China, Impact Evaluation of the Preschool Nutrition Pilot in Selected Counties of Xiangxi Prefecture, Hunan, PR China

The evaluation was commissioned to inform the scaling up of a pilot for preschool children’s nutrition improvement and was intended for both accountability and learning purposes.  It focused on assessing the relevance, effectiveness, and impact of the project. Overarching evaluation questions focused on:

• Evaluation Question 1. What is the impact of nutrition program on nutrition and development of preschool children aged 3 and 5?
• Evaluation question 2. What is the impact of nutrition program on local smallholders?
• Evaluation question 3. How appropriate is the program implementation?

The evaluation covered the following themes: a) School Feeding; b) Nutrition; and e) Capacity strengthening. Specifically the activities involved:

• Subsidize 4 Chinese Yuan per preschooler per school day to improve nutrition-balanced school meals.
• Upgrade kitchen facilities and dining environment;
• Enhance nutrition education and awareness building through various behaviour change communication activities;
• Procure agricultural products from local poor smallholders, connecting them with selected preschools, and provide agricultural production support.

Key evaluation findings included:

• Overall, the evaluation found no impact of the project on child nutrition outcomes, but with the caveat of potential spillover effects. The prevalence of anemia declined between baseline and endline. However, this decrease was similar in treatment and comparison groups.
• The program had positive effects on children’s social emotions. Specifically, the program significantly reduced the abnormal rates of hyperactivity and total difficulties in the younger children.
• Results show that the level of nutrition knowledge of primary caregivers is inadequate.
• It is found that direct purchase from smallholder farmers contributed to local smallholders’ vegetable production diversity, income, nutrition knowledge and market engagement. The smallholders in the treatment group had a higher dietary diversity score (DDS) than those in the comparison group. This program also has the potential to assist in building a local food system that is resilient, sustainable and inclusive.
• The program is well aligned with China’s national priorities, including nutrition, child development and poverty reduction policies, and closely related to UN and WFP policies, strategies, and guidance on nutrition, child development, school feeding, and poverty reduction.

Key recommendations from the evaluation included:

• Recommendation 1: Building on its experience and reputation, WFP should extend the provision of interventions in the study sites.
• Recommendation 2: WFP should consider targeting at vulnerable sub-groups to optimize the impact of the project.
• Recommendation 3: WFP should pay particular attention to the rise of child overweight and obesity.
• Recommendation 4: WFP needs to take into consideration nutrition knowledge of caregivers to improve children’s diet at home in addition to the nutritional value of the food choices offered in schools.
• Recommendation 5: WFP should strengthen supply-side interventions to support local smallholders.