in Kamuli
district.
Risks for participating in the study
There are no foreseeable risks at this time from participating in this study.
Costs and compensation
You will not have any cost from allowing your child 10 participate in this study. You will
not be compensated for participating in this study.
Confidentiality
Records identifying participants will be kept confidential to the extent permitted by
applicable laws and regulations and will not be made publicly available. Data collected
]04
will be summarized, tailed and names withheld. Data will be kept securely either on the
investigator or in a secure location.
Questions or problems
You are encouraged to ask questions at any time of the study. A Lusoga-speaking
translator will be available to help answer questions and facilitate communication. For
further information about the study, contact Laura Byaruhanga (CSRL Programme).
Parent/guardian signature
I have understood the above information concerning this study, which has been fully
explained to me. I understand what will be required of my child ifhe/she takes part in this
study. I had the opportunity to ask questions that were answered to my satisfaction.I
understand that at any time if I may wish to withdraw my child from this study I can do
so without giving any reasons and without affecting my child's access to any of the
school services. I agree to this and allow my child to take part in this study.
Participant's Name:
Parent/guardian of Participant's name: _
Parent/guardian's signature Date
Participant's signature
Your signature indicates that you voluntarily agreed to participate in this study, the study
has been explained to you, that you have been given time to read the document and that
your questions have been satisfactorily answered. You and your parent/guardian will
receive a copy ofthe written informed consent prior to your participation in this study.
Parti c ipan t' s signature------------------------------------- Date ----------------------
Investigator statement
I certify that the participant's parent/guardian has been given adequate time to ready and
learn about the study and all their questions have been answered. It is my opinion that the
participant understands the purpose, risk, benefits and procedures that will be followed in
this study and has voluntarily agreed to participate.
(Signature of the person
Obtaining informed consent)
Date
]05
APPENDIX C: INFORMED CONSENT FORM IN LUSOGA VERSION
ENDHAGAANOEYOK~KIIDZA
Omulamwa
Ebyendisa ebimala nokwinhonhola kumuwendo ogwebyendiisa tibigemagana na
nimiro mu isomero iriri mumasokolo age ebyaalo mu disitulikiti ye Kamuli
Yuganda. Tulingiliire eisomero Iya pulayimaale elya Namasagali.
Omukulu wokunoneleza kuno: Lama Agaba Byaruhanga
Guno musomo gwakunonereza. Twaala ekiseJakyo okusalawo oba iwe no omwanawo
mwenda okugwenhigiramu. Oliwaidembe okubuuza ebibuuzo woba oyendere.
Enhandhula.
Eitendekero lya Iowa ne senta ye ebyenkulakulania eye ebyalo
(Muluzungu centre for sustainable Livelihoods CSRL) ty (lSU) yatandika ebyo okuliisa
mu isomero Iya Namasagali elya pulayimaaJe ne' byenima mwisomero lino nga baline
ekyigenderelwa ekyo okulwanisa endhala. okwongera kumutiindo ogwebyendiisa ne
ebyobulamu mubaana abalimu myaka egijja kwisomero, no okwongera omuwendo gwa
basomi, endhidha yokwisomero ghalaJa nomutindo gwe byensoma. Twiidha kwenda
omwanawo okwenhigira mu kunonereza kuno kisobozese okunamanha biki enteekateeka
eyebendiisa mwisomero kyekoJeire omwana ne kyaaJo.
Emitendela Egibitibwamu.
Olumala okughandikibwa, omwana gwetujja okubuuza, atulagirira engirala etutuusa
ewaibwe tusobole okwidhuzaamu oJupapuJa oJwebibuuzo ghalaJa ni mukaire we oba
oyo amuJabirira. Ebibuzo ebibuzibwa muJimu. emere omwana gaJiire waka oJunaku
Iwonalwona, ebyenhingiza, enebisa yomwana, ne ebyobuJamu bwe omwezi gwebakubye
amabega. Tuyinza nokusaba oJukusa okukuba omwanawo ekifananyi nga aJikuJya emere
oba nga agaaba emere yekyomusana. Ekifananyi kino kyakukozesebwa musomo guno.
