Changes in school feeding operations during the COVID-19 pandemic: evidence from 139 countries

School meal programs, which provide students with meals, snacks, or take-home rations and serve as a safety net for vulnerable children worldwide, were severely disrupted by the COVID-19 pandemic. This study draws on the 2021 Global Survey of School Meal Programs to explore changes in school feeding operations during the COVID-19 pandemic and identify factors that can facilitate program resilience. The survey, inclusive of both closed and open-ended questions, gathered data on 183 programs operating in 139 countries. Findings suggest that, even though school meal programs were negatively affected by the pandemic and associated school closures, they responded with creativity, employing new feeding modalities, venues of distribution, and approaches to targeting. Regression results further show that involvement of nutritionists was associated with continuity (a lack of interruption) of feeding services. Flexibility and preparedness were highlighted as factors that strengthened programs in a time of crisis. At the same time, the experience of emergencies that occur simultaneously or in quick succession (“stacked” emergencies) hampered their ability to operate. Survey results confirm that attention must be given to school meal programs in low-income settings, as school feeding coverage is lowest in such settings, these programs often have limited resources, and they are more likely to experience stacked emergencies.


Introduction
In 2020, the COVID-19 pandemic posed a serious threat to food systems across the world.More recently, the Russia-Ukraine war and other conflicts have compounded the situation and triggered a global food crisis that is expected to drive millions more into poverty, deep hunger, and malnutrition (World Bank Group, 2022).In addition to the COVID-19 pandemic and conflicts, many countries are also afflicted by the climate crisis, experiencing increasingly severe weather and other natural disasters, with extreme heat endangering lives and limiting agricultural productivity (Harvey et al., 2022).Emergencies that occur simultaneously or in quick succession-hereafter referred to as "stacked emergencies"-are exacerbating food insecurity and threatening to reverse years of progress in public health and economic development, especially in low-and middleincome countries (LMICs).
In this context, school meal programs have been facing unprecedented threats, including the interruption of service following school closures, rising food costs, supply and staff shortages, and transportation challenges (Ala-Karvia et al., 2022).School feeding programs are one of the largest public health and social safety nets in the world (World Bank Group, 2018).Pre-pandemic, school meals reached almost 388 million children and adolescents globally (WFP, 2020), providing about two-thirds of students' daily nutritional needs and protecting many food-insecure children from hunger.School meals are associated with better school attendance, improvements in education and test scores, and enhanced physical and psychosocial health, with benefits especially pronounced for girls and disadvantaged children (Aurino et al., 2018;Chakraborty & Jayaraman, 2019;Cueto & Chinen, 2008;Kazianga et al., 2009;Kremer & Vermeersch, 2005).Additionally, most program implementers offer complementary health, nutrition, and education services alongside school feeding (GCNF 2021;WFP, 2021).
Given the importance of school feeding programs for children's health and nutritional status, it is imperative that the impact of crises and emergencies on school meals be minimized, especially in the poorest countries.Though many school meal programs showed flexibility during the pandemic (Ala-Karvia et al., 2022;Colón-Ramos et al., 2022;Connolly et al., 2021;Kinsey et al., 2020;McLoughlin et al., 2020), challenges persist, and the current world food crisis calls for more creative and multidisciplinary solutions.
Recent conflict-driven export bans and disruptions have contributed to food scarcity and higher costs of food (Espitia et al., 2022); this presents an opportunity to reflect on the importance of local sourcing.Strengthening local supply chains and supporting agri-businesses through school meals is a first step in building sustainable and resilient food systems that provide nutritious and affordable foods to communities and children, especially when food import is not a viable option (GCNF & GFN, 2022).Local sourcing from nearby farms, also referred to as farm-to-school programs in some countries, has been found to support healthier meals, bring local or regionally produced foods into school cafeterias, provide opportunities for children to practice handson activities such as gardening or cooking, and integrate nutrition education in the classroom (Connolly et al., 2021;Ralston et al., 2017).
Another important yet overlooked factor in times of crisis is the role of nutritionists in schools.Foods provided at school do not always conform to dietary recommendations (Soares et al., 2021), and the nutritional quality of school meals served during the COVID-19 pandemic deteriorated in at least some settings (Beitane et al., 2021;Colón-Ramos et al., 2022).Analysts have highlighted the need for nutritional guidelines to meet the needs of beneficiaries during emergencies (Colón-Ramos et al., 2022).The involvement of nutritionists in school meals is critical to ensure that nutritional standards are met-especially during times of food insecurity, food shortages, and increased stress among students.
This study utilizes the 2021 Global Survey of School Meal Programs © , a unique survey conducted by the Global Child Nutrition Foundation (GCNF) which gathered data on 183 school meal programs operating in 139 countries in the 2020-2021 school year (GCNF, 2022).The survey is inclusive of all large-scale school meal programs operating in each country.Large-scale school meal programs are defined as programs that are managed by country or regional governments or by non-governmental entities and that reach a substantial proportion of students in the country.These programs offer in-school or take-home breakfast, lunch, dinner, or snacks, or a combination thereof (GCNF, 2022).
The survey captured detailed information on how school meal programs were affected by, and responded to, the COVID-19 pandemic, in addition to rich information on school meal program operations and funding.The survey included both closed-ended and open-ended questions, allowing for both a quantitative and qualitative analysis of data.In addition, the 2021 survey was the second survey round, allowing for an evaluation of some trends over time with reference to a pre-pandemic baseline.
This paper focuses on large-scale school meal programs that were captured in the survey and that offered meals/ snacks of any kind to students during the academic year that began in 2020.In our study, we determine global changes in school feeding operations during the COVID-19 pandemic, and we give attention to other emergencies in addition to COVID-19.We analyze the prevalence of complementary health services (such as handwashing and water purification) and complementary education programs (such as nutrition and physical education) offered along with school feeding to discern the potential impact of school closure on such services.We also present a set of lessons learned during the pandemic.The aim of this study is to provide policy makers with guidance to support and strengthen school feeding operations during an unprecedented world food crisis.
The study makes several contributions to the literature on school meal programs and the COVID-19 pandemic.First, as noted, we draw on the recently collected 2021 Global Survey of School Meal Programs.No other data resource provides a comparable breadth and depth of information on the state of school meal programs.Second, to our knowledge, no other study has looked in detail at the role of farmers, local sourcing, and nutritionists in the response of school meals to the pandemic on a global scale.This produces important insights for school meal programming.Third, by quantifying the provision of complementary programs that are associated with school feeding and predicting the impact of school closure on such programs, we provide additional evidence that school meals need to be given priority during emergencies, especially in low-income settings.Fourth, we consider the prevalence of stacked emergencies during the 2020-2021 school year-an approach that acknowledges the complexity of the pandemic response during a time of broader upheaval.
The remainder of the paper is organized as follows.In Sect.2, we provide information on the data and methods.In Sect.3, we report the results, inclusive of a quantitative overview of school feeding and complementary programs; school closure and changes in school feeding operations due to COVID-19; stacked emergencies; and qualitative results on programs' challenges and successes during the pandemic.In Sect.4, we discuss the findings and implications for school feeding programs in a time of crisis.

