Archives of Pharmacy and Biological Sciences www.journalapbs.com
Knowledge attitude practice of school teachers, students and mid day meal staff towards the mid day meal programme Vanisha Nambiar*, Rujuta Desai Department of Foods and Nutrition, Faculty of Family and Community Sciences, The M S University of Baroda. Vadodara 390002. Gujarat. India. A RT I C L E H I S T O RY
ABSTRACT
Received:
20-02-2013
Accepted:
15-03-2013
Currently 12 crore children are covered under the National Programme for Nutritional Support to Primary Education. Yet the Mid Day Meal Programme (MDMP) faces tribulations such as lack of convergence among different related departments, poor transparency, irregular and insufficient distribution of material and monetary reseources,poorly trained staff members and many more.The study involves assessing the knowledge, attitude and practices of the 35 school teachers, 140 students and 29 MDM staff members using a KAP questionnaire supported with spot observation towards the implementation of the programme.Results reveal high levels of dissatisfaction among the MDM staff members with regards to infrastructural facilities, supply of raw materials, monetary allocation, salary and support from school authorities Teachers feel it to be additional responsibilities while the children are not contented with the menu and the quality of food. The poor and hungry children left at the mercy of the MDMP in school are fed up with the monotonous and poor quality of meal served under the programme.Urgent need for improved logistics, supervision and frequent capacity building trainings is obvious. Only community participation or rigorous monitoring by the government can help to enhance the awareness, develop a positive attitude and follow health practices by the teachers grass root level workers and beneficiaries
Available online: 30-04-2013
KEYWORDS:
MDM, KAP, school teachers, children, health
INTRODUCTION Realizing health and educational benefits of an effective school feeding programme, the Government of India launched a centrally sponsored scheme, the National Support to Primary Education (NP-NSPE) in 1995. The main objective of the programme was to improve the nutritional status of children in primary section of Government schools and encourage poor children, belonging to disadvantaged sections, to attend school more regularly and help them concentrate on classroom activities. Documents of Ministry of Finance [1] have indicated a constant increase in the annual budget allocation (Rs. 3345 Crore in 2006 to Rs. 8000 Crore in 2008 and over Rs. 10000 crores in 2012) for MDM. Currently the MDM covers 12 crore children. Realizing the immense potentialities of the program, the government has materialized its priorities thereby, making concrete efforts towards improving MDM implementation. However Mid-day meal fails to address its multidimensional benefits due to various reasons such as poor infrastructure, low priority given by the policy makers, lack of integration and lack of awareness Poor involvement by community, PTA, teacher's perception for MDM as additional burden is some of the many drawbacks of the scheme. Various evaluations conducted on the MDMP and the literature has indicated poor awareness and negative attitudes of
the staff members and teachers and dissatisfaction among the children as one of the major reasons for failure of the programme. In spite of increasing financial support, the programme fails to aptly address its set objectives. Studies have revealed different problems at the grass root level implementation of the programme. Absence of appropriate working norms, unawareness about the NP-NSPE guidelines, poor distribution of responsibility [2], inadequate salaries of staff; delay in reimbursement of the salary [3]; lack of support from the schools and hazardous working conditions which saps away the motivation of the staff and makes it difficult to retain the MDM staff [4]. Beside poor monitoring and supervision by teachers, education on nutrition, health, sanitation and hygiene is also not imparted. Negligible efforts are made to increase the number of beneficiaries and there is poor understanding about the importance of MDM among students [4-5]. Moreover, irregular and delayed supplies of raw ration that to of poor quality is a result of poor management and corruption [6]. Absence of appropriate working norms, poor distribution of responsibility [2], inadequate funds to meet salaries of staff; delay in reimbursement of the salary [3]; lack of support from the schools and hazardous working conditions saps away the motivation of the staff and makes it difficult to retain the MDM staff [4].
