In this week&rsquo;s edition, we examine children&rsquo;s health indicators in Egypt, and recommend ways to improve them.
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Egypt&rsquo;s Ministry of Education came under fire at the beginning of the month after a ministry inspector <a href="https://www.almasryalyoum.com/news/details/4260244#google_vignette">ridiculed</a> a high school girl&rsquo;s choice of lunch as uncouth; the meal consisted of the country&rsquo;s staple dish, fool, and baladi bread. The incident, which took place in Beni Souef&mdash;a socioeconomically disadvantaged city in Upper Egypt&mdash;raises questions about what is and is not an acceptable and nutritious snack or meal for school students. And more importantly, how can Egypt&rsquo;s school feeding programs help improve children&rsquo;s health?&nbsp;
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<h3 dir="ltr">Double the trouble</h3>
Egypt is facing the <a href="https://www.thelancet.com/series-do/double-burden-malnutrition">double burden</a> of malnutrition, meaning it must deal with both undernutrition and overnutrition. <a href="https://censusinfo.capmas.gov.eg/metadata-en-v4.2/index.php/catalog/665">According</a> to the Health Survey for Egyptian Households (2021), in the 5&ndash;9 age group, 45% of boys and 42.2% of girls were outside the normal weight range for their height, most of them underweight. By age 15&ndash;19, 29.6% of boys and 39.7% of girls were outside the normal range, but the problem had shifted almost entirely toward the overweight end of the scale.&nbsp;
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<a href="https://www.who.int/publications/i/item/WHO-NMH-NHD-17.3">Malnutrition</a> reduces individuals&rsquo; productivity and can trap them in a cycle of poverty and ill health. <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32497-3/fulltext">Children</a> who struggle with stunting, for example, are at a higher risk of developing non-communicable diseases later in life. It also has a significant <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC12488089/">impact</a> on their academic performance, with inadequate nutrition in the early stages in life leading to long-term cognitive deficits, or a decline in mental abilities, attention span, memory, and language use.&nbsp;
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Egypt&rsquo;s poor health indicators are attributable to several <a href="https://www.unicef.org/egypt/nutrition">factors</a>: accessibility, affordability and availability of nutritious food, as well as overall lack of information and dietary awareness.
<h3 dir="ltr">Where the problem lies</h3>
Even though Egyptian families&rsquo; largest expenditure is food, according to the latest <a href="https://www.capmas.gov.eg/publications/117">numbers</a>, in 2018, almost 40% of families reported not having access to adequate food, and nearly 50% had limited access to a diversity of nutritious food, an increase from 2015. At the root of this problem lies household poverty, a key driver of food insecurity that is aggravated by Egypt&rsquo;s skyrocketing food prices and <a href="https://aps.aucegypt.edu/en/articles/1351/wages-and-food-inflation-are-government-policies-exacerbating-or-mitigating-the-crisis">inflation</a>.
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When things get tough, most families say that they opt for cheaper foods, <a href="https://www.unicef.org/angola/media/2091/file/Full%20Report%20of%20The%20State%20of%20the%20World%E2%80%99s%20Children%202019.pdf">such</a> as sugary snacks, and cut back on protein (meat, chicken, and fish).&nbsp;
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Children in particular need a balanced diet to flourish. A <a href="https://www.capmas.gov.eg/publications/117">study</a> in 2021 found rural children who consumed legumes were less likely to be underweight, while urban children who did not consume dairy products were more prone to wasting. It also found that children who consumed meat products in urban areas were less likely to become underweight.
<h3 dir="ltr">What&rsquo;s one way to fix the problem?</h3>
Egypt introduced school feeding programs in 1942 by providing fortified meals. An assessment in 2020 found that it <a href="https://link.springer.com/article/10.1007/s12519-020-00342-8">helped</a> alleviate hunger before classes and enhance attention, concentration, and learning performance. Other reports have found that the program reduces the prevalence of overweight students and positively influences children&rsquo;s cognitive abilities, including visual memory, auditory vigilance, and working memory. However, challenges remain in program coordination and long-term nutritional impact. The program currently relies mostly on <a href="https://journals.ekb.eg/article_468761_4a606f024bc88cbf4f3bef68be620d18.pdf">processed snack packages</a> and some families have complained about the quality of the products.
Evidence from across the world indicates that school meals have a positive effect <a href="https://iris.who.int/server/api/core/bitstreams/33daf907-ef6c-4674-97a7-5f4cc67db97a/content">particularly</a> on low-income and disadvantaged families. Numerous countries have introduced and enhanced existing school meal programs to foster <a href="https://www.who.int/publications/i/item/9789240118324">healthy</a> diets and improve children&rsquo;s health indicators. In 2022, <a href="https://docs.wfp.org/api/documents/WFP-0000163830/download/">Jordan</a> shifted from a model of fortified date bars to a program of full, nutritious meals prepared in local community kitchens using fresh ingredients for 90,000 students. Children reported significantly higher levels of physical activity, found it easier to focus on learning, and reported less fatigue while being active. Similarly, Brazil&rsquo;s Fome Zero (Zero Hunger) is a multifaceted program tackling the root causes of hunger and poverty, including school meal programs supported by local family farmers, which now reaches 50 million <a href="https://policybasket.endhungerandpoverty.org/index.php/Brazil:_National_School_Feeding_Program_(PNAE)">students</a>.&nbsp;
<h3 dir="ltr">From limited scope to an all-encompassing strategy</h3>
Egypt must transform its existing program into a multifaceted strategy for tackling children&rsquo;s health, poverty, and educational challenges, with clear <a href="https://manshurat.org/node/13852">mandates</a> for the various government bodies involved and a coordinating mechanism. This is the right of every child and an investment in Egypt&rsquo;s future.
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School feeding programs should be sourced with local, fresh, and minimally processed foods, to bolster community involvement and food system resilience, and the program should be independently monitored for food safety standards.&nbsp;
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"Adasa" is a weekly policy digest by Alternative Policy Solutions.&nbsp;"Adasa" provides an analysis of a select number of policy developments and their effect on inclusive development and socioeconomic change.

عدسة

Adasa

التعليم من الروضة إلى الصف الثاني عشر

K-12 Education

الغذاء والتغذية

Food and Nutrition

التنمية الشاملة

Inclusive Development

دور التغذية المدرسية الصحية في تعزيز الأداء الأكاديمي

More Than a Meal: How Nutrition Reshapes Classroom Success