The McGovern–Dole International Food for Education and Child Nutrition Program (McGovern-Dole program) helps support education, child development, and food security for some of the world’s poorest children. It provides for donations of U.S. agricultural products, as well as financial and technical assistance, for school feeding and maternal and child nutrition projects in low-income, food-deficit countries that are committed to universal education. The McGovern-Dole program was originally authorized by the Farm Security and Rural Investment Act of 2002. The legislation called for the use of $100 million in Commodity Credit Corporation (CCC) funds to launch the program in fiscal year 2003, with future funding coming from Congressional appropriators. The program was reauthorized in the Food, Conservation, and Energy Act of 2008. That legislation provides for the use of $84 million in CCC funds and allows for annual Congressional appropriations, which has been approximately $100 million annually in recent years. The program is administered by the U.S. Department of Agriculture’s Foreign Agricultural Service and is named in honor of Ambassador and former Senator George McGovern and former Senator Robert Dole for their tireless efforts to encourage a global commitment to school feeding and child nutrition. Midline survey for the USDA mcGovern-dole school feeding project in Cambodia 1. Introduction..........................................................................................1 The World Food Programme in Cambodia, 2011 - 2016 USDA/WFP Partnership 2. Methodology........................................................................................2 3. Improved Literacy of School Age Children...............................4 Improved Quality of Literacy Instruction Improved Attentiveness Improved Attendance 4. Increased Use of Health and Dietary Practices......................13 Increased Knowledge of Health and Hygiene Practices Increased Knowledge of Safe Food Preparation and Storage Increased Knowledge of Nutrition Increased Access to Clean Water and Sanitation Increased Access to Preventative Health Interventions Increased Access to Requisite Food Preparation and Storage Tools and Equipement 5. USDA MGD/WFP Project Achievements.................................16 6. Programme Theory Evaluation Conclusions..........................17 Progress in improving literacy: Successes and remaining obstacles Progress in improving health and dietary practices: Successes and remaining obstacles 7. Annexes for USDA MGD Midline Survey.................................18 Strategic Objective 1: Improve Literacy of School Age Children Strategic Objective 2: Increase Use of Health and Dietary Practices USDA Midline Survey Methodology Socieconomic Characteristics of Midline Survey Respondents Food and Nutrition Security Situation Table of Contents The World Food Programme in Cambodia, 2011 - 2016 In support of national efforts to address food insecurity, poverty and malnutrition, the World Food Programme (WFP) instituted its first five year Country Programme (CP) in July 2011. The CP, which continues WFP’s focus on education, nutrition and rural development, seeks to strengthen food and cash-based social safety nets in Cambodia and craft sustainable and scalable implementation models that can eventually be managed efficiently by the Royal Government of Cambodia. Long-term handover strategies are increasingly important at this stage given Cambodia’s impending transition from low income to lower middle income status and the joint commitment to the establishment of a nationwide school feeding programme. The education component of the CP, which consists of a school meals programme and food or cash-based scholarships, constitutes more than 75% of all WFP programming in the country. The School Meals Programme (SMP), initially launched in 1999, provides daily, on-site, hot and nutritious breakfasts to primary school students. Schools are selected for inclusion in the programme according to poverty levels and education performance (enrollment rates, dropout rates, etc). School meals are comprised of rice, canned fish, vitamin A&D￾fortified vegetable oil, yellow split peas and iodized salt which help to alleviate short-term hunger and improve concentration. Notably, in the 2015-2016 school year, fortified rice will be introduced for the first time on a large-scale in Cambodia, courtesy of the USDA McGovern-Dole Programme. The objective of the SMP is to create incentives for children from poor families to enroll, regularly attend and complete their primary education. In 2015, the SMP is implemented in 9 provinces and provided daily meals to 268,000 primary school children from grades 1 to 6. Importantly, given resource scarcities, the total children reached by the SMP in 2015 is roughly 33% less than the number reached in 2014. Given continuity of funding, however, USDA-supported provinces were unaffected by these reductions. introduction The food and cash based scholarship programme (also referred to as Take Home Rations- THR) has been implemented in Cambodia since 2004. The target group for this intervention are poor and disadvantaged, primary school students in grades four to six. The programme is focused in these grades in particular as they have the highest dropout rates (with children leaving school to work). To ensure that poor and disadvantaged children are adequately targeted for inclusion in the programme, WFP prioritizes students Page 2 USDA Midline Survey April 2015 from IDPoor 1 households1 or children from households that may not have IDPoor cards but whose profile fit WFP criteria2 . Scholarships are conditional on the student achieving an 80% attendance rate. Currently, scholarships are implemented in 6 provinces, reaching 31,700 beneficiaries. Beneficiary reductions from the 2013-2014 school (of 40%) were due government handover rather than resource constraints, as the government’s scholarship programme extended to WFP project areas in an additional 9 provinces, allowing WFP to phase out. USDA/WFP Partnership The Government of the United States of America (US), through the US Department of Agriculture (USDA) McGovern-Dole (MGD) Programme, has been a trusted partner of WFP in Cambodia, dating back to 2001. Since its inception, this partnership has ensured that more than 3.4 million children have benefited from School Feeding Programmes. The most recent agreement, signed in 2013, provides US $ 20 million for an extension of school meals and/or food scholarships in three provinces (Battambang, Siem Reap, and Kampong Thom) for another three years. The goal of current USDA MGD programming is to improve the literacy of school age children and increase use of improved health and dietary practices, while simultaneously providing a safety net to vulnerable and at risk households and children. The Results Frameworks (RFs) for the MGD programme are shown in Annexes 1 and 2. Overall, 863 primary schools are targeted per year with 166,928 primary school students receiving onsite breakfasts and 12,221 students in grades 4-6 receiving scholarships (with priority to girls, when gender gaps exist). Alongside the provision of school meals or scholarships, USDA funded programmes also focus on the following programme activities, including; • Provision of school equipment and supplies (hygiene, sanitation, cooking equipment and literacy-related materials); • Establishing school gardens and developing partnerships with farmers groups to supply food to schools; • Building and rehabilitating school facilities (including latrines, store rooms, kitchens, wells and water stations); 1 The IDPoor system, officially referred to as the Identification of Poor Households Programme, is a standardized procedure, developed by the Ministry of Planning (MoP), to identify and classify poor households throughout the country. The IDPoor classification process occurs annually, on a rolling geographic basis, with the whole country covered every three years. IDPoor status is widely used, by both the government and the international community, as a key criteria for targeting as￾sistance. 