*CORRESPONDING AUTHOR:
Dr. Vanisha S. Nambiar, Department of Foods and Nutrition Faculty of Family and Community Science, The M. S. University of Baroda. Email :
[email protected] 01
Arch. of Pharm. and Bio Sci. | Jan-April 2013 | Vol-1 | Issue-1 A program of magnitude equivalent to MDMP requires even co-ordination at all levels of management. To bring a significant change at grass-root level in such a scheme requires transparency, immediate action implementation and synchronization throughout the hierarchical chain. Also inter departmental coordination helps to improve the quality of services under such a multidimensional programme. Mid Day Meal is being implemented in Urban Vadodara since long, yet it has not been successful in achieving its goals over a period of time. Various studies have documented the loopholes of the programme, yet effect of the awareness, practices and perceptions of the grass root level workers on quality of services under MDM need to be emphasized. Thus the study was planned with an objective to assess the Knowledge Attitude and Practices of the grass root level service
providers towards MDM and its effect on implementation of the programme. MATERIALS AND METHODS The current study was conducted in the 121 corporation schools of Urban Vadodara. Seven corporation schools across the city were purposively selected. Availability of an independent kitchen was the selection criteria. Five out of these seven schools, were conducted in the morning shift while the remaining two were afternoon schools. The MDM staff consisted of a supervisor, a cook and a helper. Depending on the proportion of students to be catered, 1-2 helpers may be appointed as per the requirement. 29 MDM staff members were covered under study. Out of seven teachers in a school, five teachers were randomly selected for the study thereby covering a
Table 1 : Assessing infrastructural facilities based on the NP-NSPE guidelines
√ - Available/present X - Not available/present 02
§- Partially available §§- Not applicable
Arch. of Pharm. and Bio Sci. | Jan-April 2013 | Vol-1 | Issue-1 Table 2 : Assessing sanitation and hygiene indicators based on the NP-NSPE guidelines
√ - Available/present X - Not available/present sample size of 35 teachers. Similarly 20 students from class 5th,6th and 7th were selected from each school such that the selected children would have received MDM services for at least three years, thus covering a sample of 140 children. Qualitative research methodology such as Knowledge Attitude Practice questionnaire and spot observation techniques were used for data collection. Parameters such as school and MDM infrastructure (kitchen, store room and serving area), availability of basic facilities for cooking and serving MDM, different sanitation and hygiene indicators, quantity and quality of MDM being served were observed. Observation technique was also used to document non-verbal details regarding the practices followed by the MDM staff, school teachers and the students. Semi-structured KAP questionnaire was used to collect
§- Partially available §§- Not applicable
information on knowledge, perceptions and attitudes of the MDM staff, school teachers and the beneficiaries regarding the quality and implementation of the mid-day meal programme. RESULTS AND DISCUSSION The results of the practices in MDM by the MDM staff are presented here. Besides the questionnaire, data was elicited using the spot observation technique to cover non verbal facts and to understand the effect of facilities and surroundings on the particular practices. Following parameters were observed.
Kitchen, Store room and Serving area
All seven schools had a separate and an independent kitchen, supplied with either LPG bottles or gas line connections as a source of fuel. One of the schools situated on outskirts had 03
Arch. of Pharm. and Bio Sci. | Jan-April 2013 | Vol-1 | Issue-1 Table 3 : Details of the cyclic menu that was observed
quality of menu being served under MDM, [9]. As shown in Table 1, all the seven schools had spacious and clean serving area.
Sanitation and hygiene indicators
Sanitation and hygiene indicators reveal that two out of seven schools did not have a functional toilet for children though the water facility was good. Improving sanitation of school personal hygiene and awareness of the food handlers under a school feeding programme like MDM, can help to reduce incidence of morbidities and nutrient deficiencies among children. Hygienic food preparing and serving environment can show an increase in number of beneficiaries, [10]. Study conducted in [11] have clearly emphasized the need to improve personal hygiene in a school feeding programme for reducing prevalence of malnutrition among children, especially in government schools. [12] have stressed on improving the safe food handling practices among the food handlers. Moreover, in the current study, six of the schools have revealed unhygienic and unsystematic waste disposal methods (Table 2) due of lack of proper waste disposal facilities.
