A Community-Led Central Kitchen Model for School Feeding Programs in the Philippines: Learnings for Multisectoral Action for Health

Program Implementation Setting

Undernutrition was a pressing issue at both implementation sites. Among the households surveyed, only 9.77% of rural households and 39.03% of urban households were food secure. Based on the Philippine Dietary Reference Intakes,⁴⁷ the caloric intake of children in surveyed households was inadequate for their age and sex. Rural children reached only a median of 58% daily caloric adequacy and urban children reached 88% daily caloric adequacy, with 100% signifying adequate caloric consumption.

According to a report by ACED for the urban site,⁴⁸ between 86% and 91% of beneficiaries were rehabilitated and drop-out rates remained below 4% of beneficiaries from 2012 to 2018 (Table 4). This contrasts with a 2016 evaluation of DepEd’s traditional SFPs, which found about 62% of beneficiaries had been rehabilitated, below DepEd’s target of 70% of beneficiaries attaining normal weight.²⁵ Parents, educators, health care workers, and local government officials also observed decreases in the number of beneficiaries after each program cycle, advocating for the continual expansion of the program.

The feeding process was similar to those of traditional SFPs.⁴⁹ According to an educator in a focus group, feeding promoted other contiguous habits, such as incorporating vegetables in diets, handwashing, and cleaning up after oneself. Feeding coordinators noted aversion to vegetables at the beginning of the feeding cycle, though beneficiaries adjusted after a few weeks.

Though these individual-level effects cannot directly be attributed to the central kitchen model, the program has standardized nutritionally balanced meals developed by nutritionists to ensure children they were exposed to a variety of vegetables and age-appropriate meal portions. Under the traditional decentralized SFPs, teachers explained that they were not able to consistently follow DepEd’s recommended recipes due to a lack of available ingredients, fluctuations in market prices, and difficulties in meal preparation on top of their teaching responsibilities.

Based on the program’s secondary goal to improve education outcomes, in the FGDs, a local government official and an educator reported that program participation increased school attendance and participation because students no longer needed to find food before classes or leave campus during lunch hours, especially for rural beneficiaries whose homes were far from school. These findings were similar to previous evaluations of Philippine SFPs, which showed that attendance improved after participation.^25,49 However, neither parents nor educators could determine whether there was a clear impact on students’ grades and participation in extracurricular activities, and attendance was not systematically investigated in this study.

More pressing was the challenge of regression during the summer months when schools were not in operation. The following sections discuss how the respective communities overcame issues of nutritional regression, volunteer commitment, and operational sustainability.

Three interconnected mechanisms facilitated the program’s successful implementation in the 2 sites: community involvement and program ownership, local government stewardship and coordination, and program scale-up and sustainability.

Community Involvement and Program Ownership

Implementation of the SFP necessitated the creation of volunteer networks and grassroots support that increased demand for more community-based health interventions and protected program sustainability from threats of political interference. Community participation and roles varied in the 2 LGUs, as LGUs in the Philippines are given some discretionary funds and administrative capacity under the country’s Local Government Code of 1991 (Republic Act 7160).³³ The decision-making space of LGUs was recognized by ACED and GK, allowing for variation in program implementation across sites.

Rural communities were less dense and geographically dispersed across the large province. Consequently, 10 of the 11 municipalities in the rural site had 1 central kitchen established in contrast to the single central kitchen of the city. The exception was 1 municipality, which required 3 central kitchens because of its size. While kitchen staff were drawn from the community, they were considered government employees and paid a salary, relying less on informal community ties to ensure responsibilities were fulfilled. Nonetheless, community buy-in to the importance of nutrition, which began with the SFP, facilitated local engagement in the program: feeding volunteers were uncompensated but consistently assisted in the schools. Though the program was a provincial-level, then municipal-level initiative, barangay (the smallest unit of local government) officials and residents volunteered to deliver meals to their respective schools. Volunteer local government employees also supported a provincial program, which provided aid to nonrehabilitated beneficiaries’ families over the summer break, to mitigate household-level causes of malnutrition.

In the urban site, 98% of volunteers were uncompensated, and 66% of volunteers did not have children participating in the SFP. However, the central kitchen could reliably assign 50 volunteers from their pool of about 600 to arrive for the day’s operations. The sustainability of the city’s volunteer pool over 6 years was attributed to ingraining volunteer operations within community relationships. In the initial phases of implementation, SFP volunteers were drawn from local people’s organizations, in particular, women’s groups supporting the LCE. As the program matured, recruitment from civil society groups waned. In 2018, 29% of volunteers joined through people’s organizations, while 51% were recruited through information from friendships and neighborhood relationships. Urban volunteers were recognized for their participation through a year-end party organized by the LGU.