Omwanawo aidha kupimibwa obuzito no obuwanvo bikozesebwe mu kunonereza kuno.
Eidembe elya eyenhigiire mumusomo guno
Iwe no mwanawo okenhigira mukunonereza kuno kyakyendere. Mwembi
bwemusalawo obutagwenhigiramu oba okukuvaamu amangu wazira kibonerezo
kyonakyona waire okufiirwa ebyo ighe oba ornwanawo byemusaniire okufuna. Era
omwanawo aidhakugya mumaiso nokufuna okuwebwa byene obyo eisomero byeriwa
abaana abandi kuisomero.
Emiganhulo eri abantu abanenhigiramu.
Bwoganha omwanawo okwenhigira mu kunonenkereza kuno, anaaba nga aJi nokufuna
ekyomusana mukiseera eisomero lyek iwerarnu abaana em ere etaamu yonayona.
ebinafunibwa biidha kugondezebwarnu era bibakoberwe . kibasobozese okutukiriza
endiisa enkalamu eyornwanawo. Kilowozebwanti okunonereza kuno kwidha kuwa
amawulile agaidha okozesebwa nga gesigamibwaku okuwa eisomero ekiwulo ekyemele
era nimumasomero agandi mu karnuli disiturikiti.
Obulabe obuli mukwetaba mukunonenkereza kuno
106
Wazila bulabe bwonabwona obwalibuboneibwa mu kisera kino nga wenhigiire
mukunonkereza kuno.
Emiwendo no okuliyirilwa
Okwikiriza omwanawo okwenhigira mukunonenkereza kuno ezira kyonakyona kyogya
kusasula.Ezira kigya kukuliyilirwa olwo okwenhigira mukunonekereza kuno.
Okukuuma ebyama.
Ebiwandhiko byonabyona ebigema kubantu ababaire mukunonenkerza kuno biidha
kukumibwa butiribiri okugiira ku mateeka nenfuga era tibiidha kwikirizibwa kumanhika
mulwatu. Ebinava mukunoneleza bidha gonzebwamu babigaite aye amaina gaidha
kwesigalizibwa. Eraebinaava mukunonereza kuno biidha kusigala nanoneleiza oba
okukumibwa mukifo ekyekusifu.
Ebibuuzo oba ebizibu
Osabibwa okubuuza ebibuuzo akaseera koonkoona . Waidha kubaawo akwiriramu mu
Lusoga okusozesa empulizagania enkalamu. Okufuna ebisingawo ebigemagana
kumusomo guno, gemagana ni Laura Byaruhanga (CSRL program e)
Omukono gwomuzaile oba amukuma owomwana
Ntegeile ebigema kukunonenkereza kuno okusinziira bwebabinhinhongoire nategela
lwaki omwana wange yandyenhigiire mu mukunonkereza kuno naaba noomukisa
okubuuza ebibuuzo byonabyona byenhenze baabindhilamu nainhonhoka. Erantegeire nti
bwenhendha okutolayo omwanawange mumusomoguno ngazira nsoga nambulukufu
ezilabulabe buyinza kutuuka kumwana mungeli gyafunamu ebintu kwisomero ndikiliiza
kino era naikiliza omwanawange okwenhigira mukunonenkereza kuno.
Amaina ageyenhigiire mukunonenkereza kuno.
Amaina agomuzaile oba amukuuma .
Omukono ogwomukuumi oba omuzaire oba omwana .
enaku edhomwezi .
Omukono ogweyenhigiire mu kunonenkereza kuno
Omukonogwo gutwamba okulaga nti okiliza okwenhigira mukunonenkereza kuno
kyeyendere ngawazila kusasulibwa nga bwoinhingoleibwa, nti ofunie ebwire okusoma
mubikuweleibwa erawabuuza ebibuzo bakwilamu. Iwe nomuzeirewo oba akukuma
ogyafunaku ekiwandiko kino ek ilaga nti mwenhigiire mukunononkereza kuno.