Data
This research utilizes data from the 2021 Global Survey of School Meal Programs © (GCNF, 2022;GCNF Global Survey, 2021), conducted by the Global Child Nutrition Foundation (GCNF).The survey asked for information on the academic year that began in 2020; just two countries could not provide this and instead provided information on the year 2021.Data collection took place from July 2021 to March 2022.The survey team reached out to national governments and asked them to designate a person, called the "focal point", who was knowledgeable about school feeding programs in their country and could gather accurate data and complete the survey.To ensure a consistent understanding of terminology, a detailed glossary of terms used in the questionnaire was provided along with the survey, which was administered in seven languages (GCNF, 2022).
One hundred ninety-four countries were eligible to participate in the 2021 survey, and a survey invitation was sent to 192 countries.Invitations were not extended to Afghanistan and North Korea, as no government contacts were identified.In total, a survey response was received by 134 countries, 14 of which reported that they did not have any large-scale school meal programs.Additionally, information for Australia, Greece, and Kyrgyzstan was obtained through third-party submission, while a desk review of countries that did not participate in the survey returned suitable data for India and New Zealand.Information from third party submissions and desk reviews was incorporated into the dataset, yielding information for a total of 139 countries and 183 individual school feeding programs.A summary of data coverage is presented in Table 5 and Fig. 9 of the Appendix.In total, data are available for 72% of the countries in the world, which together held 81% of the world's population as of 2020.The dataset and further details on the data collection process can be accessed through the Global Child Nutrition Foundation (GCNF, 2022).
The survey captured quantitative data on school feeding coverage, complementary programs, and school closures experienced during the reference year.Additionally, the dataset includes information on changes to school feeding operations during the COVID-19 pandemic, inclusive of interruptions to school feeding operations, and on the occurrence of other types of emergencies.Information was collected both at the country level and program level.
Finally, several open-ended questions were included in the survey.These asked about actions or policies the country government could take to better support getting food to children during a pandemic.Respondents were also given space to reflect on ways in which their program could have reacted differently to the pandemic, and any ways in which the pandemic presented a challenge in the response to other emergencies or generated positive developments in the school meal programs.