Why do you volunteer? You don’t have children in the feeding [program]. —Interviewer

Because in the beginning, the officers at [civil-society association] are my clique, but even if I wasn’t an officer, [they said] “Oh, sis, come on!” So there. Helping out. Until they left already. When someone else was in charge and needed volunteers, you know, experienced ones. “Okay, yeah,” was what I said…so I already got used to helping out. — Parent, urban FGD

Communities’ active participation in local policy encouraged demand for more integrated health services. LGUs responded by subsidizing medical check-ups and treatment for nonrehabilitated beneficiaries, as DepEd found that students whose nutritional status did not improve after the feeding cycle usually had underlying medical concerns, according to health workers in the focus group. LGUs also made structural investments in social services through programs sustained by community volunteerism. SFP kitchens were used in disaster relief operations, as the country is vulnerable to tropical storms. The urban LGU continued feeding operations during summer classes, as the SFP was integrated into an ambitious multifaceted educational investment program including educational reform, parenting seminars, and building physical and technological infrastructure. To generate another source of ingredients for central kitchens, the provincial LGU launched home and school gardening programs for household income generation and food production, and locally sourced ingredients for feeding.

People’s roles in the success of their own programs created a sense of ownership that withstood changes in political leadership. Since its pilot in 2011, the city SFP has persisted through 4 terms and 2 mayors, while the provincial SFP has operated since 2016. This culminated in local ordinances that codified local priority and support for the SFP, according to local government officials in focus groups, ensuring these programs’ implementation regardless of who is elected to local office.

Local Government Stewardship and Coordination

The program underwent an iterative process of planning, implementation, and evaluation with multisectoral input, which helped overcome challenges faced by traditional feeding models. Public school feeding was originally under the purview of DepEd, and operations were decentralized to individual schools; however, schools faced difficulties coordinating with the centralized NGA. School staff identified beneficiaries, bought and cooked ingredients, and submitted progress reports and liquidation forms for reimbursement. In both urban and rural settings, this additional uncompensated work was assigned to teachers, who reported being unable to focus on teaching and paying out-of-pocket when ingredients were insufficient or unavailable in the market. DepEd’s hierarchical bureaucratic processes delayed reimbursements and incentivized schools to decline feeding programs.

Before the [DepEd SFP], I fed [students] through the help of the parents. So, every 3 times a week, we cooked. We got our funds from the [school] canteen…Later, the [DepEd SFP] came. We were given a budget of 15-pesos or 16-pesos per child. So, last year—2 years ago—I think, I was asked if I would accept the SBFP again. I really didn’t want anymore because it was so tiring being the [SBFP] coordinator. Because I was the one who went to the market and I was the one who liquidated, and then if the parents I assigned didn’t come in or come here, I was the one who had to cook. So, it was really tiring, really tiring. —Educator, rural FGD

When the centralized-kitchen model was first proposed, schools in the city perceived the LGU did not trust them to implement the program on their own, as one local government official reported. The LCE held dialogues with all public school administrators to onboard them. Following the successful pilot, the LGU then coordinated with DepEd to develop a unified work-and-financial plan, as each had unique liquidation and procurement protocols that necessitated a new system to interface between them. Through the LGUs’ efforts, initial ambivalence toward the program was overcome.

As another local government official stated, LGUs deliberately engaged other sectors to minimize threats to implementation. Though successful pilots were funded by DepEd in subsequent years of operation, LGUs augmented funds through their internal revenue allotment and contributed to building and renovating kitchens and hiring full-time kitchen staff. By mobilizing their civil society groups, LGUs created an initial pool of volunteers. They also responded to context-specific needs. To alleviate the burden of SFP implementation on teachers, the city LGU hired full-time feeding coordinators to conduct feeding and monitoring activities. The provincial LGU coordinated transportation at the barangay-level so teachers did not need to pick up or return meal containers. LGUs also played an important role in expectation setting and both formal and informal accountability. When some schools tasked feeding coordinators with teaching errands, they were reprimanded by the mayor and the practice was stopped. Volunteers, though unpaid, attend an annual seminar retreat organized by the LGU to refresh their training and raise morale. As such, stakeholders felt recognized and seen and were incentivized to perform better because they were being rewarded or sanctioned for their actions.