Omukono ogweyenhigiire mukunonereza kuno .
enaku edhomwezi ._.. _.. _ __ _ .
Ebigambo eby omunonereza.
Ndhikiliza nti omuzaire oba ornukumi ow omwana aweleibwa ebisera ebimala
okusomamu ne okutegera ebigerna kumusorno guno ne emigaso. emitendera no obulabe
obuvaamu, era yaikiriza okugwenhigiramu nga wazira kusasulibwa kwonakwona.
Omukono ogwo omuntu aline endhagaano eno enaku edhomwezi
]07
APPENDIX D: CHILD ASSENT FORM IN ENGLISH
~
Effect of school garden· food production on nutrient adequacy and nutrition status of
children in Namasagali Primary school in Rural Kamuli District, Uganda
My name is [researcher name. I am trying to learn about the benefits this school feeding
program has brought to you, your school and the community; and how the program can
sustain it through the school garden.
If you agree 10 take part in this study, I will ask you and your parents/guardian some
questions about your feeding habits and about home and later on we will take your
weight and height. There are no right or wrong answers because this is not a test; we want
to get your views. The benefit of this study is that your participation will assist the
researcher come up with answers that will assist other schools h-ave a school lunch
program with a school garden.
You can ask questions about this study at any time. If you decide at any time not to
finish, you can ask us to stop. Your parents or guardian have to say it is OK for you to be
in the study. After they decide. you get to choose if you want to do it too. If you do not
want to be in the study, no one will be mad at you. If you want to be in the study now
and change your mind later. that is OK. You can stop at any time.
Agreement
I have decided to be in the study even though I know that I don't have to do it. [Name of
researcher] has answered all my questions.
Signature of Study Participant Date
Signature of Researcher Date
]08
APPENDIX E: CHILD'S ASSENT FORM IN LUSOGA
Olupapula olulaga okwikiriza kyo omwana
Omulamwa
Ebwendhisa ebimala ne ebintu ebwetolerela tumulamwa ogwebendhisa enimilo mu
bwalobwa Kamuli district: Uganda: tusinzira Namasagali Primary School.
Amanagange ninze( ) Nga ndhigezaku okusomaku biJungi
ebwe omulamwa ogwe bendhisa eli-ewe, esomero ene ekwaJo nengeJi omulamwa guno
jjegusoboramu okwemerezebwawo kunimiro eyesomelo.
Bwoba okiJiza okwetaba mumusomo gune njakubuza ebibuzo ewe enomuzelewo oba
akukuma kumbera eyebwendisa ewaka near mare nkupimeku obuzitowo ne obuwanvu
bwo. Wazira kiribwemu kifu oba kitufu oJokuba bino tibigezo. Twetaga bidhubobwo.
Ebinava mumusomo guno bedhakuyamba ku alikunonereza okutandhika omulamwaguno
mumasomeJo aganhi.
Osobola okubuza ebibuzo ebigema kumosomo guno ekiselakyonakyona era bwoyendha
okukoma okulamu ebibuso osobola okukoba twakoma awo. Ne omuzerewo oba akukuma
atekwaokukiriza otwetaba mu musomoguno. Nerawebaba tibasazewo musete kumpi era
webabatinga tibakukiriza okwetaba mumusomo guno, tibaJalu nerabaziransobi jjebakoze.
Era bwobatinga osazewo otwetaba mumusomo guno mare nochusamu mubirowozo,
oliwegedhembe okusaba omusomo guno okukomawo.
Okwikirisanganya
Ndhikiriza okwetaba mu musomoguno nibwekyandhibeJe nti tisanire kukoJakino.