Analysis
Statistical analyses were conducted in July 2022 using STATA 17 (StataCorp, 2021).We analyzed data at the global level and by subpopulation, with three main groupings: by income level, region, and rural population status.Income categories reflect the 2020 World Bank classification of countries by high-income, upper middle-income, lower middle-income, and low-income (Serajuddin & Hamadeh, 2020).Region classification includes Europe, Central Asia, and North America; Latin America and the Caribbean; Middle East and North Africa; Central Asia, East Asia, and the Pacific; and Sub-Saharan Africa.This classification loosely matches that employed by the World Bank; however, North America is combined with the Europe/Central Asia region to ensure a suitable number of countries in each group, and South Asia is combined with the East Asia/Pacific region for the same reason.Finally, countries were categorized according to whether they have more or less than half of their population living in rural areas (World Bank, 2021).Table 5 in the Appendix includes a summary of school meal programs by region, income group, and rural status.
The rate of school feeding coverage was constructed as the percentage of the total number of children of primary and secondary school age in the country or, alternatively, the percentage of children enrolled in primary and secondary school in the country that were reached by school feeding programs.Information on the number of children and school enrollment was either provided by the focal points or drawn from the UNESCO Institute of Statistics database (UIS, 2022).One-way ANOVA tests were performed to determine whether the provision of complementary programs and experience of school closure differed by income level, geographical region, and rural population.Pearson's Chi-square tests were used to determine differences among subgroups regarding changes in school feeding operations, and Wilcoxon signed-rank tests were used to analyze changes in complementary programs from 2019 to 2021.Statistical significance was determined at p < 0.05.
We performed a multinomial logistic regression to further explore the correlates of an interruption in school feeding operations during the COVID-19 pandemic.In the model, we included explanatory variables that can plausibly influence the success and sustainability of school feeding programs during a global emergency.These include variables such as presence of a government agency with primary management responsibility for the school meal program, assessed through question C3 in the survey; national food sourcing, assessed through question E1.2, asking whether any food in the program was purchased from local, regional, or national sources or national food reserves; involvement of farmers, which encompasses the involvement of farmers of any size in selling produce to the school meal program directly or through their farmers organization, assessed through question H1; involvement of nutritionists in the program, assessed through question D20; funding from the national government, assessed through question G1.1; occurrence of any emergencies in addition to COVID-19, including slow-onset emergencies such as desertification or deforestation, natural disasters, financial crises, conflict, health epidemics, or other emergencies, assessed through question I6; and country income categories (GCNF Global Survey, 2021).A summary of these variables can be found in the Appendix (Table 6).
As noted, the survey included several open-ended questions on how school meal programs had experienced the COVID-19 pandemic.To analyze the qualitative data, we coded the text by reviewing raw responses and labeling and assigning codes to each sentence (Rouder et al., 2021).We then identified commonalities among the preliminary codes and grouped them into larger categories called "organizing themes" (Attride-Stirling, 2001).Finally, we calculated the frequency of each organizing theme and created pie charts to visually represent their distribution (Rouder et al., 2021).Through these steps, we discerned patterns across responses to the open-ended questions and identified the most salient themes in the submitted narratives.

Overview of school feeding
As noted, our measure of school feeding coverage refers to primary and secondary school.Across the 139 countries in the database, out of 1.18 billion children of primary and secondary school age, approximately 309 million children (or 26%) received food via school meal programs during the school year 2020/2021 (Fig. 1).Of 1.08 billion students enrolled in primary and secondary school (with out-ofschool children now excluded from the denominator), 29% received school meals (Fig. 2).
Coverage of enrolled students varied across income categories.High-income countries had the highest coverage at 47% of enrolled students.Coverage was 31% for upper middle-income countries and 27% for lower middle-income countries, while low-income countries had the lowest coverage at 13% (Fig. 3).This pattern strongly suggests that school meal coverage is lower in more vulnerable settings, and that more work is needed to provide a social safety net for children at higher risk for poverty and hunger.Coverage also varied by region.Latin America and the Caribbean had the highest coverage at 57%, followed by Europe/North America/Central Asia at 46%.South Asia/East Asia/Pacific had 25% coverage, Sub-Saharan Africa had 22% coverage, and the Middle East/North Africa had just 9% coverage (Fig. 3).Coverage also varied by rural population status.Countries in which less than half the population lived in rural areas had 30% coverage, compared to 27% in other countries (Fig. 3).Coverage for all children of primary and secondary school-age, rather than just enrolled students, was slightly lower, though patterns were extremely similar (Fig. 10 of the Appendix).
Primary school students had higher rates of school meal coverage than secondary school students.Specifically, across the 139 countries in the database, among 604 million students enrolled in primary school, a total of 234 million (or 39%) received food through school meals.Of 472 million students enrolled in secondary school, a total of 75 million (or 16%) received food through school meals.