You see your name has a blank everywhere. Then you feel ashamed moving forward [laughter]. I see my name is blank, I get ashamed to be absent. —Central kitchen volunteer, urban FGD

It’s unacceptable that you don’t find a solution. You need to find a solution because every day there are those [students] who need to eat. —Central kitchen staff, rural FGD

Because the LGU sat at the intersection of different government agencies, the central kitchens were maximized across sectors. Coordinating with the DSWD’s city office, the central kitchens also provided universal feeding for the city’s 70 day care centers as an early childhood health intervention. Collaborating with the local health care sector, LGUs began to include micronutrient supplementation in the SFP. When class suspensions occurred, LGUs transported packed meals to shelters, detention centers, and health care workers, to prevent food waste. The LGUs remained receptive to feedback from parents, teachers, and implementation partners. FGD participants often mentioned the modification of the feeding menu for each locale, accounting for local market availability and familiarity with the ingredients used. For instance, tomato-based sauces had small amounts of added sugar or used Filipino-style sweet sauce popular in the country. In the rural site, higher energy requirements necessitated increasing rice portions. Given the limited availability of vegetables, local vegetables were used, and potatoes were substituted with sweet potatoes. Instead of mushroom sauce, the province used coconut milk with turmeric.

Students and parents initially complained about every meal being soup-based with finely chopped viands. Though research-based and nutritious, when packed with rice, the meals would resemble slop or porridge. Drier viands were quickly substituted, increasing the acceptability of the program.

They [students] compare the food with what was there before. “At least the one before, our viands were delicious.” You could really see the viand, the beef and the contents…Because now, we chop [everything], ground beef. —Educator, rural FGD

Before it was like that, there were really those [meals] that the children didn’t want to eat, especially the food that was sweet, the one like the food of the elderly. —Parent, urban FGD

Scale-Up and Sustainability

Visible successes in multisectoral collaboration have fostered a culture of data sharing and evidence-based decision making among stakeholders. Respondents from all sectors proudly shared that their SFP protocols were based on research, making them trustworthy. Program data were not only collected from schools but also compared to program goals. Results and recommendations were presented to school principals, feeding coordinators, and kitchen managers semiannually by the LGU and NGOs.

It’s not really an issue for us because of support. All the programs and projects of the LGU, we always support…Because we know that those are beneficial to us, to the children, to the community, to the parents. Just like another project they have that’s also ongoing, the [parent-teacher seminars]. We support the LGU because we know the results of it will benefit us too…Why not support, right? —Educator, urban FGD

Actually, Mayor looked forward to the [evaluation] study. Because we wanted [to know] how can we improve the feeding more. Because the problem of malnutrition does not originate from just a simple problem, right? —Local government employee, urban FGD

Multisectoral involvement in the SFP had spurred investments in physical and social infrastructure that allowed the program to continue operations despite crises. Despite the shift to remote learning during the COVID-19 pandemic, central kitchen operations continued. In the provincial site, meals were delivered to barangays and distributed directly to households by barangay health workers, barangay nutrition scholars, and volunteers from the Sanggunian ng Kabataan (barangay youth councils).

In the city, the central kitchen provided meals to health care workers at the height of community lockdowns from March to May 2020, when mobility was limited to reduce the spread of COVID-19. Due to limitations on gathering sizes and community quarantines, central kitchen operations were reduced. Through the central kitchen channels, beneficiary children were initially given food packs and Nutribun, fortified bread distributed in DepEd’s usual SFP. However, full kitchen operations are planned to resume in November 2022 as all students in the country return to on-site classes.⁵⁰

The central kitchen model eased the scaling-up process by facilitating LGU initiatives to implement universal feeding in economically disadvantaged areas, such as a relocated community in the city, and geographically isolated and disadvantaged areas in the province. This was enabled in part by economies of scale.²⁸ DepEd sets each meal for SFPs at 16 Philippine pesos (PHP) (about US$0.31 in 2018 prices), for a total of PHP1,920 (US$37) per beneficiary for the 120-day feeding cycle.²⁵ Through the central kitchen, the actual cost per meal was about PHP11.50 (US$0.23) per day, and PHP1,380 (US$27) per beneficiary for 120 days.

The success of the central kitchen SFP model has prompted other localities to inquire about the program template for implementation in their own LGUs.

Our visitors—they also benchmark against us—love shortcuts. Because immediately they want the root. “Where’s the root?” …They’re looking for the root of the problem. Why is it like that? Because in their [operations], there are volunteers, but it still failed. — Central kitchen staff, urban FGD

In addition to the assistance from volunteers, a key contributor to success was the input received from multiple stakeholders, which led to improvements in existing feeding procedures as well as innovations applicable to other local government programs. For instance, implementers expressed a major concern about the need for a single database for feeding coordinators, principals, DepEd, ACED, and GK, with each having different levels of access to the data while maintaining children’s data privacy. This prompted ACED’s development of a web-based integrated nutrition database where schools input individuals’ nutrition data, DepEd’s local offices consolidate them, LGUs generate reports, and ACED provides recommendations for LGU interventions beyond SFP. User training for the application was conducted in 2019; the full pilot scheduled for 2020 was interrupted by the COVID-19 pandemic.

Table 5 summarizes the implementation results in both sites. Differences in the implementation experiences of the rural and urban sites are highlighted, as the model allowed for local modifications to adapt the program.