BMJ, doi: 10.1136/bmj.39359.525174.AD, (Published 22 October 2007)

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Realist review to understand the efficacy of school feeding programmes

¹ Department of Primary Care and Population Sciences, University College London, London N19 5LW, ² School of Psychology and Institute of Population Health, University of Ottawa, Canada K1N 6N5, ³ Institute of Population Health, University of Ottawa

A recent Cochrane review found that school feeding programmes significantly improve the growth and cognitive performance of disadvantaged children. Trisha Greenhalgh,Elizabeth Kristjansson, and Vivian Robinson look more closely at the highly heterogeneous trials to see what works, for whom, and in what circumstances

The first 150 words of the full text of this article appear below.

Our Cochrane review of school feeding programmes in disadvantaged children included trials from five continents and spanned eight decades.¹ Although we found that the programmes have significant positive effects on growth and cognitive performance, the trials had many different designs and were implemented in varying social contexts and educational systems; by staff with different backgrounds, skills, and cultural beliefs; and with huge variation in the prevailing social, economic, and political context. Simply knowing that feeding programmes work is not enough for policymakers to decide on the type of intervention that should be implemented. We therefore looked at the trials more closely to determine the aspects that determine success and failure in various situations.

We analysed the 18 studies (reported in 29 articles) included in our Cochrane review^{2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30} using the methods of a realist review. Realist review exposes and articulates the mechanisms by which the primary studies assumed the interventions to . . . [Full text of this article]

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