title: New benchmarks for costs and cost-efficiency of school-based feeding programs in food-insecure areas.
abstract: BACKGROUND
  School feeding is a popular intervention that has been used to support the education, health and nutrition of school children. Although the benefits of school feeding are well documented, the evidence on the costs of such programs is remarkably thin.
  
  
  OBJECTIVE
  Address the need for systematic estimates of the cost of different school feeding modalities, and of the determinants of the considerable cost variation among countries.
  
  
  METHODS
  WFP project data, including expenditures and number of schoolchildren covered, were collected for 78 projects in 62 countries through project reports and validated through WFP Country Office records. Yearly project costs per schoolchild were standardized over a set number of feeding days and the amount of energy provided by the average ration. Output metrics, such as tonnage, calories, and micronutrient content, were used to assess the cost-efficiency of the different delivery mechanisms.
  
  
  RESULTS
  The standardized yearly average school feeding cost per child, not including school-level costs, was US$48. The yearly costs per child were lowest at US$23 for biscuit programs reaching school-going children and highest at US$75 for take-home rations programs reaching families of schoolgoing children. The average cost of programs combining on-site meals with extra take-home rations for children from vulnerable households was US$61. Commodity costs were on average 58% of total costs and were highest for biscuit and take-home rations programs (71% and 68%, respectively). Fortified biscuits provided the most cost-efficient option in terms of micronutrient delivery, whereas take-home rations were more cost-efficient in terms of food quantities delivered.
  
  
  CONCLUSIONS
  Both costs and effects should be considered carefully when designing school feeding interventions. The average costs of school feeding estimated here are higher than those found in earlier studies but fall within the range of costs previously reported. Because this analysis does not include school-level costs, these findings highlight the higher nontransfer costs for programs delivering cooked meals in schools than for other school feeding modalities. The benchmarks presented here reflect the centralized WFP implementation model, which is not always relevant in terms of government school feeding programs, particularly those procuring within national boundaries using "home-grown" approaches.
authors.affiliation: Partnership for Child Development, Department of Infectious Disease Epidemiology, Imperial College, London, UK. aulo.gelli09@imperial.ac.uk
authors.forename: Aulo
authors.initials: A
authors.lastname: Gelli
authors.forename: Andrea
authors.initials: A
authors.lastname: Cavallero
authors.forename: Licia
authors.initials: L
authors.lastname: Minervini
authors.forename: Mariana
authors.initials: M
authors.lastname: Mirabile
authors.forename: Luca
authors.initials: L
authors.lastname: Molinas
authors.forename: Marc Regnault
authors.initials: MR
authors.lastname: de la Mothe
mesh_terms: D000465:Algorithms; D019985:Benchmarking / Q000379:methods*; D002648:Child; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005522:Food Services / Q000191:economics*; D005527:Food, Fortified / Q000032:analysis / Q000191:economics; D014943:Global Health; D006293:Health Promotion / Q000191:economics; D006801:Humans; D011204:Poverty Areas; D012574:Schools; D014480:United Nations