There have been multiple attempts at developing nutrition outcome indicators. Most attention is on early childhood. The Global Nutrition Report, established at the 2014 Nutrition for Growth Summit, tracks government, donor and other stakeholder commitments for nutrition, spotlighting the first 1,000 days. Monitoring efforts are developed in areas of maternal and infant nutrition, with global targets focusing on stunting, anaemia, low birth weight, childhood overweight, breastfeeding and wasting.
But this leaves a blind spot on middle childhood and adolescence. Without indicators for these age groups, it is hard to set and monitor nutrition targets, perpetuating the perception that the nutrition of these children may matter less, even though it is critical for their development and for making the most of their education opportunities.
School meal coverage is a potential indicator for monitoring older children’s nutrition
One opportunity is to monitor school meals. School meal programmes are viewed as ‘triple duty’ actions, addressing undernutrition, reducing processed food exposure, and supporting farmers, while encouraging school attendance and performance. Efforts to institutionalize data, monitoring and advocacy on school meals have intensified with the School Meals Coalition, which was launched during the UN Food Systems Summit in September 2021 with the goal that ‘by 2030, every child receives a healthy, nutritious daily meal in school’. Its Research Consortium for School Health and Nutrition and, notably, its Data and Monitoring Initiative, have helped advance thinking on school feeding monitoring.
A new SDG 4 thematic indicator, which links education with nutrition, measures the proportion of children attending school who receive school meals. The World Food Programme (WFP) provides data for this in its biennial publication, State of School Feeding Worldwide, drawing primarily on the Global School Feeding Survey. This is a survey run by the Global Child Nutrition Foundation, a non-profit organization which has completed three rounds of data collection (2019, 2021 and 2024). The publication also draws on WFP Annual Country Reports and secondary sources, including official reports, publications and case studies.
According to the last round, at least 459 million children, or 47% of primary school students, received school meals, an increase of 41 million relative to 2022 and of 71 million relative to early 2020. Coverage is much higher in primary than in secondary school. Among 127 countries in 2022, the coverage rate was below 10% for 7 countries in primary education and 60 countries in secondary education.
School meal quality and relevance also need to be monitored
Provision is important, but quality is just as critical. There are at least three areas where the indicator needs to be improved to be more relevant for policy.
- The policy goal of school meal programmes needs to be clear in order to understand better what the indicator shows. The Gambia, for example, has a school meals programme that provides a hot mid-morning meal to children enrolled in public schools in the country’s most vulnerable regions. In 2022, around 47% of primary school children enrolled were fed. But one third of primary school students are enrolled in private schools and are therefore not eligible for the school meals programme.
- The indicator does not reveal the type of meal provided, which makes it difficult to compare national efforts. For example, countries may be offering a breakfast or a lunch; a cold meal or a hot meal; a snack or a full meal; a meal in the school or take-home rations; and food of variable nutritional value, including items that are not healthy. Some concerns have also been raised as to whether schools offer meals that end up not being eaten. Not all of these monitoring issues can be addressed at a reasonable cost, but some refinements are needed to strengthen comparability.
- The administration may also need some refinement. Despite the wide coverage, some countries have expressed a preference for the questionnaire to be administered by an intergovernmental organization, such as WFP or UNESCO, instead of a non-governmental organization.
The Food and Agricultural Organization, meanwhile, is advocating for a whole-school approach and deeper investigation into how food and nutrition education are integrated into national curricula. It has developed a White Paper on school-based food and nutrition education for low- and middle-income countries and has conducted surveys and capacity needs assessments. It has also developed curriculum guidelines with an emphasis on experiential learning. Its School Food and Nutrition Global Action Plan 2022–2026 proposes monitoring the uptake of holistic approaches.
Beyond school meals
Alongside the food being provided in schools, monitoring nutritional knowledge and attitudes can be important for understanding dietary practices and nutritional outcomes. International large-scale assessments can offer some insights. The science questions in the 2025 PISA assessment cover knowledge of food systems, such as the environmental impacts of eating meat. Nutrition-related knowledge on food consumption and choices will also be assessed in the context of science and environmental education.
The 2023 TIMSS life science questions for grade 4 students that relate to human health also identify common food sources for a balanced diet and behaviours that promote good health, while grade 8 questions focus on the importance of diet, exercise and other lifestyle choices in maintaining health.
Conclusion
A core recommendation in our Learn to eat well report, published at this year’s Nutrition for Growth Summit, which we hope will carry through to the 2nd Global Summit of the School Meals Coalition in Fortaleza this week, is to monitor the relationship between education and nutrition through the life cycle, including tracking school meals and related health and nutrition programmes to improve the effectiveness of interventions. In practice, the following are necessary:
- Improve research on education–nutrition links beyond the first 1,000 days by collecting data on nutrition indicators for school-age children linked to learning outcome data.
- Refine the SDG 4 thematic indicator on school meal coverage in terms of alignment with policy targets, comparable quality definitions and how country surveys are administered.
