Abstract
BACKGROUND: Previous studies confirm a high prevalence of malnutrition among school children and adolescents in Nepal, indicating that Mid-day Meal Program (MDMP) could significantly address these issues. The Nepalese government launched the MDMP since 2020 to reduce malnutrition and improve educational and health outcomes among school children. This study explores sustainable practices for MDMP in a community school of Nepal, building on a participatory action research (PAR)-based study conducted by a team of PhD researchers under the NORHED Rupantaran Project (2016-2023). METHODS: Practice-oriented qualitative case study design was conducted in a community school in Chitwan District. Participants included basic school students, their parents, School Management Committee (SMC) members, School Mid-day Meal Management Committee (SMDMMC) members, and canteen service providers. Data were collected through focus group discussions (FGDs) and in-depth interviews (IDIs) and analyzed them employing a thematic analysis framework. RESULTS: Although the federal government's MDMP covered early to grade five students in the community schools nationwide, it has been extended to grade eighth in the study school through collaboration with all school community and the local government. The federal government has provided funds to implement the MDMP for the students of early grades to grade five. However, the study school was able to extend the MDMP upto grade eight. The results indicate that teachers' involvement in the MDMP, formation of the SMDMMC, local government subsidy, collaboration with all school stakeholders, and plans for sustainability are key actionable strategies for sustaining the MDMP in the community school. CONCLUSION: The findings of the study indicate that the school can implement a tripolar cost-sharing and teacher-supported service model to sustain the MDMP in the community schools, particularly from rural areas. The study suggests longitudinal research focusing to ascertain continuity of the culture of collaboration and active participation among the school stakeholders and local government to achieve both health and educational outcomes of school mid-day meal intervention.