Overview of complementary services and education programs
Information on complementary services and education programs that were offered alongside school feeding activities was available for all 183 school feeding programs in the database.A large majority (90%) of programs reported offering at least one complementary service, and 96% offered at least one complementary education program.School meal programs offered, on average, 4 complementary services and 5 complementary education programs.The most common complementary services were handwashing facilities and the provision of drinking water, reported by 139 and 98 programs, respectively.The most common complementary education programs were food and nutrition education and hygiene education, reported by 153 and 130 programs, respectively.
As seen in Fig. 4, school meal programs in higher-income countries offered fewer complementary services, on average, than programs in lower-income countries.Similarly, programs in regions with greater economic resources, such as Europe/North America/Central Asia, offered fewer complementary services compared to regions with a lower resource base, such as South Asia/East Asia/Pacific and Sub-Saharan Africa.Finally, programs in countries with a majority urban population offered fewer complementary services than those operating in countries that were majority rural.This is likely indicative of a greater need for complementary services that are not otherwise available in settings with limited resources.One-way ANOVA tests of the mean number of complementary programs indicate that these differences are statistically significant across income categories (F 3,179 = 3.69, p = 0.013), regions (F 4,178 = 9.63, p < 0.001), and rural status (F 1,181 = 4.75, p = 0.031).
Interestingly, there was no statistically significant difference for the mean number of complementary education programs across income categories, though a difference was evident across regions (F 4,178 = 4.31, p = 0.002).Programs in South Asia/East Asia/Pacific had the highest mean number of complementary education services (6).
As we aim to understand the impact of the COVID-19 pandemic on school meal programs and their associated complementary offerings, we performed Wilcoxon signedrank tests to analyze changes in the median number of complementary programs from 2019 to 2021.The median number of complementary services decreased from 2019 to 2021, falling from 7 to 6 (Z = 3.360, p < 0.001), and the median number of complementary education programs also decreased from 5 to 3 (Z = 3.260, p = 0.001).The implication of this finding will be discussed in Sect. 4.

School closures in 2020/2021
Of the 139 countries in the database, 119 countries provided information on school closures during the 2020/2021 academic year.Respondents were asked to report the number of months during which schools were all open; all closed for holidays; some open and some operating remotely; all closed because of COVID-19 or other emergencies and operating remotely; or all closed because of COVID-19 or other emergencies and not operating.School closure statistics reported in this section do not account for holidays, but rather for closures due to COVID-19 and other emergencies.On average, across these 119 countries, schools were closed for 5 months.A majority (59%) of respondents reported that, in their country, all or most schools were closed for at least three months.Results of a one-way ANOVA test revealed a significant difference in the mean number of months of school closure between regions (F 4,114 = 3.88, p = 0.005), with Latin America/Caribbean standing out with the highest average number of months of school closure at 7 months.As school closures translate into a disruption or temporary restructuring school feeding activities, this likely has implications for the geography of how school meal programs were affected by the COVID-19 pandemic.There was no significant difference in school closure by income categories or rural population status.

Occurrence of other emergencies
Data on the occurrence of other emergencies apart from the COVID-19 pandemic is available for all 183 programs.Almost half of the programs, or 46%, reported that their country was affected by at least one other emergency in addition to COVID-19, while 16% of programs reported that their country was affected by at least two other emergencies.Chi-squared tests are used to test for statistically significant difference across various subgroups.
The experience of other emergencies varied significantly by income categories (χ 2 df(3) = 34.12,p < 0.001), regions (χ 2 df(4) = 24.88,p < 0.001), and rural status (χ 2 df(1) = 16.76,p < 0.001), with programs in higher resource settings less likely than others to experience additional emergencies.As an example, 21% of programs in high-income countries reported the occurrence of other emergencies, compared to 78% of programs in low-income countries (Fig. 5).Similarly, only 17% of programs in Europe/North America/Central Asia reported the occurrence of other emergencies, while 63% of programs in Latin America/Caribbean did so (Fig. 5).
Of note, programs in Sub-Saharan Africa were the only programs to report the occurrence of slow-onset emergencies (19%), such as droughts, and other health epidemics (13%), such as Ebola or HIV/AIDS.Additionally, 28% of programs in Sub-Saharan Africa and 27% of programs in the Middle East/North Africa reported the occurrence of conflicts, compared to 4% in Latin America/Caribbean, 2% in Europe/Central Asia/North America, and 0% in South Asia/East Asia/ Pacific, though programs in the latter region did report other emergencies.We acknowledge that the data on emergencies is likely to be less precise than the information collected in the survey that more directly relates to school meals.