2 Given levels of work migration in Cambodia, certain poor households are not present (and thus not captured) in the rotating IDPoor classification rounds. WFP takes this into account by assessing poverty levels of households within their project areas to ensure that poor households and children (who happen not to have IDPoor cards) are not overlooked but rather given the opportunity to benefit from the scholarship programme. • Awareness raising on hygiene, sanitation and nutrition; • Capacity development on food safety through training of school administrators and teachers; • Strengthening monitoring and evaluation. A quasi-experimental approach was selected as the preferred design for the baseline, mid and endline surveys; employing a control group to measure how key outcomes change in the absence of intervention. In addition, the midline survey incorporated a Programme Theory Evaluation approach, in order to assess how changes in certain outcome and output indicators are impacting the key outcome variables. This provides a glimpse as to the strength of the conceptual model underlying the USDA programme as well as provides detailed information on programme gaps within Cambodia facilitating prioritization of activities as the third year of programming approaches. While USDA McGovern-Dole monies support WFP’s School Feeding Programme in the provinces of Siem Reap, Battambang and Kampong Thom, the midline survey (like the baseline survey) was only conducted in Siem Reap and Battambang. Kampong Thom province was excluded as only SMP are currently being implemented with USDA support; the food scholarships is provided by other donors. Inclusion of Kampong Thom would have thus complicated the sampling procedures and analysis, resulting in additional costs with little added value3 . Within Battambang and Siem Reap, 118 (of 531 possible) intervention schools were selected, using random, probability proportional to size sampling. A further 25 control schools (10 in Battambang and 15 in Siem Reap) were selected via a propensity score matching approach4 . Amongst the selected intervention schools, 60 were receiving SMP and scholarships while 58 were only recipients of scholarships. A detailed list of selected schools can be found in Annexes 3. Within each intervention school, a number of households were selected for inclusion using a random sampling approach. In schools with SMP and scholarships, 15 households with children in grades 1-3 were selected for inclusion in the SMP cohort, while five households with children in grade 4 were selected for the SMP and scholarship programme cohort. A further 10 households with children in grade 4 were selected for the scholarship programme cohort. Amongst 3 For the midline, however, an additional exercise was conducted in Kampong Thom in order to make sure that the province was not excluded from detailed review for the duration of project.. Findings from Kampong Thom will be provided separately in an ensuing addendum in the coming weeks. 4 The Propensity Score Matching Approach is a statistical method that allows control clusters to be identified based on the same characteristics used to identify intervention clusters. It is intended to ensure that control clusters have very similar characteristics to the intervention clusters. What is Programme Theory Evaluation? As the mid-term evaluation has taken a program theory evaluation approach, it useful to take a moment and explain more fully what this means and how such an approach can be useful in understanding the reasons behind programmatic successes and failures. Programme theory evaluation is based on a simple concept---when trying to understand the success of any programme, evaluations should be guided by the expected causal relationships underpinning the design of the programme itself. For the USDA funded, WFP school feeding programme in Cambodia, this means assessing how outcomes, such as literacy, are changing in relation to how these outcomes would be expected to change given improvements or deterioration in attentiveness, attendance or quality of instruction. Programme theory evaluation can also be used to assess more distal causal pathways, looking at the various indicators for attendance or improved quality of education and assess whether the improvements or deteriorations in these indicators are impacting the outcomes as would be expected. The usefulness of programme theory evaluation is that it makes it possible to expose faulty thinking in programme design, while allowing a visualization of the weak links in programme implementation and indicating areas where programmes need to improve. methodology Page 3 USDA Midline Survey April 2015 Recognizing the Importance of Monitoring and Evaluation To ensure that USDA McGovern Dole funding is having maximum impact, WFP is establishing an innovative M&E system that will not only enable more efficient outcome monitoring but also provide more responsive programme monitoring to address problems in implementation real-time. WFP’s Real-time Monitoring and Evaluation System WFP has recently entered an innovative partnership with InSTEDD and MangoMaps to develop streamlined data collection and management systems, with the aim of improving systems within WFP and ensuring that similar technologies are available for other actors in the development and humanitarian fields. Development of mobile-phone based real-time data collection system WFP is working with InSTEDD to significantly expand the capacities of their Resource Map application, thus creating an open-sourced, integrated mobile phone-based Monitoring and Evaluation (M&E) data collection system. Information collected is linked to a geographic interface and provides real-time alerts to programme managers to ensure rapid responses to programmatic issues. In practice, this means that key M&E and VAM indicators, once data is collected and uploaded via mobile phone, are displayed geographically on a google-maps based interface. If certain indicators exceed pre￾defined triggers, alerts (in the form of emails or SMS’s) are sent to relevant programme and managerial staff, ensuring that problems in programme implementation are identified and solved quickly. This has the capacity to improve WFP’s programme implementation as well as their response times immeasurably. This technology also serves as a central repository for M&E and VAM data, allowing all programme staff the capacity to view the latest updates in real-time. Giving beneficiaries a voice: Development of an automated complaint mechanism A further aspect of WFP’s and InSTEDD’s collaboration focuses on the establishment of an automated complaint mechanism, allowing beneficiaries avenues by which to confidentially report issues in WFP programming, whether it be related to serious problems (food diversions, theft, etc) or more minor issues (such as mistakes in ration sizes or targeting criteria). Again, this is a free and open-source tool, created by InSTEDD, that allows beneficiaries to listen and record messages in their own language and dialect or answer questions with a phone keypad. Importantly, the automated complaint mechanism has the capacity to build in triggers, which would allow real-time alerting of WFP management (via phone calls, SMS or emails) to significant problems requiring immediate resolution. Making information actionable: Collaboration with MangoMaps WFP is taking advantage of state-of-the￾art technologies to make M&E information more actionable to programme managers and decision makers. By utilizing Mango Maps unique geographic mapping platforms, WFP is able to display all key information in an interactive map, which allows users to explore the information behind the map with a click of a button, providing the information they need to address problems more efficiently (see Figure 1). InSTEDD and WFP giving back: Importantly, WFP’s support of and collaboration with InSTEDD will also provide a service to other WFP offices, the wider development and humanitarian communities and the Royal Government of Cambodia as the technologies under development are open-sourced and thus accessible to any organization or government free of charge. This will improve existing technologies and ensure greater access to sophisticated data collection and management systems. Figure 1: Example of Real-time Monitoring and Evaluation Platform Founded in 2006 from a TED Prize, and based in California’s Silicon Valley, InSTEDD is a unique software development and design company, using open source technology tools to help actors in the development field improve collaboration, information flow and knowledge sharing with the ultimate aim of improving delivery of critical services to vulnerable populations. With long term sustainability in mind, InSTEDDs interdisciplinary team of public health experts, scientists, and software engineers help build local capacity to solve critical health, safety and sustainable development problems. InSTEDD now operates around the world to implement their vision. With startup funding from Google.org and the Rockefeller Foundation, which includes setting up innovation labs in Southeast Asia and Latin America, that are fostering collaborative engineering practices and entrepreneurial innovation in those regions. MangoMaps is a GIS web map publication platform that can be used to