Table 4 : Comparing the average ration usage per child as observed with the NP-NSPE guidelines, 2006
interrupted supply of gas, thereby forcing them to use firewood during month ends. Study done in Rajasthan, [7] reveals that due to lack of basic infrastructure 76% cooks are forced to use firewood, thus inculcating hazardous and unhygienic cooking practices resulting in ineffective implementation of the MDMS. Kitchens in three out of seven schools had intact flooring and ceiling and were at least white washed with no cracks in the walls. Remaining four kitchens were poorly ventilated, had broken floor or ceiling and the walls were also not painted (Table 1). Lack of physical facilities not only affects the efficiency of workers but also creates a threat on food safety. Findings of [8] have revealed that inadequate infrastructure saps the motivation of the cook and poor usage of existing facilities aggravates problems of poor hygiene. All the schools except two had separate store room. Store room in two out of five schools was well lighted and ventilated with proper storage space. However, store rooms in remaining three schools had cracked walls, broken floors and was dark and stingy thus allowing the pests and rodents to harbor on the raw food storage. None of the store rooms had cupboards to facilitate safe storage of the raw ingredients. Due to lack of proper storing space, the raw ingredients get contaminated; this adds on the tedious cleaning job for the workers in the limited salary. Thereby quality of work gets affected resulting in monotonous and poor 04
Quantity and quality of MDM
Observations on quantity of ration used per child revealed a deficit of 55.5 gm/day/child when compared with the [13] (Table 4), even though the menu was not changed and the records of beneficiaries showed an increased. Inadequate salary, and low conversion cost coupled with poor monitoring leads to record manipulation and siphoning of the ration [2]. Also the menu served was devoid of any seasonal or green leafy vegetable (Table 3). [14] have described the difficulty in preparing a nutritious and varied menu due to lack of basic infrastructure. The staff members also faced difficulty in serving and cooking due to old and damaged utensils which also affected the quantity and quality of the MDM being served. Inadequate facilities such as serving plates, drinking water, no sitting space affects participation of the students. Apart, the serving size also varies a lot depending on the serving plates [9]. Healthy practices of supervisors, cooks and helpers in preparing and serving MDM In spite of such difficulties the MDM staff did try to adhere to some good practices. The serving area was cleaned before the serving the food, in one of the school sitting mats was also used for the children. In two schools the left over food was separately collected in a bucket to prevent the school campus from becoming dirty. [10] recommends supportive training, improved working conditions and providing basic facilities as an impending strategy to improve the attitudes and practices of the MDM staff members. The staff members did not chew tobacco nor did they smoke during cooking or serving food. In one of the school the staff members had different set of clothes to wear during working. Supervisors, cooks and helper's attitude towards MDM The results of the knowledge attitude practice (KAP) survey, conducted with MDM staff revealed that the MDM staff was not contented with the wages and the working conditions. Dissatisfaction also affects the quality of services provided. According to [15] the MDM staff in urban Vadodara persistently complained about inadequate salary. All of them demanded new
Arch. of Pharm. and Bio Sci. | Jan-April 2013 | Vol-1 | Issue-1
Table 5 : Negative and positive perception of MDM staff, school teachers and children towards MDM
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Arch. of Pharm. and Bio Sci. | Jan-April 2013 | Vol-1 | Issue-1 Table 6 : Suggestions given by the MDM staff, school teachers and children for improvement of MDM
utensils, repair of the kitchen and store rooms. The staff members also mentioned about being overburdened and exploited and devoid of any government benefits though they are an important part of the government scheme. Comparing the findings of present study with the results obtained by [14] there is a reduction in the staff members as against the number of MDM centers. Such disproportionate staff may result in overburdening of the available staff and unsatisfactory implementation of the scheme. Though the mid-day meal is implemented under the education department, yet 58.6% respondents reported on lack of support and cooperation from the school staff members (Table 5). Findings of Rajasthan, [7] reveal that absence of essential equipments such as weighing machines in most schools makes it difficult to measure the quantity of food grains delivered, thereby increasing the chances of unutilized food grain balances. Delays in receiving budget and food grain allocations also result in interrupted serving of the meal. Role and perception of teachers in implementing MDM
education, sanitation and hygiene practices and discipline were not given much importance by 85% of the teachers. Though they were put on a time table, the teachers hardly followed it. About 66.7% teachers considered MDM as an additional burden that adversely affects the teaching quality [16]. Apart no efforts were made by them to increase the number of beneficiaries as well. Another study in urban Vadodara also reveals that teachers were found to rarely encourage children to eat the school meals [17]. However with regards to the perception of the teachers, 100% of them felt that MDM had increased the attendance. Only 25% of the teachers/principals were unaware of the cyclic menu. Teachers repeatedly mentioned about they being overburdened by external duties which affected the teaching quality. Under such circumstances MDM was looked upon as another time consuming responsibility (Table 5). Many times the teachers had to involve maintaining the registers of MDM and also in cooking of MDM due to inadequate MDM staff. As a result the teaching quality suffered up to an extent and the parents also complained for the same [7]. Pressures from the higher authorities resulted in inflating the registered figure of beneficiaries [18].