Changes to school feeding operations in response to the COVID-19 pandemic
Focal points (survey respondents) were asked to report on how school feeding operations were affected by the COVID-19 pandemic in the 2020/2021 school year.The number of students fed and the frequency of school feeding were affected the most (Table 1).Specifically, 46% of programs reported that the number of students fed decreased, and 44% reported that the frequency of school feeding decreased.
A smaller share of programs (18% and 5%, respectively) reported that their numbers of students fed and frequency of food provision increased in response to the emergency.
In terms of how school meal programs actively responded to the pandemic, the feeding modality changed temporarily for 46% of programs and changed "to this day" (i.e., as of the time of survey completion) for 9% of programs.Finally, 40% of programs reported that they temporarily ceased feeding operations.Results are presented in Table 2.
To better understand the distribution of impact and potential mitigating factors, we also analyzed the above changes in feeding operations by income, region, and rural population status, as well as involvement of a national agency responsible for the programs, involvement of nutritionists, involvement of farmers, local/national food purchase, government funding, feeding modalities (e.g., in-school meals, take-home rations), and occurrence of other emergencies.More information regarding these mitigating factors can be found in Sect.2.2.
Programs sometimes responded to the pandemic by changing the setting of eating, as when schools had students eat lunch outside or in their respective classrooms, rather than in a crowded cafeteria.Interestingly, chi-square tests revealed a significant difference in whether school meal programs changed their venue of food distribution across income groups (χ 2 df(3) = 18.37, p < 0.001), regions (χ 2 df(4) = 27.92,p < 0.001), and rural population status (χ 2 df(1) = 5.57, p = 0.018).Specifically, programs in resource-rich areas were more likely to report a change in the venue of food distribution (Fig. 6).The ability to change location of food distribution might be associated with a greater availability of resources.
Programs that offered take-home rations were more likely to report a change in venue of distribution compared to programs that did not offer take-home-rations (χ 2 df(1) = 9.63, p = 0.002).This is likely because the two features of programming were linked, with programs pivoting to offer take-home rations and pass off the food in a new location.Programs that offered take-home rations were also more likely to report a change in beneficiaries (χ 2 df(1) = 24.05,p < 0.001), often shifting from targeting students to targeting their families.
Programs that reported involvement of nutritionists were less likely to report interruption of feeding operations, either temporarily or to this day, compared to programs in which nutritionists were not involved (χ 2 df(1) = 6.05, p = 0.014) (Fig. 7).This may be attributed to differences in available resources but may also reflect the influence of nutritionists and their keen attention to stability of food access.
Finally, programs that reported an occurrence of emergencies in addition to COVID-19 were more likely to see a change in feeding modality, compared to those that did not report other emergencies (χ 2 df(1) = 7.45, p = 0.006) (Fig. 8).We did not find a significant difference for changes in feeding operations based on involvement of a national agency in school feeding activities, involvement of farmers, local/ national purchase programs, or government funding.

Creative responses to the pandemic
Out of 183 school meal programs, 34% reported serving meals differently than before in response to the COVID-19 pandemic (e.g., having students sit far apart), and 22% reported making meals available for pick up.Additionally, 24% of programs reported making ingredients (rather than prepared meals) available for pick up, and 11% delivered ingredients directly to students' homes.A smaller share (8%) of programs provided monetary support electronically, and 5% provided monetary support with coupons or hard currency.Complete results can be found in Table 3.

Correlates of program vulnerability
A program-level multinomial logistic regression model was used to further identify correlates of the interruption of feeding operations.Covariates include the presence of a government agency responsible for the program, involvement of nutritionists, funding from national government, purchasing of domestic foods, involvement of farmers, occurrence of emergencies, and country income categories.Results indicate that, holding all else constant, the relative risk ratio of ceasing feeding operations, either temporarily or to this day, decreased by 58.8% (95% CI [0.187-0.910])for programs that reported involvement of nutritionists compared to programs that did not.Results of the logistic regression analysis can be found in Table 4.

