Intergenerational nutrition benefits of India’s national school feeding program

India has the world's highest number of undernourished children and the largest school feeding program, the Mid-Day Meal (MDM) scheme. Because school feeding programs target children outside the highest-return “first 1000-days” window, they have not been central to the global stunting agenda. Using nationally representative data on mothers and their children spanning 1993 to 2016, the study assesses whether MDM supports intergenerational improvements in child linear growth. Height-for-age z-score (HAZ) among children born to mothers with full MDM exposure was greater (+0.40 SD) than that in children born to non-exposed mothers. Associations were stronger in low socioeconomic strata and likely operate through women’s education, fertility, and health service utilization. MDM was associated with 13–32% of the HAZ improvement in India from 2006 to 2016.

Suman Chakrabarti, Samuel P. Scott, Harold Alderman, Purnima Menon, Daniel O. Gilligan