Omukono gwa obwana/omuzere
edhomwezi
enaku
Omukono gwa ali kunonereza enaku edho
]09
APPENDIX F: RESEARCH AUTHORIZATION FROM KENY ATTA
UNIVERSITY
KENYA'rrA UNIYERSrry
GRADUAT£ SCHOOL
f.O.Jkn. 43&44,00100
NAIROlH, KL,'YA
ra, 5710001 Dt!.51530
Uganda N;lh()t}iti Council fur Science ill1d
Tc~'hnok~,y H:NC81)
Fi(A t:. Kuncta .MHd, Ntil1dJl
P. () H,)x Ci'\i';·!
~~.rAIAJ,JG...<~A.
:1
I
~2~'j~ >1 t ') 7-..."\-;:'<..).\}
+" L5b ~~!;:.l. a 4h(~~)
~~2~~;4 !'-L:'_C~')';"~
gt;,.,~Li:\RC!J..l\1J']J1Q~rM.,.1JQ~L,JdlUl\!L;1<;iM!i.\jl~~\Jl!MiGA..':..Rf;.GL~":
HtKlLt293.l!O:;;
1 ....vritc ko' t!ltT(xhH ..lA ~t">, Laura j\ylh~~BYilruh~H~:~l\t.'h~., 1~d 1\.).).t:4r~~Juatl'Stu-:knt
G1 thi\ l'~L\'('~!';-,HY -She is n:.'?ls.t\.'rtd ior ~i.x dC'.:.rl't: ~lro_\.nHnnh': in IlK
Department of l'00d5) Nutrition~nd Dietetics. ' .
\1'\. gy~lndL-ln>:a mte uds 1(1 conduct rcsearc h tor ~t pr('T~.),\:ii cnt it L:ti, U"N-utrient
Adequacy and Cost Effectiveness of Garden Linked Feeding Programme in Rural
Karnuli District, Usanda: A Case of Namasagali Primary School".
/\nv ~t,~)J>LHhA.·.,,~ty.\·_,nwill be h1(~hly ltpprl'.(it!tl'I.1
Ynpr<f0l\!h!'n1] -r, . ""',,-,"I,. _
,v.
t'.'/~r~~,,;tLLtull /:~;>~,·(~t~;WCYN,&~j
~~~~.~~I:tQQJ.
11
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11
"
'\"'"
110
APPENDIX G: ETHICAL CLEARANCE
MAKERERE UNIVERSITY
P.O. Sox 107'1. Kamp;.Ia,Uganda
E-mill>r: lo%ullQ>~h3,m:a!q!%;,\)g
d~,msh~@:l;h!J!la:k,Il&,.og
T,,'I: 2S8 1112303625
T"l; 2654'14 5;11533
Fa:x: L.Se 4lt :~j-10,_;Jl
COLLEGE OF HEALTH SCIENCES
SCHOOL OF HE.Al TH SCIENCES
OFFICE OF THE DEAN
C:akgof)'of n-\'j~w
IX}lniJiaJ Tt'·}",.,
~ ] C:o:nrhluIng review
~A-n1:~ad!ne:n:!
~ It"'rtninf11hM1 nf study
1 jSAh
Ms. Lill.ll'aAgaha:Byarumutg!!
Ken>'e!!e Univltrshy,Naimbi
Rt: Appm"'ll fJfPropOSlIl #SHSREC Rtf: 2012,032
~;'llf:rit'nl,Adt'\ljj}cy and Co,,, Oc);eript\vn of Gnnkn Un).;I'.! ft't'(Hn~Ptu\1n.mm" in
I~nralKanmli l>islrit'l-lJwrnda: C ••", studv or Nalll, •• ,,);ali ,'rim"0 ~"dwol~
['hank y-ou for !->ubmlHing an apph'::-;J:tlon f{~rapprOY:1~ nf ~h~'':11,,-'\'t" r~fi;r('n~cd
ih: ';ornm.;Uct revrewed if ;wd lttantei! 'llp!'mYJ) k., "",. ,;.! -,,"" . d1<.:"",,· July h'. ZOLt
A:pJYH)\~:;j 'ISvrdid untd Jul)' 1~" 2DJ4.