create innovative, interactive maps, which allow non GIS specialists the power to better explore and utilize GIS information. MangoMaps also enhances GIS information sharing by serving as a platform by which GIS information can be stored and shared by multiple actors across the private sector and development and humanitarian communities. Page 4 USDA Midline Survey April 2015 performance by teachers, the Government, in 2014/2015, has increased salaries from 70 USD per month to 120 USD per month with a further increase planned in mid-2015 to 162 USD. The Government has also instituted a system to recognize and award teachers for exemplary performance and placed greater focus on monitoring the attendance and performance of teachers. The Government is also currently updating the curriculum at schools, with a renewed focus on improving literacy as well as providing more textbooks, teacher guides and training materials, with distribution of these focused primarily in poor and marginalized areas. Despite these positive changes, observed literacy levels are still lower than USDA MGD Programme targets of 80%. Thus, while improvement to the educational sector are happening, the quality of schooling in Cambodia remains one of the most significant challenges. WFP will continue to work with the Government to encourage and support policies and strategies that improve literacy. Improved Quality of Literacy Instruction To assess quality of literacy instruction, the midline survey examined the percentage of teachers who demonstrate improved literacy instruction as identified by supervisors5 . Overall, according to supervisors, 49% of teachers demonstrated improvements, which falls well short of the target of 80%. To achieve this target by the end of the project will be challenging but improvement in the below indicators will build the foundation for improvement in this area. More consistent teacher attendance To measure improvements in teacher attendance, WFP examined overall teacher attendance rates as well as the percent of teachers who were present at school for at least 90% of the scheduled school days. Findings at both baseline and midline indicated that teacher attendance, while not quite achieving USDA MGD targets, is still quite good. At midline, average attendance for teachers was 88% with roughly 81% present for at least 90% of the scheduled school days, showing relative stability since the baseline (Figure 3). To meet USDA targets, however, it will be necessary for teachers to focus more exclusively on teaching (as a primary livelihood) and less on other income generating activities such as paddy or cassava farming (which are often the activities that result in teacher absenteeism). It 5 Notably, the baseline survey was unable to collect this indicator given confusion as to what con￾stitutes improved literacy instruction among enumerators and respondents. For the midline, WFP was able to remedy this problem by including more detailed training on this topic, improving enu￾merator and field monitor’s understanding. Given lack of a baseline, however, the midline survey findings will serve as the baseline moving forward and will be used as the comparison for the final evaluation. control schools, 20 households with children in grades 1-4 were randomly selected. It’s important to note that the numbers of selected households per school was lower than intended in certain cases, as the number of children benefitting from the scholarship programme was fewer than the required 10 in certain schools. Thus, the actual number of households interviewed is 2,202 households as opposed to the 2,280 required by the sampling design. Alongside household surveys, school assessments and teacher interviews were conducted. School assessments included basic information on the composition and performance of the school (number of children enrolled, attending, availability of advanced teaching materials, literacy testing success rates, etc) as well as specific information on the school’s infrastructure (latrines, water sources, kitchens, school gardens, etc). The primary respondent in the case of the school assessment was the school’s principal or chief administrator. In the case of teacher interviews, a total of 540 teachers, for grades 1-4, were interviewed in each selected school, an average of three teachers per school. Data analysis was conducted using STATA and SPSS software. Overall households and school level estimates for the intervention schools were weighted to reflect the proportion of the population benefiting from each programme. More detailed information on the survey methodology, including specifics on the survey tools and the process of data collection and supervision, can be referenced in Annex 3. A primary objective of USDA McGovern-Dole funded projects is to improve literacy amongst school age children. To assess improvements in literacy, the midline survey (following a similar methodology to the baseline survey) examined a proxy for literacy, namely whether children in grade 6 are reading at their grade level by the time they graduate primary school. In addition, the midline survey assessed a series of indicators that are the building blocks to better literacy, including quality of literacy instruction, improved attentiveness while in school and improved attendance. In terms of literacy, midline information suggests an improvement, from 57% able to read at grade level at baseline to 66% at midline (Figure 2). This improvement reflects the renewed focus from Government to improve the quality and commitment of teachers as well as the overall curriculum at schools. To encourage better Figure 2: Percent of student who, by the end of grade 6, demonstrate reading comprehension equivalent to their grade level as defined by national standards Figure 3: Percent of teachers in target schools who attend and teach school at least 90% of scheduled school days per year improved literacy of school age children Page 5 USDA Midline Survey April 2015 Education Context in Cambodia: 1970’s to 2015 The educational legacy of the Khmer Rouge Already suffering from funding cuts and school closures during the regime of General Lon Nol, the education sector in Cambodia was fundamentally disassembled with the arrival of Pol Pot and his “great leap” revolutionary ideology. Deeming education and literacy as unnecessary (and even dangerous), Pol Pot’s regime abolished formal schooling, destroyed school infrastructure and set out to purge Khmer Rouge society of all teachers, students, professionals and intellectuals. It is estimated that roughly three-quarters of the educated population were either killed or forced to flee the country as a result.1,2 With the fall of the Khmer Rouge in 1979, formal education could restart, but the entire foundation of the educational system needed to be reconstructed. This included re-building the physical infrastructure of the educational system while also identifying and harnessing the human resources with the capacity to teach children the basics of reading and writing. Educational priorities in the initial post-Khmer Rouge period are best illustrated by a quote from an education official who was actively working on restarting the education sector at the time: 1979-1981 was a period of restructuring and rehabilitating of both infrastructure and human resources. By restructuring and rehabilitation, I refer to collecting school-aged children and putting them in schools despite [the fact, they were] in (the) poor condition. Classes were even conducted in makeshift, open-air classrooms or under trees. We appealed to all those surviving teachers and literate people to teach the illiterates. We used various slogans such as ‘going to teach and going to school is nation-loving’ and so on. There were no official licenses or any requirements for taking on the teaching job. We just tried to open schools and literacy classes, regardless of their quality.3 This difficult rebuilding process was further complicated by the continuing conflict with remnants of the Khmer Rouge and the devastating, destructive legacy of the Khmer Rouge regime, which, in the late 1980’s, left 30% of primary school-aged children without a father, 10% without a mother and between 5-10% without both parents.4,5 The rebirth and revitalization of the education system Education at all levels restarted in the 1980’s. Primary and secondary school enrollment rapidly increased, from less than 1 million in 1980 to more than 1.5 million in 1989.6 By 1999/2000, the net primary school enrolment rate had reached 85.5% and was continuing to improve. To build on these improvements, the government adopted its first set of coherent policy documents and strategic plans for the education sector in 