Abstract
BACKGROUND: Universal, healthy school meal programs can address poor nutrition, improve educational outcomes and job and life opportunities, and support environmental sustainability. While many countries have extensive experience with such programs, New Zealand's initiative (Ka Ora, Ka Ako) was launched in 2020 as part of the COVID-19 recovery strategy and, by 2024, reached over 236,000 (~ 27%) school students. OBJECTIVES: This study aimed to assess the value generated from the investment (~ NZD320 million/year) in Ka Ora, Ka Ako and its potential for further value creation. METHODS: The study employed the participatory Value for Investment framework to assess the program across five economic domains: effectiveness, efficiency, economy, equity, and cost-effectiveness. Four workshops with key community, government, and research stakeholders co-developed 21 evaluation criteria and rated the program's performance based on evidence from program monitoring data, national research and international studies. RESULTS: Ka Ora, Ka Ako rated very well overall, with seven criteria rated as excellent, 12 as good, two as adequate, and none as poor. All six primary outcomes set as the original purpose of the program, relating to alleviating hunger, improving nutrition, improving health and wellbeing, reducing financial burdens on families, reducing barriers to education and supporting local economies, were rated good (4) or excellent (2). The program's continuity was rated only as adequate due to announced major budget cuts and uncertainty about future funding. Although enhancing environmental sustainability was not part of the program's original purpose, some sustainability criteria-packaging and food waste management-were rated as good. However, the criterion for sustainable food procurement systems was rated only as adequate. In light of these findings, the study assessed Ka Ora, Ka Ako as providing very good value for investment overall. CONCLUSIONS: The use of the Value for Investment approach was key because school lunch programs have many dimensions and the participatory research processes of the approach enabled stakeholders to emphasize the program's wide-ranging social and health benefits while identifying areas for improvement. While Ka Ora, Ka Ako rated very well across most of the 21 value dimensions, there are major concerns that this level of quality will not be upheld under the program's budget cuts from 2025 onwards.