ContiIlU'Jlj! R(',i.,.w
ltl order In cominuc \vork on lhi~ stn-Jy {w\.'hdin;; d:H;,')~ln,~!~~\; } X~ ~"nd [he ~x.plntt~('nJut('.
ih,,: S•..'hool nf Health Sciences Rt;~eat('j1 and Flb(~ C;)rnn:nt('( mn~{ !;;..::ppn:~"ed1C pr-ot-fr('ol
~ftcr {:'(~nd\1ctjngn :5uhstandv(7 .• rrlcan_in~fuL (onli:rnnn:t: (;;Ylt:'I.\
nH:<. mc~'.:Y)thin you mu~l St~hmit n (Dntim,lir:.~ H·r~..n !<:r((l cp· ,I ~I,.~~T,}.\,·~-tf(~t (,dncfn,nn;; rC';l:(:'\\
10 b~'''7;!a.\nid n lapse, youshould s-uhmn tht JC~t}{';-.~:ii', u~; L'~ r,}:h-i tS) 'o\('-c.}..;). ~:k:p-: chI.;
bp:>-.t Ja1<:. Plci:si;." use tht fnnn.:s ~upf'h(.'"lj h~ t~,;.:~plf<.:<
Amrr"lmtnb
Uunng th"': ;tppt<)val period, d" }--f;U PfCP{;~~1.,'J{',~, -ch,~:~::>..· !,! PSi.: PLd'-'~,·~;'lH(n ~1~•• )1:,; fund;n~'
";~·..i~'..C,rt',r; ..T'-li~ing nutl."T~ttb. ,~r (~.'n;.,·.:'n·!>.k.·;:erne 1',h, :.U,j :-:':U ': ",,\.:'~. ~,·L,., ,;.! 11,-\~);h \;:~';'n-..:';.',:,-
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III
':l! ..
updalerl version of your N'igitwJ protocol ~p!,hca:inn· one !.h{,m.ng aH proposed <.:i;aIlScsin
bold or <trad changes.' and ;ht:othct without lX'lcior t::K~ .::hatlgcs,
Rtportln~
Other evems which must 1')(:rcp:mcd prompt!) in wnting 10 the School tlf Health Sciences
Research and Ethics Comrmnce Include
S'u.~r"-~fls!<)nor termination of ibe yr01~\ii h~ ;('U t~r the t'r:lnt(~:
UnexJXxlcd pr\)bh....ms j:rr\·t.)h~ing lisk to p;!n~(lPJn~~,"It o~h~
Adverse events, iJj<:iud~Jlg un,arHidp;HCG d!:~.mi{ip;th:d ~Hl severe physi-cal hI1UH to
j-mllkipM)!$,
Donot hesltJilC to coruact ill jf you h.'IYCatl} qucsnons. 111ank you f()f your cooperanon and
commitmCll! to the 'protection of human subjects ill research.
f)(~Umtnl~ ~trrHJ'.('~11~)r'\L5Ccionr \<; ;~hf:;,'~:,·...,'l
InfonncJ consent fun.i~ (Fngh'.h ~vxj [ H"';~~<}'
• l\sS(';n forms {Fn~l3'sb an,d Lll"<~~J~:a}
• t.)uesUOnn2Jn., ...;!;; r~-'"
Mr. Paul K1ICpbami
Chairpersen, SdHHJI t>J Health S,il'n{'e'< nl''''a~cb aJHj nhk~Commirtee
J 12
APPENDIX H: UGANDA NATIONAL COUNCIL OF SCIENCE AND
TECHNOLOGY APPROVAL
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113
APPENDIX I: LETTER TO RESIDENT DISTRICT COMMISSIONER, KAMULI
DISTRICT
OFFlCE OF THE PRESIDENT
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t OH: 'I { HI ) \ It) , 01' r I( L O~ I HE l'IU:SWL' r
KENYATTAUNIVERSITY LIBRARY
J J4
APPENDIX J: VEDCO ENDORSEMENT OF RESEARCH APPLICATION
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115
APPENDIX K: QUESTIONNAIRE
SECTION A: SOCIALDEMOGRAPHIC DATA
Part I: Identification
Name oflndex Pupil: _
Class------------------------
Date of Birth of Pupil (Date: Month: Year) _
(Request for birth certificate)
How many members are in this household? _
What is your marital status (caregiver)?