2001, marking a shift toward a sector wide approach to accelerate reforms. These included; the first Education Strategic Plan (2001- 2005), an Education Sector Support Programme (2001-2005) and the National Education for All Action Plan in 2003. The first Education Strategic Plan was followed by a second (2006-2010) which highlighted three priorities in the education sector; achieving equitable access to education, improving the quality and efficiency of education and strengthening institutional capacity to deliver education. By 2009/2010, as a result of this sustained focus, universal enrollment had almost been achieved, with 95.8% of primary school age-children enrolled. Likewise, the rate of students entering grade 6 doubled from 2000/2001 to 2007/2008 (from 47% to 79.5%), likely indicating a similar increase in graduation rates. Secondary school enrollment rates experienced similar improvements with rates doubling to 31.9% in 2009/2010. Notably, by 2010, gender parity in enrollment in both primary and lower secondary school had been achieved.7 From 2010 to 2015, progress has continued, but inevitably at a slower pace. By 2013, the net enrollment rates for primary and secondary schools had increased further, to 97% for primary and 43% for secondary. Completion rates for primary school have also continued to increase, reaching 92% in 2013. The third and fourth Education Strategic Plans (2009-2013/ 2014-2018) as well as the 2014-2018 National Strategic Develop Plan (NSDP) have all highlighted the importance of education as well as the need to focus on skill development of the Cambodian population, ensuring that education remains high on the agenda moving forward. Key remaining challenges and USDA McGovern-Dole contribution Despite significant improvements to the education system over the last couple of decades, the 2014- 2018 Education Strategic Plans cites numerous remaining challenges including the need to focus on; expanding equitable access to primary school education for remote, often marginalized communities and improving the quality of education by developing an accountability framework and by providing highly qualified teachers as well as better textbooks and learning materials. Notably, the USDA McGovern-Dole support through WFP is actively supporting the government in addressing these remaining challenges. Be it through the provision of scholarships to the poor and marginalized or through its focus on teacher and administrator trainings, distribution of learning packages and focus on better literacy materials and curriculum, USDA support in Cambodia is increasing equitable access to education as well as improving teacher skills and overall educational quality. Notably, USDA support is also funding the development of a robust, real-time monitoring and evaluation system as well as a complaint mechanisms system for the Ministry of Education, modeled after the systems currently in use by WFP. These systems will go a long way towards improving the accountability of the educational system, not only to policy makers but the Cambodian people as a whole. Taken together, it is clear that USDA support is uniquely aligned with government priorities for the coming years. 1 Asian Development Bank. Cambodia: Education sector strategy study. 1996 2 UNESCO (Prasteri, S.) Rebirth of the learning tradition: A case study on the achievements of Education for All in Cambodia. 1996. 3 Sideth S. Dy, Strategies and Policies for Basic Education in Cambodia: Historical Perspectives. International Education Journal, Vol 5, No 1, 2004. 4 Postlethwaite, T.N. (1988) Kampuchea. In T.N. Postlethwaite (ed.) The Encyclopedia of Comparative Education and National Systems of Education, (pp.412-13), Oxford: Pergamon Press. 5 Sideth S. Dy, Strategies and Policies for Basic Education in Cambodia: Historical Perspectives. International Education Journal, Vol 5, No 1, 2004. 6 Ministry of Education, Youth and Sport. Education in Cambodia. 1999. 7 Overseas Development Institute. Development Progress Stories. Cambodia’s story: Rebuilding basic education in Cambodia: Establishing a more effective development partnership. 2010. Page 6 USDA Midline Survey April 2015 Improved literacy instructional material To measure improvements in literacy instruction materials, the baseline survey assessed the percent of teachers who used the approved, national literacy curriculum as a part of their instructional materials as well as the number of classrooms (according to teachers/ school administrators) which had literacy materials sufficient for effective instruction. Midline findings show mixed results since the beginning of the project. Overall, 75% of teachers are using national literacy curriculum and related instructional materials, up significantly from 60% at baseline (Figure 8). By contrast, 77% of classrooms have sufficient literacy materials for improved instruction, down from 86% at baseline. The notable improvement in teacher utilization of national literacy instruction is likely due to the convergence of USDA MGD support and the renewed Government commitment to improve literacy and it is likely a key reason behind the modest increases in literacy observed since the project’s inception. The decline in the number of classrooms with sufficient literacy materials, on the other hand, is a concern to WFP and will be addressed as quickly as possible. Increased skills and knowledge of teachers To assess increases in the skills and knowledge of teachers, the midline survey examined the following indicators; is hoped that salary increases will improve the situation quickly, as teachers now receive the necessary incentives to focus more fully on teaching. Better Access to School Supplies and Materials To measure access to school supplies and materials, WFP regularly monitors the following indicators which measure progress in terms of programme implementation: • Number of schools receiving school supplies and materials • Number of learning material packages provided to target schools • Number of stationery packages provided to target schools • Number of students (boys/girls) benefitting from the provision of school supplies Since the project’s inception, almost all schools have been provided school supplies and materials, with 99.2% of schools reached and 88% of children benefiting as a result (Figures 4 and 5). WFP has identified which schools have not been reached and is actively working to remedy the situation. The total number of learning material and stationary packages delivered is only slightly behind schedule, with more than 38% of the planned number already delivered as of the halfway point of the project (Figures 6 and 7). It is expected, however,that all targets will be reached by the end of the project. Figure 4: Percent of schools receiving school supplies and materials (learning material packages and stationery packages) Figure 6: Percent of stationery packages provided to target schools Figure 7: Percent of learning material packages provided to target schools Figure 5: Percent of students benefitting from the provision of school supplies Page 7 USDA Midline Survey April 2015 • Number of teachers/ educators/ teaching assistants trained or certified • Number of teachers / educators / teaching assistants who successfully completed in service or received intensive coaching or mentoring • Number of teachers in target schools with recognized teacher certification credentials • Percent of teachers in target schools who demonstrated use of new and quality teaching techniques or tools Midline findings suggest that teacher qualifications and skills are improving, but much work remains if targets are to be achieved. Overall, 81% of teachers in USDA supported schools were certified as of the midline and there has been significant progress (a 48 percentage point increase) in the number of those recently trained and/or certified6 . More than a third (39%) of teacher trainings have yet to be completed but the majority of these trainings are planned for the end of the school year in 2015. Notably, 63% of teachers, educators or teaching assistants have also successfully completed in service training or received intensive coaching or mentoring, while 37% are yet to receive such training. Findings and USDA MGD targets are shown in Figures 9-11. 