Value-for-money of school feeding programs in sub-Saharan Africa: A multi-country cross-sectoral analysis

Introduction: School feeding programs (SFPs) can contribute to address undernutrition in low- and middle-income country settings while can simultaneously improve education outcomes and deliver social and economic benefits. However, evidence on their comprehensive value for money (VfM) remains limited. This study models the multi-sectoral impacts of SFPs across education, health, social protection, and the local agricultural economy in five sub-Saharan African countries, providing benefit-cost ratio (BCR) and VfM estimates to inform policy decisions. Methods: The analysis used secondary data from national reports, program budgets, and national household surveys. SFP impacts on education were assessed through changes in years of schooling and linked to lifetime income gains. Health impacts were quantified as averted anemia cases, converted into disability-adjusted life years (DALYs) and monetized using gross domestic product (GDP) per capita. Social protection benefits were measured as the in-kind value of school meals relative to household food expenditures, while local economic impacts were assessed through monetary transfers to smallholder farmers (SHFs) from local food procurement. BCRs were calculated considering education and health impacts, with additional VfM and expanded BCR estimates considering broader benefits and transfers. Results: Across countries, SFPs were associated with a cumulative gain of 0.6 to 2.3 years of schooling per beneficiary. Moreover, reductions in anemia cases are expected to avert between 4 to 51 DALYs per 1,000 beneficiaries. The BCR for education and health ranged between 3 and 31. Meals provided covered up to 28% of annual household food expenditures for low-income families. Local food procurement generated economic transfers between USD 7 and USD 15 per beneficiary per year to SHFs. Conclusion: SFPs demonstrate high VfM, offering significant educational, health, and economic benefits. Policymakers in sub-Saharan Africa should prioritize the expansion and scaling of SFPs to enhance educational attainment, improve health, and foster economic resilience, contributing to sustainable development.