Zambezia (1978), VI (ii).RESEARCH REPORTTHE SUPPLEMENTARY FEEDING OF SCHOOL CHILDREN IN ATRIBAL TRUST LAND OF RHODESIATHE RECORDING OF the heights and weights of schoolchildren in theChiwundura Tribal Trust Land was initiated by Dr J. C. A. Davies in 1970;after his transfer to Salisbury this work was continued by Dr G. Lochriewho was subsequently also involved with the administration of a school-feeding scheme sponsored by the Freedom from Hunger Campaign.' UsingDr Davics"s demographic data i was able to show in a report that, in 1973,the height for age of 40 per cent of school children in the Chiwunduracommunity was below the 10th percentile, 'Boston Standards'; this suggestsa relatively high level of nutritional stress within the community.2A follow-up of agro-economic and health survey not only verified thisfinding, but also showed that socio-economic variables such as the cultivationof vleis, size of livestock holdings, wage earnings of migrant family heads,school education of family heads, and religious practice were significantlyrelated to family nutrition, height for age of children, child mortality and birthrate.3 Furthermore, evidence from these surveys clearly indicated that whilethe supplementary feeding of children was likely to bring about an improve-ment in their nutrition, growth and academic performance, such action wouldmerely remedy the symptoms rather than effect the cure of nutrition andhealth problems which were rooted in the home environment rather than theschool environment. Therefore dynamic action directed at changing the homeenvironment, as well as the supplementary feeding of children in schools,was required to effect a permanent change in the nutrition and physicaldevelopment of children.*Dr J. C. A. Davies, City Medical Officer of Health, Salisbury and formerlyTuberculosis Officer, Gwelo; Dr P. Lochrie, Government Medical Officer of Health,Gwclo2R. J. Theisen, 'Agro-economic Factors Influencing the Health and AcademicAchievement of Rural School Children' (unpubl paper, mimeo, 1976). Data from myfollow-up health survey shows that the 'heigh: for age' rating of African schoolchildrenis Significantly correlated with the size of the family's livestock holdings, the incidenceof protein foods in the diet and with religious practice. These findings suggest that theheight-for-age factor may be more indicative of long-term protein stress rather thancarbohydrate Stress. On the other hand, the weight-for-age factor is more variable thanthe height-for-age factor, and is significantly correlated with season and crop yield.This suggests that the weight-for-age factor is more indicative of short-term carbohydratestress rather than protein stress. However, there is a significant correlation betweenheight-for-age and weight-for-age values which indicates a high level of interdependency.The more stable height factor has been uSed in the analyses of this report in order tocontrol seasonal influences.3R. J. Theisen. 'Variables of population growth', Zambezia (1977),V,161-8.16917OSUPPLEMENTARY FEEDING OF SCHOOL CHILDRENIn June 1974, a school-feeding scheme sponsored by the Freedom FromHunger Campaign (OXFAM) was initiated in all schools of the ChiwunduraTribal Trust Land. Children in Grades 1 to 4 were given 190 ml of Nutrescodaily. No payment was made for the meal which was prepared at the school.What follows is a summary of the influence of this scheme on the physicaldevelopment of children in St Barnabas, Siwundula and Gunde schools.Analysis 1 shows that there has been an overall 12 per cent improve-ment in the growth of children who have participated in the scheme. Thisfinding has been verified by other analyses which show that during theperiod of supplementary feeding 73 per cent of severely stressed childrenAnalysis 1THE INFLUENCE OF SCHOOL FEEDING ON THE HEIGHT FOR AGEOF CHILDRENHYPOTHESIS: After two years of supplementary feeding there will be asignificant improvement in the height for age of school children.ANALYSISWih PercentileSchoolSiwundulaSt BarnabasGundeYear197319761973197619731976Numberat or above11212410115665108below_ 57356259636210th. PercentilePercentage Percentagebelow Improvement_Jl..-.[ ,222 138 !1127 i49 |r 1336 ICONTROLS: Children in Grades 1, 6 and 7 and all new children have beenomitted from this analysis, as these children were unlikely to have benefitedfrom supplementary feeding.SIGNIFICANCE EVALUATION AND CONCLUSION: A statistical testshows that there has been a significant improvement in the growth of schoolchildren (the hypothesis is significant at less than the 5 per cent level).R. J. THE1SEN171*Ł <who were below the 10th percentile height-for-age 'Boston standards'4 werefound to be growing taller at a faster rate than that predicted by the 10thpercentile standard, This improvement is significant at the 1 per cent levelwhen compared with the situation prior to supplementary feeding.Growth-rate statistics also show that the number of children in anyparticular school who actually benefit from supplementary feeding wouldnormally depend on the number of stunted children prior to feeding. In fact,this evidence suggests that supplementary feeding, in schools or classes wherethe height-for-age value of less than 20 per cent of children falls below the10th percentile standards, is not likely to result in a significant increase inthe numbers of children benefiting from the scheme. At this level otherfactors involving genetic, climatic and socio-economic variables wouldappear to be more important to nutrition and growth. These findings, as DrDavies has emphasized,3 suggest the need for a simple height-for-age screen-ing programme in order to isolate those schools which have the greatest needfor subsidized feeding.In spite of these findings, however, it could perhaps be argued that theimprovement in the physical development of children in the Chiwunduracommunity has resulted from the recent spate of good seasons rather thanfrom supplementary feeding. The validity of this assumption is tested byAnalysis 2, which compares the 1973 and 1976 height-for-age measurementsof children in Grade 1 in ovder to determine whether there has been animprovement in the growth of children entering school. The analysis, in fact,shows that there is only a marginal difference in the 10th percentile height-for-age ratings of children entering school in 1973 and in 1976; and thissuggests that the significant improvement in the growth of the older childrenhad