Challenges and successes of school meals during the COVID-19 pandemic
In a set of open-ended questions, focal points identified the ways in which their programs reacted well or could have reacted differently to the COVID-19 pandemic.A breakdown of the themes mentioned in the relevant survey questions is provided in the Appendix (Fig. 11).Reflecting the statistics presented in Sect.3.1-3.3,respondents noted the importance of program flexibility and the ability to provide food through a diversity of distribution modalities.A recurring theme was the provision of take-home rations, a modality of meal distribution that proved to be an effective way to reach children and families during a time of crisis.
The role of at-home food delivery during school closures was also noted by the focal points in Argentina, El Salvador, Chile, Mozambique, Poland, and elsewhere.Additionally, some programs reported quickly adapting to the situation by creating different menus and finding alternative spaces to allow students to eat in a safe manner.Some respondents mentioned the importance of local autonomy.As noted by the focal point from Latvia, "The government responded to the situation by… allowing local governments to individually adapt to the situation and make decisions independently".Importantly, several programs voiced the need for additional funding from the government, which can allow for greater flexibility and resilience.These results are consistent with previous findings that the success of school meal programs during the COVID-19 pandemic was highly dependent on programs' autonomy and financial support (Colón-Ramos et al., 2022).
A common theme regarding the role of government was the need to establish an emergency or contingency plan to facilitate a quick response to an emergency.Such a plan should include clear guidance on COVID-19 hygiene and preventative measures, regulations for school meals during closure, and policies on safe school reopening.Several respondents also identified the need for more financial support to families and school meal programs and for a national law to ensure the provision of school feeding as a social safety net, especially for the most vulnerable children.
Many respondents gave attention to supply chain disruptions that arose during the global pandemic and suggested  Despite the many difficulties that the COVID-19 pandemic generated for food systems and school feeding programs, there have been some positive developments.Respondents widely reported a better understanding of, and appreciation for, hygiene practices.This was observed both at the program level-with attention to sanitation protocols and construction of hand washing stations-and at the student level.Many programs highlighted improvements in food safety practices, greater provision of potable water, and increased purchase of eating utensils (to decrease the need for sharing).These results are consistent with the findings by Ala-Karvia et al. (2022), who studied COVID-19-driven adaptations in the provision of school meals in the Baltic Sea region and found improvements in hygiene education and behavior.Additionally, a few programs were able to redirect money to different purposes during the pandemic.For example, in Argentina, the school meal program received additional funding that it was able to utilize for canteen renovation.
Finally, respondents broadly noted an increased appreciation for school feeding programs and greater awareness of their importance and benefits.This phenomenon was observed at multiple levels.First, some programs reported that leaders in the national government recognized the importance of providing school meals to children to fulfill their nutritional needs.As a result, some governments expanded funding, coverage, and number of meals.For example, the Government of Palau was reported to add breakfast to the school meal program.Second, parents showed increased appreciation for school feeding programs and became more involved in the process.Third, a few programs noted the interest of communities in school meals.For example, a program in Sierra Leone reported that the immediate support provided to households through takehome rations sparked interest in the community and community leaders who are now more supportive and engaged in school feeding.Additionally, in Italy, the COVID-19 pandemic revealed a need to reform the canteen service from an individual demand service to an essential public service, such that the concept of supporting the service though collective taxation has now been introduced.

Challenges of responding to other emergencies during the pandemic
As noted in Sect.3.4, many respondents reported experiencing multiple emergencies at once-what we refer to as stacked emergencies.Such emergencies included flooding, earthquakes, volcanic eruptions, droughts, hurricanes, Ebola outbreaks, terrorism and the presence of armed groups, influxes of refugees, protests, and economic crises.These emergencies increased insecurity and were responsible for the displacement of populations.They impeded access to schools, created price spikes in food markets, limited access to water, and damaged houses.The occurrence of COVID-19 aggravated the situation and compromised the response to other emergencies.Responses to open-ended questions indicated that governments often felt overwhelmed by the occurrence of stacked emergencies.For example, in eSwatini, mobility restrictions and curfews introduced to limit the spread of COVID-19 made it more difficult to provide health care; this can be particularly disruptive if victims of a public health emergency or humanitarian crisis need urgent medical assistance.Elsewhere, the displacement of populations led to overcrowding that exacerbated the public health threat.For example, the focal point from Saint Vincent and the Grenadines reported that about 20,000 people were evacuated due to a volcanic eruption, and COVID-19 cases increased in shelters for evacuees where it was difficult to adhere to social distancing measures.Food products were also significantly affected by COVID-19 restrictions, as transportation was restricted and food prices increased; this can limit the reach and effectiveness of humanitarian response.The need to find resources to deal with stacked emergencies was commonly emphasized as a source of stress.Altogether, this points to a need for emergency response plans that account for the occurrence of stacked emergencies.