J= Single
2= Married
3= Separated
4= Divorced
What is your education level (caregiver)?
I= No formal education
2= Primary school level
3= Secondary school level
How old are you (caregiver)?
1= 20-30 years
2=31-45 years
3= 46-55 years
4= above 55 years
Who is the head of the home?
I=Female headed home
:2=Male headed home
Who is the principal caregiver?
I=Mother
:2=Grandmother
3=Aunt
4== Others (specify) _
116
Occupation of the caregiver?
1= Casual laborer
2= Housewife
3= Farmer
4= Others (specify) ----:- _
Part 2: SOCIO-ECONOMIC FACTORS.
Do you live in a:
]=Rented house
2=Own house
How many rooms does the house have? ----------------------
What is your main source of lighting?
I=Kerosene
2=Electricity
3=Solar
4=Candle wax
5=Others (specify) _
What is your main source of cooking fuel?
1=Kerosene
2=Electricity
3=Charcoal
4=Firewood
5=Others (Specify) _
Observe around the house for the following and tick
Item Yes No
Bicycle
Motorcycle
Radio
Television I
Mobile phone I
Land i
Vehicle
Sofa set
Plot
What kind of roofing materials has been used on the house?
I=Jron sheet
2=Grass thatched
3= Disposable material
4=Others (specify) _
117
What kind of material has been used on the floor material?
l=Cement
2= Mud floor
3=Mud floor plastered with cow dung
4= Earth
5=Others -----------------------------------------
Do you keep any animals at home? I=Yes 2= No
If yes which ones?
Do you have a garden? I=Yes 2=No.
If yes indicate crops you cultivate?
PART 3: DIETARY INTAKE
24-HOUR DIETARY RECALL
Ask the caretaker what the child has consumed in the previous day. Use local households
measures like spoons, cups. glasses and bowls to estimate amount consumed.
Interview date: Official use
Day recall: only
Recall Date:
Time Type of Ingredi HH Amt Vol of dish Vol taken Amt taken
/Meal dish ents Meas In cooked by child by
in dish ure (gm) child(gm)
Breakf
ast
.
Mid
mornin
g snack
J 18
Lunch
Mid
afterno
on
snack
Supper
After
supper
Snack
FOOD FREQUENCY QUESTIONNAIRE
Ask and Tick the foods consumed by household and the frequency.
Foods Daily >3times a Twice Once a Rarely/never When in
week a week week Season
PROTEINS
Meat
Silver fish (Mukhene)
Fish
Eggs
Milk
Sova bean
Beans
Groundnuts (Paste)
Other proteins
CARBOHYDRATES
Posho (stiff porridge)
ll9
Rice
Millet/sorghum bread
Sweet potato
Irish potato
Yams
Cassava
Green Bananas
(M atook e)
Chapatti (flat fat cake)
Other carbohydrates
FATS/OILS
Margarine
Ghee
Cooking oil
Other oils
FRUITS
Oranges
Avocado
Pawpaw
Pineapple
Ripe bananas
Lemons
Passion fruits
Guavas
Mangoes
Other fruits
VEGETABLES
Kale (sukurnawiki)
Cabbage
Pumpkins
Pumpkin Leaves
Spinach
Carrots
Tomatoes
Egg plant
Nakati. dodo.
amaranth
Peas
Other vegetables
]20
PART 4: NUTRITIONAL STATUS
Name Weight of pupil Height of pupil
Date of Class Date of Birth Wt. Wt. Av. Ht. I Ht.2 Av.
pupil (dd/mm/yr.) ] 2 Wt. Ht.