Data collected from the spot observations described that the teachers were not regular in monitoring MDM and supervised just for the name sake. Activities like imparting nutrition health
Practices followed by students and their feedback regarding MDM
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Arch. of Pharm. and Bio Sci. | Jan-April 2013 | Vol-1 | Issue-1 Table 7 : Summary of all the parameters observed during the study.
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Arch. of Pharm. and Bio Sci. | Jan-April 2013 | Vol-1 | Issue-1 As recorded from the observations as well as inventories, girls are the major beneficiaries. Sanitation and hygiene practices revealed that just 30.0% students washed hands before having the mid-day meal, 55.6% children did not remove shoes while eating food and students in only one school used sitting mats while eating MDM. [10] states that educating, guiding and creating awareness among children can inculcate healthy practices among them. Also availability of adequate water and toilet facility can help to improve personal hygiene and sanitation among the children. Modifying the menu and improving water facilities have shown an increase in enrollment, especially that for girl child [2]. Just 43% students consumed the vegetables provided in MDM, while rest of the beneficiaries removed them out of their plates while eating. Training through Nutrition Health Education material and serving tasty and variety of menu have shown to increase the consumption of vegetables by the children [17]. Table 5 describes that 75% of the respondents were satisfied with the amount of food served under MDM. Reasons for not eating MDM as explained by the beneficiaries were; disliking the recipes (50.7%) and presence of harmful particles (47.8%). Nearly 80% of the respondents wanted rice based recipes to be served under the MDM. Poor sanitation and hygiene practices, among students and food handlers bring a threat on the quality of the cooked food. [19] have reported 85.5% of the MDM beneficiaries did not wash hand before eating as observed in Madhya Pradesh. As evaluated in Rajasthan, 91% students have admitted that they receive variety in the menu and its quality can be rated as average or above average [7]. Contrastingly children interviewed in Delhi have mentioned that they do not consume MDM as it is not tasty (65%) and/or they do not get the serving plates from home [16].
Suggestions for improvement
During the KAP, the respondents also gave their suggestions for improving the programme (Table 6). Adhering to the NPNSPE specification and adopting HACCP approach to achieve food safety standards in kitchen setup of schools is suggested [14]. The MDM staff has demanded new utensils and has suggested increasing the number of staff members, while teachers and children have suggested changing the timing of serving the MDM as most of the children in afternoon shift of school have their lunch from home and feel hungry by evening, when they do not have anything else to eat. Also demand was put forth to provide variety of food that is tasty and appealing to eyes. The nutritional impact of MDMS depends both on the quality and the quantity of food provided at school, which in turn depends on the budget, which affects the menu as well as cooking practices [5]. Other studies done in Baroda, [20] have also revealed many such lacunas in the implementation of MDM. Poor contingency and price inflation results in preparation of micro nutrient deficit menu. Management issues such as irregular and delayed supplies of raw ration which is of poor quality have also been reported [6]. Poor working conditions coupled with lack of adequate facilities result in preparation of monotonous and hygienically poor menu. Above all unsatisfied staff members who are paid meager salaries and also do not get adequate support from the teachers and principals in the school feel disheartened and develop a negative attitude towards the programme. Providing good working conditions with adequate facilities 08
would facilitate the MDM staff members in their work. Support and cooperation from the education department and the teaching staff can help to solve many problems at the grass root level itself. Inadequate supervision and monitoring, incomplete reimbursement of fuel or transport costs, low and delayed remunerations of MDM staff, adversely affects the programme implementation at grass-root level [4]. Periodic training and supervision would help to improve in the quality of the services provided under the programme [10]. CONCLUSION A mammoth programme like MDM, can meet success by strengthening the skills of MDM grass root level workers, by increasing transparency in its hierarchy. Regular and sufficient reimbursement of salary, adequate conversion cost and satisfactory contingency would reduce the incidence of corruption and manipulation. Improved logistics and efficient management with frequent supervision can help to regularize and improve the quality of services under MDM. Along with material and financial resources, it is important to provide correct knowledge about the NP-NSPE guidelines to the service providers through different trainings and supervision to help them develop a positive attitude and execute safe and healthy practices, especially in food handling. REFERENCES 01.
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20.
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