6 Please note, the narrative of the baseline survey erroneously reports that 51% has received such a training or certification. This was a mistake in the narrative only, as the Strategic Results Frame￾work (in Annex 1) showed the correct information. While teacher qualifications are improving, trainings and certifications themselves do not necessarily improve the quality of teaching, as only 41% (up slightly from 36% at baseline) demonstrated the use of new, quality teaching techniques or tools (Figure 12). As such, focus should be placed not only on expanding the coverage of trainings but also improving the quality of trainings, ensuring that all teachers have a basic set of skills that allow them to take advantage of better quality teaching methods and tools. To support continuing improvement in this area, WFP will highlight these better teaching methods and tools to educators during all WFP-led trainings for the remainder of the USDA MGD project. Increased skills and knowledge of administrators To assess increases in the skills and knowledge of school administrators and other officials, the midline survey examined the following indicators; • Number of administrators trained or certified • Number of administrators in target schools with recognized education certification credentials • Percent of administrators in target schools who demonstrated use of new and quality teaching techniques or tools Training and certification of school administrators and other officials appear to be a more significant challenge than teacher training and certification. Overall, 13% of school administrators and officials have Figure 8: Percent of teachers using the national literacy curriculum and the related instructional materials Figure 10: Percent of teachers / educators / teaching assistants trained or certified Figure 11: Percent of teachers / educators / teaching assistants who successfully completed in service or received intensive coaching or mentoring Figure 9: Percent of teachers in target schools with recognized teacher certification credentials Page 8 USDA Midline Survey April 2015 Figure 12: Percent of teachers in target schools who demonstrate use of new and quality teaching techniques or tools Figure 14: Percent of school administrators and officials trained or certified Figure 13: Percent of school administrators and officials in target schools with recognized education certification credentials Figure 15: Percent of school administrators in targeted schools who demonstrate use of new techniques or tools recognized education certification credentials as of the midpoint of the 2014-2015 school year. New trainings are proceeding, however, with 53% of targeted school administrators trained since 2013. As seen in teachers, however, training does not necessarily improve performance, as only 29% of school administrators use new, quality educational techniques and tools. Findings and USDA MGD targets are shown in Figures 13-15. Improved Attentiveness To measure improved attentiveness, the midline survey measured perceived or reported attentiveness through the eyes of both the student and the teacher, while also assessing indicators that impact attentiveness, including short term child hunger amongst others. To assess attentiveness directly, teachers were requested to indicate the percent of students that they perceived as inattentive on a regular basis. Students were likewise then requested to indicate how attentive they perceive themselves as being. Findings were quite consistent with teachers indicating that only 9% of students were inattentive on a regular basis while 95% of students reported being attentive (Figure 16). With increases in attentiveness observed since the baseline, USDA MGD targets (of 10% for inattentiveness and 90% for attentiveness) have now been exceeded, though continued focus on this is required to ensure further progress. Reduced short term hunger To assess short term hunger, the midline survey reports not only on child hunger but also on various programme implementation measures, including; • Number of take home rations provided to students (boys/girls) • Number of students (boys/girls) benefitting from a take home ration • Quantity of commodities (tons) provided for take-home rations provided to students (boys/girls) • Number of students (boys/girls), cooks and storekeepers benefitting from school meals (breakfast) • Number of daily school meals (breakfast) provided to students (boys/girls) • Percent of students in target school consuming daily meals at schools • Quantity of commodities (tons) provided for school meals, students (boys/girls), storekeepers and cooks Regarding the implementation indicators above, midline results show that quantities of commodities distributed as well as numbers of beneficiaries reached is largely on target. Regarding food scholarships, 34% of all planned rations have been delivered to date, with 33% of total rice allotment distributed as well. The impending second quarter distribution for 2015 is expected to take this total to approximately 50% for the overall project, putting WFP Page 9 USDA Midline Survey April 2015 on course to meet targets by the end of the project. So far, 82% of the total number of expected food scholarship beneficiaries have been reached, with the new beneficiaries for 2015-2016 school year likely to take this figure higher than the expected targets. Findings and USDA MGD targets are shown in Figures 17-19. Similar progress has been observed in the SMP. Overall, 45% of all scheduled school meals have been delivered as of the midline survey, placing WFP on course to meet expected targets. Likewise, 44-45% of the total rice, yellow split pea and oil to be distributed has already been dispatched as of the midline. In terms of beneficiaries reached, 97% of the expected number of students are benefiting from SMP, with 3% still not reached. This shortfall will be rectified by the number of children entering grade 1 in 2015-2016 school year. Notably, 97% of children reported eating school meals on a daily basis, which falls above the USDA threshold of 95%. Findings and USDA MGD targets are shown in Figures 20-25. To measure child hunger, children were asked whether they were “hungry” or “very hungry” during school days. On average, midline findings indicate that 17% of children reported hunger during the school day which is close to a 10 percentage point improvement from baseline. Notably, the provision of school meals seemed to be the main factor in this improvement, as children receiving school meals indicated an improvement of 13 percentage points while children receiving only scholarships reported only a 4 percentage point improvement (Figure 26). As indicated in the baseline, such an improvement, while expected (given that a meal is provided), is always dependent on the smooth functioning of the programme overall, something which is demonstrable given the implementation and hunger indicators. Improved Attendance Official student attendance rates are not available in Cambodia as adequate attendance records are not kept at some schools. Therefore, it was only possible to estimate attendance rates via the actual head count of students present in classrooms on the day the schools were visited. The midline survey also explored the percent of children that attended classes at least 80% of the time, as this is a common indicator that WFP uses for determining eligibility for food scholarships. Overall, findings suggest fairly strong attendance, with estimated rates hovering near USDA MGD project targets. On average, 86% and 87% of children were present on the day intervention and control schools were visited, respectively, versus USDA MGD target of 90%. Findings from the midline were virtually unchanged from the baseline where 85 and 88% respectively were attending. Within the intervention cohort, attendance did not differ, with rates steady at 86% (Figure 27). Figure 16: Percent of students in target schools identified as attentive Figure 17: Percent of take home rations provided to students Figure 18: Percent of quantity of rice provided for take-home rations provided to students Figure 19: Percent of students benefitting from a take home ration Page 10 USDA Midline Survey April 2015 Figure 20: Percent of daily school meals (breakfast) provided to students Figure 21: Percent of quantity of rice provided for school meals provided to students, storekeepers and cooks Figure 22: Percent of quantity of YSP provided for school meals provided to students, storekeepers and cooks Figure 23: Percent of quantity of vegetable oil provided for school meals provided to students, storekeepers and cooks Figure 24: Percent of students benefitting from school meals (breakfast) Figure 25: Percent of students in target school consuming daily meals at schools Midline findings indicated significant shifts since the baseline in the precentage of students who regularly attended school (>=80% of the time). Regularly attendance at intervention schools increased 8 percentage points, from 78% at baseline to 86% at midline, surpassing WFP’s target of 80% (Figure 28). Within the intervention cohort, increases in attendance were only