African Journal of Public Health and Health Systems | 27 November 2009
An Ethnographic Study of the "Milk Matters" Programme: School Feeding, Adolescent Anaemia, and Academic Performance in Zambia's Copperbelt Province
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Abstract
Adolescent anaemia is a persistent public health concern in Zambia, affecting health and educational outcomes. School feeding programmes are a common intervention, but qualitative insights into their local implementation and perceived effects are scarce. This ethnographic study explored the implementation and perceived effects of the ‘Milk Matters’ school feeding programme on anaemia prevalence and academic performance among adolescent girls in Zambia’s Copperbelt Province. An ethnographic approach was employed. Data collection included participant observation in schools and communities, in-depth interviews with adolescent girl beneficiaries, their teachers, parents, and programme implementers, and analysis of local programme documents. The programme was widely perceived to improve school attendance and concentration in class, primarily by reducing hunger-related distractions. However, logistical challenges in maintaining consistent milk delivery were identified. Levels of parental understanding about anaemia and its prevention varied considerably within communities. Stakeholders value the ‘Milk Matters’ programme for its perceived educational and nutritional benefits. Its potential impact is mediated by the consistency of implementation and existing community knowledge. Complementary strategies are needed to support its objectives. Strengthen supply chain mechanisms to ensure reliable delivery. Integrate targeted community sensitisation on anaemia prevention alongside the feeding programme. Future quantitative research should measure changes in haemoglobin levels and standardised test scores to triangulate these qualitative findings. School feeding, adolescent health, anaemia, ethnography, Zambia, academic performance, nutrition This study provides an in-depth, contextual understanding of a school feeding programme's operation and perceived impacts from the perspective of beneficiaries and implementers, contributing qualitative evidence to inform public health nutrition policy in similar settings.