Discussion
Our study provides a summary of changes in school feeding operations during the COVID-19 pandemic, drawing on a unique quantitative and qualitative data resource, the Global Survey of School Meal Programs.Results showed that more than a quarter of all children of primary and secondary school-age worldwide relied on school meals to get food for themselves and, in some cases, for their families during the year 2020/2021.Higher income settings had a higher rate of school meal coverage compared to lower income settings.Studies have shown that free school meals are associated with higher school attendance and better performance, especially among low-income students and girls (Aurino et al., 2018;Afridi, 2011;Bartfeld et al., 2019;Chakraborty & Jayaraman, 2019;Gordanier et al., 2020;Kleinman et al., 2002;Leos-Urbel et al., 2013).This indicates a need to offer greater meal coverage in low-income settings where children are already at risk for poverty and hunger and school attendance rates are low.
In addition to fulfilling nutritional needs, school meal programs are also a critical vehicle to provide complementary services.Over 90% of programs reported offering complementary services or education programs, such as deworming treatment and nutrition education.These programs make an important contribution to children's overall wellbeing.For example, deworming interventions provide students with periodic anthelmintic, or deworming, treatments to fight worm infections that are prevalent in certain regions and are associated with malnutrition, impaired growth, and poor school performance (Taylor-Robinson et al., 2012).These complementary services are almost certainly affected when schools close in a time of emergency.
Given the importance of school meals for children and families, it is imperative that the effect of emergencies on school meals is minimized.At a time when the world is facing an unprecedented hunger crisis, with 345 million people in 82 countries facing an acute risk for food insecurity and food prices reaching an all-time high in 2022 (WFP, 2022), it is important to understand how school feeding programs are affected by emergency school closures and how they respond.Almost half of the school feeding programs reported that their country was affected by at least one other emergency in addition to COVID-19, including climate shocks, conflicts, and health epidemics, and programs in low-income countries were more likely than others to experience multiple emergencies.The number of people in LMICs that are affected by humanitarian emergencies is expected to rise due to conflicts, extreme weather hazards, and climate change (EAPSG, 2013;Walker et al., 2012;WHO, 2013).Policy makers in the school feeding space should therefore direct their attention to low-income settings, increasing technical and financial support and ensuring that contingency plans that account for the occurrence of multiple emergencies are in place.
School closures are perhaps the greatest effect of the pandemic and other emergencies on school meals.Respondents in 119 countries reported that all or most schools were closed for an average of 4.63 months in the 2020/2021 school year due to COVID-19 or other emergencies.School closure has enormous implications for students' health, as it limits the operation of school meal programs and health-related complementary services.While several studies on influenza and hand-foot-andmouth disease demonstrated that prompt school closure in response to a viral pathogen can significantly reduce the rate of infection (Cauchemez et al., 2008;Chadsuthi & Wichapeng, 2018;Ferguson et al., 2006), in the case of COVID-19, the benefits of school closure are less clear.Available data suggests that school closure did not significantly contribute to controlling the pandemic (Viner et al., 2020) and that children, who are less susceptible to the virus, have not played a substantive role in intra-household transmission of COVID-19 (Heavey et al., 2020;Zhu et al., 2020).Instead, health education and preventative practices such as handwashing, wearing a mask, and social distancing could be less disruptive and more effective in controlling the spread (Viner et al., 2020).Indeed, many respondents to our survey reported an improvement in handwashing practices and facilities, more attention to preventative measures such as social distancing, and increased health awareness.This demonstrates the recognition that school meal programs gave to hygiene measures and constitutes a reminder that school closure may not be the most suitable response to a similar public health emergency.
Importantly, we observed a significant decline in complementary services offered between 2019 and 2021.As these services are most pervasive in lower-income settings, this suggests that the disruption to school meal programs in 2020 may have had even wider implications for children in low-income settings, beyond interrupting their access to school meals.Policy makers should carefully determine if the risks associated with school closure outweigh the benefits in different settings, with attention to the feasible schooling modalities under different resource constraints.
The pandemic drove both negative and positive changes in school feeding operations.On one hand, almost half the programs reported that the number of students fed and frequency of school feeding decreased, putting millions of students and families at risk of food insecurity.On the other hand, the pandemic prompted many programs to quickly react and adapt to new conditions in order to continue or resume feeding operations.Modifications in feeding modality and venue of food distribution were among the most popular changes.The provision of take-home rations, which have been shown to be associated with higher school attendance and participation (Gelli, 2015;Kazianga et al., 2009), was associated with changes in venue of distribution and changes in beneficiaries.During an emergency, the pivot toward take-home rations can ensure coverage of the most vulnerable students and families.Therefore, governments and other program implementers should ensure that feeding programs have flexibility and enough resources to offer take-home rations or employ other creative feeding modalities during emergencies.
We found that several potential mitigating factors were associated with better outcomes during emergencies.Notably, holding constant a country's income level, the involvement of nutritionists was associated with a lower likelihood of interruption of feeding operations (i.e., a higher likelihood of continuity) during the COVID-19 pandemic.This could be attributed to the influence that nutritionists have on ensuring stable food access.Nutritionists help supervise key activities related to school meal programs, such as menu planning, monitoring of food handling, training of staff, and nutrition education, among others (Kitaoka, 2018).Nutritionists become even more critical in emergency conditions, as schools must find creative ways to reach children, and the quality of food is at risk of deteriorating.Future research is needed to assess the benefits associated with the involvement of nutritionists in school meal programs during emergencies and isolate the causality of such relationships.
Many respondents highlighted the importance of relying on local resources and farms, even though this did not emerge as a statistically significant correlate of continuity in school meal provision.Local food production is especially relevant to ensure access to food when supply chain disruptions and higher food prices are putting more people at risk for food insecurity (Campbell, 2021;Smith & Harrington, 2014).Policy makers should give attention to ensuring that more school meal programs have the resources to invest in local procurement.Future research could explore the costs and benefits of local procurement in school meal programs in countries of different income levels.Additionally, detailed analyses are needed to evaluate the impact of partnerships with local farms on local economies.
Our study has several limitations.First, the results are not representative of, and cannot be generalized to, all countries, as some countries did not participate in the survey.Second, our analyses revealed simple associations and not causal relationships.Third, the data are self-reported by focal points.Even though respondents were asked to complete the survey to the best of their abilities, the data may be subject to bias or inaccuracy.
Despite these limitations, we showed here that school feeding programs have been negatively impacted by the pandemic, though they demonstrated great resilience and flexibility in their response.More research is needed to understand the risks and benefits of school closure; to explore causal relationships between outcomes for school meal programs and various factors that could potentially facilitate robust responses to an emergency; and to inform policies that support school feeding programs during crises, especially in low-income settings.The Global Survey of School Meal Programs sheds light on the impact of shocks on school feeding, and the value of this data resource will grow as the survey is repeated in future years (Tables 5 and 6).