observed at schools receiving school meals (rather than just food scholarships alone), with regular attendance jumping 18 percentage points, from 71% at baseline to 89% at midline. This illustrates the “pull factor” that school meals continue to have throughout USDA intervention areas in Cambodia. As regular attendance also makes it more likely for children to do well in school, the provision of school meals is likely to impact overall academic achievements. To ensure that targets are met, WFP will continue to focus heavily on improving attendance, both by encouraging attendance directly Page 11 USDA Midline Survey April 2015 Figure 26: Percent of students in target schools who indicate that they are “hungry” or “very hungry” during the school day Figure 28: Percent of students regularly (80%) attending USDA supported classrooms/schools Figure 27: Estimated student attendance rate and by improving the various indicators that impact attendance, including; • Increased economic and cultural incentives • Reduce health related absences • Improving school infrastructure • Increasing overall enrolment • Increasing community understanding of the benefits of education The specifics of these indicators at baseline are described below. Increased Economic and Cultural Incentives To assess increased economic and cultural incentives for education, the midline survey examined the number of schools providing separate latrine facilities and the number of children at target schools that regularly receive school meals and/or food scholarships. Overall, progress on the provision of separate latrine facilities for boys and girls continued to be far below USDA MGD targets, with virtually no improvement since the inception of the project (63 versus 64% at baseline and midline respectively) (Figure 29). WFP must renew focus on this issue if targets are to be achieved. The number of beneficiaries regularly receiving food scholarships actually, as of the midline, exceeds the expected targets. Reduced health related absences To improve attendance and improve overall well-being of children, health-related absences must be minimized. As discussed in the baseline, WFP has set the ambitious target that children should miss 5 days or fewer per year due to illness. Baseline findings provided an indication as to how hard it would be to achieve this target, with children amongst the intervention schools missing more than 3 times that amount (16 days) per year due to illness. Midline findings, unfortunately, reiterate how difficult it is to tackle this issue. Amongst all intervention schools, health-related absences only reduced by 1 per year (to 15 days). Looking within intervention groups, there were mixed findings, with children receiving school meals showing 1 fewer day of health-related absences while children receiving only scholarships showed a 5 day increase in health-related absences (Figure 30). With much work remaining, a sustained focus on the project components that relate to improved health and nutrition is absolutely vital if targets are to be achieved. Improved School Infrastructure To assess improvements in school infrastructure, WFP is monitoring the following programme implementation measures: • Number of latrines at target schools rehabilitated or constructed • Number of kitchens at target schools rehabilitated or constructed • Number of energy-saving stoves at target schools rehabilitated or constructed • Number of storerooms at target schools rehabilitated or constructed Figure 29: The percent of schools providing separate latrine facilities Page 12 USDA Midline Survey April 2015 Figure 30: Average number of school days missed by students due to illness • Number of school gardens at target schools rehabilitated or constructed • Number of drilled wells/water stations at target schools rehabilitated or constructed • Number of students benefitting from the rehabilitated or constructed latrines • Number of students benefitting from the rehabilitated or constructed kitchens • Number of students benefitting from the rehabilitated or constructed energy-saving stoves • Number of students benefitting from the rehabilitated or constructed storerooms • Number of students benefitting from the rehabilitated or constructed school gardens • Number of students benefitting from the rehabilitated or constructed drilled wells/water stations Midline results show that there is less progress on school infrastructure projects than expected at this stage of the programme, with the percent of projects completed ranging from 34% (of storerooms rehabilitated or constructed) on the low side to 53% (latrines rehabilitated or constructed) on the high side. The only exception is school gardens, where 92% of the targeted gardens have been rehabilitated/ constructed. The reason for generally low implementation rates of infrastructure projects at this stage, however, is due to the fact that the bulk of these projects were Figure 31: Percent of latrines at target schools rehabilitated or constructed Figure 32: Percent of kitchens at target schools rehabilitated or constructed scheduled to begin in the latter half of 2015, so implementation should be back on track by early 2016. Findings and USDA MGD targets are shown in Figures 31-36. Increased school enrollment To assess school enrollment, the midline survey examined the numbers of children enrolled as well as the percentage increase in students enrolled in school. Overall, the number of children enrolled exceeded targets in 2014/2015, with enrollment increasing by 2% on average (Figure 37). Increased community understanding of the benefits of education To measure progress in terms of better community understanding on the benefits of education, the midline survey measures the number of parents in target communities who are members of Parent Teacher Associations (PTAs) as well as the percentage of parents that can name at least three benefits of primary education. Findings from the midline survey showed improvements in the percentage of parents who are members of PTAs, with the percent increasing from 84% at baseline to 92% at midline. By contrast, the percentage of parents who are able to name three benefits of primary education remained low and was virtually unchanged from baseline (18 to 17% respectively). As the USDA MGD target stands at 85%, it is clear that targets will not be achieved absent a clear focus on community awareness raising activities on the importance of education (Figures 38 and 39). Figure 33: Percent of energy-saving stoves at target schools rehabilitated or constructed Page 13 USDA Midline Survey April 2015 Figure 36: Percent of drilled wells/water stations at target schools rehabilitated or constructed Figure 35: Percent of school gardens at target schools rehabilitated or constructed To assess the use of health and dietary practices, the baseline survey examined the following indicators (acting as proxies for this strategic objective): • Percent of schools with soap and water at handwashing stations commonly used by students • Number/percent of schools using improved sanitation facilities (latrines) • Percent of households in target schools that store food off the ground • Percent of schools in target communities that clean cooking and eating equipment, consistent with accepted standards At baseline, it was observed that much progress had been made advancing health and dietary messages from previous school feeding programmes, with 93% of targeted schools reporting improved sanitation facilities and 86% and 83% of schools reporting proper storage techniques (storing food off the ground) and use of clean cooking and eating utensils, respectively. Midline findings revealed little additional improvement in these indicators, with the percentages of each remaining unchanged. As the pool of schools lacking proper sanitation facilities and hygienic storage and cooking behaviors becomes smaller, it is natural that achievements on these indicators will slow. To ensure targets are met, however, WFP will have to identify those schools that lag behind and better target interventions. Findings and USDA MGD targets are shown in Figures 40-42. The indicator where the least progress was observed at baseline was the percent of schools with soap and water at handwashing stations. Amongst the targeted schools, only 64% reported properly equipped handwashing stations at baseline, falling well short of the 85% required by USDA MGD programme. Findings from the midline survey, however, showed considerable progress on this front, with percentages increasing from 64% to 80% amongst intervention schools. Notably, most progress was made in schools receiving school meals with percentages improving by 25 percentage points (from 64 