]2]
PART 5: ILLNESS, SANITATION AND HYGIENE
Morbidity
Have you been sick in the Past 2 weeks? ]=Yes 2=No
If yes, what you suffering from? _
Which of the following illness have you suffered from?
Diseases Duration
Malaria
Tuberculosis
Pneumonia
Diarrhea
Cold and Flu
Worm infestation
Skin infection
Jigger infestation
Measles
Others (specify)
What do you do first when the child falls sick?
]= Take the child to the health clinic
2= Buy drugs to treat the child
3= Did not consult a health care
4= Others (Specify) --'-- _
How far is the nearest Health Center from your home?
]=Less than Km
2=]Km
3=2Km
4=More than 2Km
Please circle the most appropriate
What is your main source of drinking water at home?
I=River/spring/swamp
2=Borehole/well
3=Rain/tank
4=Tap water
5=Others (specify)
]22
What type of toilet do you have at home? (You could request to be shown)
] =T raditional pit
2=VIP pit
3=No toiletlNo Latrine
Is the latrine just for your own use and household members or for the community?
I=Own use
2=Community
Do you have a bathroom at home? (Request to see it) ] =Yes 2=No
PART 6: SCHOOL FEEDING PROGRAM COSTING
Part 1: School Gardening
Garden Input/ltem Unit cost Acreage Total cost Total cost
(per acre) (ugshs) (US dollars)
Land
Ploughing
Planting
Weeding
Harvesting
Seeds
Pesticides/herbicides
Other costs
Total
Part 2: School Gardening OutputlRevenue
Crop Acreage Expected Actual Total Total revenue (US
Grown Planted yield (kg) yield (kg) revenue Dollars)
(Ushs)
]23
Part 3: Parents Contribution
Class Total Contribution Amount in Ug Amount in US
(Maize) in k2 shs if sold dollars
Grade]
Grade 2
Grade 3
Grade 4
Grade 5 ..
Grade 6
Grade 7
Total
l24
APPENDIX L: LABORATORY ANALYSIS OF SCHOOL MEAL
Kampala-UGANDA
UNIVERSITYMAKERERE P.O. Box 7062,
E-mail:
oodtech@agric.mak.ac.ug
Phone:
Fax:
256-414-533865
256-414-533676
COLLEGE OFAGRICULTURAL AND ENVIRONMENTAL SCIENCES
SCHOOL FOOD TECHNOLOGY, NUTRITION & BIO-ENGINEERING
DEPARTMENT OF FOOD TECHNOLOGY & NUTRlTJON
24/l0/
2012
Laura Byaruhanga
Through Archileo N. Kaaya (PhD)
Professor and Head,
Dept. of Food Technology & Nutntion
Re: Results for the analysis of food composite (maize. beans and Sukumawki)
Please find below the tabulated results for the analysis of food composite (Maize, Beans and Sukumawki)
No. Parameter measured rnit Results samnle content
Wet weiaht basis Drv weizht basis
I Moisture content (giIOOgm) 62.18
2 Drv matter (1?1l00gm) 37.82
3 Ash content Ig/IOOglll) 1.62 4.28
4 Dietary fibre (giIOOgm) 4.04 10.68
:) Crude Protein IQ'IOOg111) 4.~4 11 74
6 Oil Conreru Ig/IOOgm) 03 0.78
7 Carbohydrates Ig/ IOOQIll) 656 17.35
8 Total Energy (K(aIIlOUgm) 948)8
(DM27 2%)
9 Toral Energy (Kcalll OOgm) 341.717
iDM95%)
10 Vitamin A Im!!R!\EilOOglll) 200.58 530.35
II Zinc Img,IO()21ll) 660 1145
12 Iron 11ll1!!IOOQIll) 19.48 51.51
13 Iodine 1111[1'IOOQIll) 3.67 9.70
Okalany Emmanuel
Technician DFT &N
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