PARTICIPATION IN COMMUNAL DAY CARE CENTRE FEEDING PROGRAMS IS ASSOCIATED WITH HIGHER DIET QUANTITY BUT NOT QUALITY AMONG RURAL GHANAIAN CHILDREN

Communal School Feeding Programs (SFP) are based on local foods brought by children from home which are cooked and shared at school. These programs may be a sustainable food-based strategy for improving children's diets in low-resource areas. The objective of this study was to compare the dietary intakes of children who attend Day Care Centres (DCC) with communal SFP to children who do not attend any DCC or school in rural Ghana. Interviewer-administered questionnaires were used to collect dietary and other household information for 104 DCC and 89 non-DCC children aged two to five years living in two communities. In addition, the DCC lunches (ingredients and servings of each food preparation) were weighed. The Day Care Centres' lunch was higher in energy (by 64 kcal; p<0.001), but lower in calcium (by 18 mg; p=0.002), iron (by 1.3 mg; p<0.001) and zinc (by 0.2 mg; p=0.046) than the non-DCC lunch. DCC children ate more times in a day (4.2 ± 0.8 vs. 3.4 ± 0.6, p<0.001), had greater dietary diversity (7.2 ± 0.6 vs. 6.7 ± 1.0 food groups, p<0.001) and had higher daily intakes of energy (1140 ± 320 vs. 878 ± 240 kcal; p<0.001), calcium (282 ± 139 vs. 244 ± 118 mg; p=0.048), iron (12.4 ± 6.4 vs. 10.7 ± 4.7 mg; p=0.048) and zinc (0.40 ± 0.15 vs. 0.35 ± 0.11 mg; p=0.019) than non-DCC children. However, after controlling for total energy intake and other dietary, health and socio- demographic variables, daily iron and zinc intakes were lower in the DCC compared to the non-DCC group. Participation in the communal SFP was associated with higher quantity but not quality of children's diets. Communal SFP offer an opportunity to address specific population's micronutrient needs, using interventions to improve dietary quality such as point-of-use fortification, commercially fortified foods, or processed animal source food products.