to 89%), surpassing the target of 85% (Figure 43). Over the coming year or so, schools receiving only food scholarships should also be targeted for intervention, as children in these schools need these facilities as well (regardless of the fact that they are not served a school meal). To better assess progress in health and dietary practices, WFP also examined a series of more specific indicators, looking at the following issues in more depth; • Increased knowledge of health and hygiene practices • Increased knowledge of safe food preparation and storage • Increased knowledge of nutrition Figure 34: Percent of storerooms at target schools rehabilitated or constructed Figure 37: Percentage of targeted children enrolled Increased use of health and dietary practice Page 14 USDA Midline Survey April 2015 Figure 39: Percent of parents in target communities who can name at least three benefits of primary education • Increased access to clean water and sanitation • Increased access to preventative health interventions • Increased access to requisite food preparation and storage tools and equipment Findings are shown by indicator below. Figure 38: Percentage of parents who are members of PTAs Increased Knowledge of Health and Hygiene Practices To assess health and hygiene knowledge, the midline survey explored parents’ understanding of proper health and hygiene practices as well as their knowledge on where to find accurate information on health. Overall, midline findings suggest that parents remain quite knowledgeable on where to access health information (with 88% reporting at least one local source of accurate health information￾Figure 41: Percent of schools in target communities that clean cooking and eating equipment Figure 40: Percent of schools that store food off the ground Figure 42: Percent of schools using improved sanitation facilities Figure 43: Percent of schools with soap and water at handwashing stations commonly used by students Page 15 USDA Midline Survey April 2015 --exceeding USDA MGD targets). As seen in the baseline, however, this does not necessarily translate into more first-hand knowledge on proper health and hygiene, as only 54% at midline were able to identify three important health and hygiene practices (remaining far below USDA targets--Figures 44 and 45). Notably, both percentages declined slightly from baseline to midline so WFP will need to redouble efforts, particularly in relation to the educating communities regarding health and hygiene practices. Increased Knowledge of Safe Food Preparation and Storage Safe food preparation and storage is assessed by examining what percent of cooks and storekeepers at target schools achieved a passing grade on a safe food preparation and storage test. As mentioned in the baseline survey, this test was under development at the time of the baseline survey field work and thus was not included amongst the baseline survey tools. Thus, the midline survey provides the first real indication of progress in this area. Overall, however, findings indicate insufficient knowledge amongst these groups on this issue, with only 64% achieving a passing grade on the test. To reach USDA targets and ensure that children are protected from food borne diseases, WFP must ensure that training packages and trainings are provided to address this issue. Increased Knowledge of Nutrition To assess progress on improvements in nutrition knowledge, the baseline survey examined: • The percentage of students and parents who can identify at least one local source of information on proper diets and nutrition . • The percentage of cooks and storekeepers that have a passing grade on good nutrition and dietary practices The percentage of parents who can identify at least one local source of information on proper diet and nutrition declined significantly from baseline to midline (88% to 74%). If true, this is one of the more concerning findings of the midline evaluation. One indication that it may be spurious, however, is that similar declines were also seen amongst controls, perhaps indicating that the question was interpreted differently by enumerators and/or respondents in baseline and midline surveys (Figure 46). This will be a key focus of WFP in the aftermath of this evaluation, as it is absolutely critical to understand whether parents have the tools they need to ensure their child has proper diets and overall nutrition. As mentioned in the baseline survey, the test on good nutrition and dietary practices was under development at the time of the baseline survey field work and thus was not included amongst the baseline survey tools. Thus (as is the case with the test on safe food preparation and storage), the midline survey provides the first real indication of progress in this area. Findings again indicate, however, insufficient knowledge amongst these groups on nutrition and diet. Overall, fewer than half (only 41%) achieve a passing grade on this test. To reach USDA targets and ensure that children reap the full benefits of school meals, WFP must ensure that training packages and trainings are provided to address this issue. Increased Access to Clean Water and Sanitation To measure access to clear water and sanitation, the baseline survey examined: • The ratio of latrines (boys/girls) to students at target schools • The percentage of schools with year round access to safe and clear water source • The number of target schools that have latrines of sufficient quality that are in good repair According to midline findings, all three indicators have improved since baseline. Overall, the ratio of students to latrines improved from 1: 131 at baseline to 1:105 at midline, with similar reductions seen for boys and girls (though slightly more pronounced amongst girls) (Figure 47). Access to clean water (year round) improved from 67% at baseline to 77% at midline. Likewise, access to quality latrines improved from 78% to 93%. All indicators remain below USDA MGD targets but the trends are in the right direction. Increased Access to Preventative Health Interventions To examine access to preventative health measures, the baseline survey assessed the following: • Percentage of children dewormed within the past 6 months • The number of target schools with at least one month supply of soap (hand and dish soap) • Number of students receiving daily school meals with micronutrient fortified commodities In total, more than 82% (up only slightly from 80% at baseline) of children have been dewormed in the past six months, while 80% of schools maintained stocks of soap (up from 70% at baseline). This demonstrates significant progress to date, but most of this success Figure 44: Percent of parents who can identify at least one local source of information on good health practices Figure 45: Percent of parents who can name at least three important health/ hygiene practices Page 16 USDA Midline Survey April 2015 Figure 46: Percent of parents who can identify at least one local source of information on nutrition and diet Figure 47: Average ratio of latrines to students still derives from programming in years past. In terms of the number of children receiving micronutrient fortified foods, 96% of children were receiving fortified food at the midline, including fortified oil and salt. Notably, fortified rice is soon to be introduced as well in all USDA provinces, beginning in the 2015-2016 school year. Increased Access to Requisite Food Preparation and Storage tools and Equipment To assess this, the midline monitored the number of target schools with improved food preparation and storage equipment. While at baseline no schools indicated such improved equipment, midline findings showed substantial improvements, with 455 of the 600 targeted schools having increased access to this equipment. This will continue to be a focus of moving forward, to ensure targets are met. Using the various information collected as a part of the USDA MGD evaluation (both baselines and follow ups), WFP is able to track progress in terms of project implementation as well as outcomes by creating and plotting composite/ index variables which track achievements across a host of indicators. The composite variables include; • Progress on educational programme implementation • Progress on educational outcomes • Progress on health and dietary practices programme implementation • Progress on health and dietary practices outcomes Composite variables are calculated by summing the actual completion percentages for all key USDA MGD indicators and then comparing this rate to the achievement thresholds. It is then possible to plot Alignment of USDA supported school feeding programme with government priorities Through its USDA support, WFP has been working closely with the