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|Year : 2014 | Volume
| Issue : 3 | Page : 345
Impact of midday meals- have all variables been considered?
Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
|Date of Web Publication||14-Aug-2014|
Dr. K Kaushal
Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kaushal K. Impact of midday meals- have all variables been considered?. J Postgrad Med 2014;60:345
This is with regard to the article "Comparison of nutritional status of rural and urban school students receiving midday meals in schools of Bengaluru, India: A cross sectional study" by Shalini et al., published in J Postgrad Med.  The authors have done a commendable job by assessing the nutritional status in rural schools and comparing it with that in urban schools in Bengaluru, India.
However, I have a few concerns regarding the results.
The authors have concluded in the discussion that the magnitude of the burden of undernourished students as seen in this study would have been much greater in the absence of the midday meal program.  However, the authors have not consolidated their statement with evidence in terms of comparison with either those children who were not receiving any midday meal or longitudinally, i.e. observing a child's growth over a period of time. That is why it is questionable as to how the authors have validated this study without any comparison group in it. It would have been useful if the authors had provided us with the protein and calorie requirement being fulfilled through the midday meal program.
Further, apart from enhancing school attendance and child nutrition, the midday meal program has an important social value and fosters equality. It also reduces the gender gap in education, since it improves female school attendance. 
Apart from finding the present nutritional status of children, the authors could have studied the impact of existing midday meal scheme on the attendance rates of both boys and girls in schools, along with their academic performances. This would have given an idea of other causes of malnutrition, like sickness rates, in these children. In 2007, the GOI extended the existing scheme to cover children of upper primary classes (i.e. class VI-VIII) and changed its name to "National Program of Mid Day Meal in Schools" (NP-MDMS) from "National Program of Nutritional Support to Primary Education" (NP-NSPE). The nutritional norm for upper primary schools has now been fixed at 700 calories and 20 g of protein.  Despite the cut off for calories and protein being increased from the basic 300 calories and 8-12 g of protein to the present (700 calories and 20 g of protein), the authors should have been able to justify the reasons that were responsible for the 13.8% and 13.1% (results) of the studied students being underweight and stunted, respectively (below the third percentile for weight and height for age).  It is possible that these children were from disadvantaged sections of society or were female children who could be discriminated against. Assessing the impact of midday meals in terms of other factors is as important as in regard to nutritional status improvement, as there may be other factors influencing the nutritional status.
| :: References|| |
|1.||Shalini CN, Murthy NS, Shalini S, Dinesh R, Shivaraj NS, Suryanarayana SP. Comparison of nutritional status of rural and urban school students receiving midday meals in schools of Bengaluru, India: A cross sectional study. J Postgrad Med 2014;60:118-22. |
|2.||National Programme of Nutritional Support to Primary Education, 2006 (Mid-Day Meal Scheme). Available from: http://www.schooleducation.kar.nic.in/pdffiles/mdmguidelines2006.pdf. [Last accessed on 2014 May 17]. |
|3.||Department of School Education and Literacy and Department of Higher Education. Ministry of Human Resource Development, Government of India. Annual Report 2012-13. Available from: http://www.mhrd.gov.in/sites/upload_files/mhrd/files/AR_2012-13.pdf. [Last accessed on 2014 May 17]. |