in fact been brought about by supplementary feeding and not by animprovement in season and crop yields.The findings of Analysis 2 are further verified by replicated observationof the agro-economic survey which showed that agricultural productivityactually declined after the 1971 season when the Lands Inspectorate pro-hibited the cultivation of areas of highly productive vlei or wet land arablein accordance with the Natural Resources (Protection) Regulations.6There can, therefore, be little doubt that the school-feeding scheme inthe Chiwundura community has had a significant influence on the nutritionand growth of school children. Furthermore, headmasters and teachers main-tain that there has been an overall improvement in academic performanceand school attendance.In February 1976 a series of interviews were held with the parents ofchildren who were participating in the feeding scheme in order to determinewhether the people wished to support and continue with supplementaryfeeding after the withdrawal of the sponsors. Analysis 3 shows that attitudesto supplementary feeding were generally favourable: 76 per cent of respond-ents maintained that feeding improves health and is important in combating* Those readers who question the suitability of using the 'Boston Standards' as abasis for the comparison of growth statistics of African children should refer toM. Bohdal et a/., 'A comparison of the nutritional indices in healthy African, Asianand European children", Bulletin of the World Health Organization (1969), XL, 166-76.5 J. C. A, Davies. 'A screening programme for rural school children in Rhodesia',Developmental Medicine and Child Neurology (1971), XIII, 779-83.sThe 'unauthorized cultivation' of wet land is illegal according to these regulationswhich are designed to protect natural resources, Rhodesia, Government Gazette, 14June 1968, Rhodesia Government Notice No. 774.172SUPPLEMENTARY FEEDING OF SCHOOL CHILDRENdiseases; 68 per cent said that it assisted poor families who could not affordto give their children sufficient food; and others maintained that the childrenwere more contented at school and did not come home hungry.There were, however, some indications that the scheme could beimproved. For example, 26 per cent of respondents maintained that school-feeding was likely to spread diseases because the children shared dirty cups.Other indications for improvement can be seen in the category, 'AcademicPerformance', where it is suggested that the scheme interferes with lessonsas teachers spend too much time preparing food. Also to be noted is that 69per cent of respondents (all men) maintained that the food was medicated orthat the feeding scheme was a Government plan designed to sterilize Africanchildren. A few respondents objected to the scheme for religious reasons.Analysis 2THE HEIGHT FOR AGE OF GRADE 1 CHILDREN IN 1973 AND 1976HYPOTHESIS: In view of the recent spate of good agricultural seasons, theheight of children entering school in 1976 will be significantly better thanthe height of children entering school in 1973.ANALYSISYear19731976TotalsHeight for Age of Children in St Barnabas,Skvundula and Gunde10th Percentilebelow6573138and above76Percentagebelow the 10thPercentile46102 ; 42178 44CONTROLS: None.SIGNIFICANCE EVALUATION AND CONCLUSION: The Hypothesis isnot significant. With reference to the 10th percentile standards, the height ofchildren entering school in 1976 is only marginally better (4 per cent) thanthe height for age of children entering school in 1973. This suggests that theschool-feeding scheme, rather than season and crop harvest, has broughtabout the significant improvement in the height for age of children in Grades2 to 5 (see Analysis 1).R. J. THEISEN 173Analysis 3ATTITUDES TO THE SCHOOL-FEEDING SYSTEMQUESTION: What are the good things . . . AND bad things about the schoolfeeding scheme?RESPONSES, MENAND WOMENHealth: Feeding improves health and is important incombating illnesses such as colds, flu and bilharzia.The scheme is likely to spread disease because thechild's cup is not properly cleaned. Each child shouldhave his own cupHunger: It assists poor families to feed their children,and so they are more contented at school and do not gohome hungry.The scheme encourages laziness amongst parents.Children will not be properly fed at homeAcademic Performance: Children become more attentivein class. Their work improves.The scheme interferes with lessons. Teachers spendtoo much time preparing the food. The Tribal Councilshould employ someone to undertake the preparation.(in percentages)Positive76Negative26Positive68Negative9PositiveNegative15Sterility: The food has been medicated and the scheme isa plan to sterilize the children.Religion: Parents of the Apostolic faith will not allowtheir children to participate, because the food isfermented.12Although attitudes to the school-feeding scheme are generally favourable,Analysis 4 shows that there is a real possibility of the scheme collapsing afterthe withdrawal of the sponsors. While 62 per cent of respondents maintainedthat parents should attempt to support the scheme, many of these samerespondents also maintained that they themselves could not afford to payfor the food or that people in general are too poor to pay or that the schemeshould be sponsored by some other external organization, such as the Ministryof Health. In other words, most of the people who would like to see thescheme continued also have reservations about financing it. This indicatesa considerable degree of frustration in the community.174 SUPPLEMENTARY FEEDING OF SCHOOL CHILDRENAnalysis 4ATTITUDES TO CONTINUING THE SCHEME AFTER THETERMINATION OF SPONSORSHIPRESPONSES, MENAND WOMEN(in percentages)Question: Do you think parents should pay for thefeeding when the Rhodesian Freedom fromHunger Campaign terminates its support?They shouid pay. People who can afford it should try Positiveand pay but this will depend on how much it costs. 62We cannot afford it. Many arc too poor to pay. People Negativedo not realize the importance of the scheme. The Rho- 68desian Freedom from Hunger Campaign, the Ministry ofHealth or the Tribal Council should pay. We payenough school fees alreadyCONCLUSIONThese findings suggest a need for a multi-disciplinary extension drive topromote a greater awareness of the importance of the scheme. Without sucha drive the scheme is likely to collapse after the withdrawal of the sponsors.University of RhodesiaR. J. THEISEN