Fig. 1
Fig. 1 School Feeding Coverage for All Children of Primary and Secondary School Age

Fig. 3
Fig. 3 Coverage of Students Enrolled in Primary and Secondary School by Income Categories, Regions, and Rural Population Status

Fig. 5
Fig. 5 Occurrence of Emergencies Other than COVID-19 by Income Category and Region

Fig. 6
Fig. 6 Share of Programs that Changed the Venue of Food Distribution by Income, Region, and Rural Population Status

Fig. 7
Fig. 7 Share of Programs that Ceased Feeding Operations by Involvement of Nutritionists

Fig. 8
Fig. 8 Share of Programs that Changed Feeding Modality by Occurrence of Emergencies in Addition to COVID-19

Fig. 9
Fig. 9 Data coverage for the 2021 Global Survey of School Meal Programs

Fig. 10
Fig. 10 Coverage of All Children of Primary and Secondary School Age by Income Categories, Regions, and Rural Population Status

Table 1
Changes in School Feeding Operations (Impacts)

Table 3
Responses to the Pandemic: Meals, Ingredients, and Monetary Support nity food security, and promote healthy foods in schools.As the focal point from Barbados wrote, "During pandemic, the re-introduction of dishes that incorporate locally grown indigenous foods supports getting food to children.These tend to be more affordable and are usually healthier while supporting the local farming industry.Community food security is a growing trend that could be most applicable in a time when entire neighborhoods are quarantined, and children are home from school."The focal point from Bhutan further wrote, "The pandemic prompted the Government to prioritize in-country, local food production by investing in the local farmers.This fast-tracked the initiative of linking farmers to schools where schools could buy local, fresh, and nutritious foods for school meals."

Table 4
Multinomial Logistic Regression Analysis of Interruption of School Feeding a RRR relative risk ratio

Table 5
Data Coverage of the 2021 Global Survey of School Meal Programs a The number of surveys is inclusive of 134 surveys received from national governments, three third party submissions from NGOs, and two desk reviews of government-published data