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Q&A: How to keep children fed and healthy as the pandemic ends school meals

‘If you take away the guarantee that a child will be fed at school every day, you are adding an expense to a family.’

Carlos Garcia Rawlins/REUTERS
As COVID-19 lockdowns stop school meals, aid groups are looking for ways to ensure that malnutrition and other health risks don’t rise. Gregoria Hernandez’s daughter was hospitalised for malnutrition in Venezuela last year.

With classrooms in 195 countries now emptied to help contain the spread of the coronavirus, school meals programmes are on hold, too. And that is raising concerns that millions of children who depend on school meals will become increasingly susceptible to malnourishment and other health risks.

“The reason that the issue of school meals is so prominent these days – not only for developed countries, including the US and the UK, and big countries, including Brazil and India, but also poor countries – is because meals themselves provide two functions,” the World Food Programme (WFP) director of school feeding, Carmen Burbano, told TNH. As she explained: “The first concern is to keep children well-nourished, and the second is economic. Meals represent about 10 percent of monthly incomes in poor households. If you take away the guarantee that a child will be fed at school every day, you are adding an expense to a family that may also be dealing with unemployment and other issues.”

WFP estimates that 368 million children worldwide are not receiving school meals, up from 300 million in mid-March. In 51 countries where classrooms are now empty, the agency normally funds school meals for 12 million children who no longer receive that aid. Six million children are still receiving school meals supported by WFP.

While the pandemic’s footprint has until now been largely in middle- and high-income countries, where malnutrition is less prevalent, nutritionists and aid groups are keeping an eye on increased risks of food insecurity and malnutrition elsewhere.

Lauren Landis, WFP’s director of nutrition, worries about the timing of the pandemic in many of the poorest countries. “When you go into the lean season, which we are likely to hit in many countries before the crop comes in, this is when children may not be getting adequate nutrition and may be more vulnerable”, she explained. Somalia, Ethiopia, and Sudan are amongst countries facing the greatest risk, she said.

It’s still unclear just how coronavirus may affect undernourished children. “There is no global systemic reporting on the impact of COVID-19 on children right now,” explained Marixie Mercado, UNICEF’s senior communications advisor. “We don’t have the science yet”. 

But earlier studies have shown that children suffering from severe malnutrition are nine times as likely to die than those who are not, from both malnutrition itself and common infections. 

“We know that those children’s immunity is diminished,” said Marie Petry, health and nutrition manager in the Democratic Republic of Congo for Action contre la Faim, a NGO fighting hunger. “They are much more vulnerable to bacteria and viruses”.

Petry, who leads nutrition programmes in Ituri and North Kivu, is concerned that COVID-19 may overstretch health services for young patients suffering from malnutrition. 

“We know that those children’s immunity is diminished. They are much more vulnerable to bacteria and viruses.”

She worries that DRC communities served by her programme may soon feel the negative impacts of measures taken to contain the outbreak. Food deliveries are already slowing, as quarantines go into effect and fewer staff are available for distribution, she said.

For a look at how to tackle some of these issues, WFP’s Burbano spoke with TNH last week from Rome. She focused on what children and their families in poorer countries will face as school meal programmes continue to be disrupted, and on how governments and aid organisations may need to respond. “We are working country by country on solutions,” she said. 

This interview has been edited for clarity and length. 

TNH: In which countries are children most vulnerable?

Carmen Burbano: Our greatest concern is in low income countries, where circumstances are complicated. We are keeping an eye on places that were already experiencing fragility, including conflicts, and countries that are dependent on the international community for aid programmes. These include countries in the Sahel region and in the Horn of Africa. Those countries had existing exacerbating circumstances and incipient national capacity issues. 

If the pandemic starts to explode in Africa, for instance, the continent will also be very hard hit in terms of its health sector. We are looking at these complications in order to put in place mechanisms to support, and solutions for, children who no longer receive meals, to assure they receive assistance. 

TNH: How many children are currently supported by WFP? 

Burbano: The latest numbers are around 12 million children that we support directly through our own operations. This represents slightly more than half of WFP’s global caseload of children we support in the school feeding programme. We are working country by country on solutions. Options include take-home rations and assembling family rations, which would be the equivalent of what the child would receive for one or two weeks and we would distribute them to the family directly. We are also looking at working with communities to prepare the food and make it available at community distribution points. Another option is vouchers, so that families could go to stores and get the equivalent of the food the child would have received at school, or cash alternatives. 

TNH: Are you concerned about the effects that tightening borders and mobility may have on the availability and distribution of food?

Burbano: We are concerned about the impact government policies may have on the future of food availability in countries where borders are closing, making it difficult for transporters to bring food into countries. 

At the moment, food availability does not appear to be a problem. It is more about consumer behaviour and panic buying, rather than scarcity in the markets. But we are keeping track of this because government policies will affect the availability of food, and in the long run there is the possibility of that happening. 

We are asking donors to frontload contributions and commitments that we expect to come in during the year. We are asking donors to advance approximately $1.9 billion in contributions now, so that we can pre-position stocks in the form of food or cash. We are moving to pre-position three months’ worth of food or assistance so that we can support governments in what will inevitably become a growing crisis in the developing world.

TNH: Due to potential delivery issues, what sort of rations are you considering, particularly regarding the one- to two-week packages?

Burbano: One thing we are grappling with now is that we have to change the type of food we are providing to families. What we distribute to the schools has to be non-perishable. In most of these countries, a combination of food distributed to the school includes rice, lentils, beans, and other foods that are non-perishable, and a local procurement element where school districts buy locally from farmers fresh foods, such as vegetables and fruit, eggs, and milk. But now, the question is what do we do about fresh food? At the moment, that is not an element that we can guarantee. Our offices are looking now at how that basket may look, how we will package it, and how we get it to the families. If it is in the form of a voucher, there has to be more flexibility around what families can buy in a supermarket. But that only works where there are supermarkets nearby, such as in urban or peri-urban areas.

TNH: As traditional donor countries need to devote funds to deal with the virus’s fallout at home, concerns grow that they may be less inclined to contribute to global assistance programmes. What’s your view on this?

Burbano: That is a concern overall, regarding the huge expense that developed countries are having to put toward their health sector, which should come first. All countries now have to prioritise their capacities to respond to the health crisis. 

“We will probably see a rise in poverty, in malnourished and hungry populations, and in vulnerability, which we will have to contend with.”

We are keeping track of what impact the economic downturn is having on the availability of funding. This is something we are concerned about, and we are having to look at each individual donor country and what their reactions may be moving forward. While priority is and should be on the health sector, the aftermath of the crisis will leave behind an enormous amount of vulnerable people who were not in that category before. 

We will probably see a rise in poverty, in malnourished and hungry populations, and in vulnerability, which we will have to contend with. Within the UN, part of the discussions regarding what will happen after the most acute part of the crisis is over will have to be how we work with governments to assure the social protection systems are still working, and among those the school feeding programmes.


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