Ministry of Education, Youth and Sport (MoEYS) to align the existing school feeding programme with government priorities moving forward. WFP and MoEYS are working to finalize a School Feeding Road Map in 2015 which outlines the pathway to a fully government-owned and operated school feeding programme that is sustainable and focuses on five internationally-recognized quality standards; • Sound alignment with national policy frameworks • Stable and predictable funding and budgeting • Quality programme design • Strong institutional arrangements and coordination for implementation • Strong community participation and ownership The School Feeding Road Map specifies the short, medium and long-term actions required by both Government and WFP to ensure a fully government-owned school feeding programme by 2021. In the short and medium-term, Government will begin to assume more responsibilities in terms of day-to-day management of programmes while also setting up the required financial and institutional mechanisms to pay for and manage these programmes. WFP, on the other hand, will continue to manage school feeding programmes in close collaboration and partnership with MoEYS, in order to ensure there is no duplication with existing Government scholarship programmes and to mainstream the roles and responsibilities of managing school feeding programmes into the regular work of government employees, thus eliminating the need to incentivize employees. WFP is also modifying its existing implementation models to explore models that would be more suitable for government implementation, including the initiation of a “Home-Grown School Feeding” pilot (where food is purchased locally, thus supporting the local economies) and a national “lunch programme” pilot (as the government plans in the near future to transition to full day schools). Finally, WFP will also work with the MoEYS to design and implement a real-time, responsive monitoring and evaluation system, replete with a complaint mechanism to ensure that recipients of government support have avenues to express their thoughts and concerns over the programme. WFP active involvement in school feeding programme implementation is expected to last until 2021. At that point, WFP would transition away from implementation and become more of a technical assistance provider. USDA MGD/ WFP Project Achievements Page 17 USDA Midline Survey April 2015 Programme theory evaluation: conclusions actual process or outcome achievements in relation to each other to better understand the holistic effectiveness of WFP programming. Progress to date on implementation and outcomes are shown in Figures 48-51. As is evident, there have been sizeable advancements in terms of programme implementation since baseline, with 59% and 72% of implementation targets achieved for the education and health and dietary components respectively. This is in comparisons to the 13% and the 29% that were achieved at baseline. With such improvements observed since baseline, there is every indication that WFP will achieve all of its implementation targets by the end of the project. In terms of outcomes, much was already accomplished as of baseline (70% of both education and dietary and health outcomes had already been achieved) given that similar programming has been ongoing in these schools for a decade or more. A comparison with midline findings, however, show that improvements continue, with a 3 and 2 percentage point improvement in educational and health and dietary outcomes, respectively. Currently, 75% of educational outcomes (on aggregate) have been achieved versus 82% of health and dietary outcomes. A broader discussion on what has improved and why is provided in the section below. As mentioned previously, WFP is assessing the success and failures of the USDA School Feeding Programme through the lens of Programme Theory Evaluation. Doing so allows a detailed look at the conceptual models underlying the USDA school feeding support and most importantly facilitates an assessment of progress to date on the individual programme components and how changes in these components are affecting child literacy levels and the use of specific health and dietary practices. To visualize progress to date, conceptual models were developed with individual programme components colored according to current progress towards the achievement of USDA targets. Both baseline and midline models are presented side-by-side in order to visually illustrate project progress. Likewise, two distinct models were developed, one for each Strategic Objective (Improve Literacy of School-Aged Children, Increased Use of Health and Dietary Practices). Table 1 below illustrates what individual colors denote in terms of programme achievements. According to the programme theory behind the USDA MGD project, literacy and health/ dietary practices can be impacted via different pathways, including; Figure 50: Progress in to date in achieving programme outcomes by Results Framework (Baseline and midline) for intervention group Figure 51: Progress in to date in achieving programme outcomes by Results Framework (Baseline and midline) by type of programmes Figure 48: Progress in to date in programme implementation by Results Framework (Baseline and midline) for intervention group Figure 49: Progress in to date in programme implementation by Results Framework (Baseline and midline) by type of programmes Page 18 USDA Midline Survey April 2015 Table 1: Scale of programme achievements. Literacy is impacted via: 1. Improving the quality of literacy instruction 2. Improving attentiveness and 3. Improving attendance Health and dietary practices impacted via: 1. Knowledge on safe food preparation and storage 2. Knowledge of health and hygiene practices 3. Knowledge of nutrition 4. Access to clean water/ improved sanitation 5. Access to preventive health measures 6. Access to requisite food preparation and storage tools and equipment Within each of these key drivers of literacy or health and dietary practices, there are sub components, which if addressed, would in theory facilitate improvements in these key areas. So for instance, to improve quality of literacy instruction, access to and quality of literacy instruction materials and general school supplies should be improved, while also addressing overall teacher skills and commitment. The overall policy environment in which the project functions is important as well, with improvements in policy and regulatory frameworks necessary as well as improvements in government capacity and support. Below programmatic progress is assessed in terms of the USDA MGD strategic objectives of improving literacy as well as health and dietary practices. Progress in improving literacy: Successes and remaining obstacles As figure 52 shows, some key building blocks of better literacy, including attentiveness, attendance, government capacity levels and local engagement, have all improved significantly since baseline, with attentiveness, attendance and government capacity already exceeding promised USDA MGD targets. Notably, improvement in these areas have lifted literacy levels, with the percent of 6th graders able to read at grade level increasing from 57% at baseline to 66% at the midpoint of the project. Attentiveness has increased as hunger levels have reduced (from 27 to 17%), suggesting that hunger does indeed play a significant role in the ability of children to pay attention in class. Improvements in attendance are a bit more nuanced, as improvements in underlying indicators are less pronounced. Findings do suggest, however, that attendance is impacted significantly by the implementation of the programme itself, with school meals and food scholarships providing a significant pull factor. This is demonstrated by actual attendance rates, with intervention schools showing an 8 percentage point improvement in regular attendance. It is also visually displayed by the improvements (the shift from 20-39% achievement towards targets 80-99%) seen in reaching targets for “increased economic and cultural incentives”, which show that more than 12,000 children now regularly receive food scholarships and close to 26 million school meals have been served to date. So while there have been successes, Figure 52 also illustrates the key remaining obstacles to improvements in literacy, namely the lack of proper policy and regulatory framework as well as a continued capacity gap amongst teachers and school administrators. Specifically, the government has not drafted and implemented a national school feeding policy nor established a national school feeding unit, making it difficult for the government to set aside resources and capacities to support the programme. Likewise, the knowledge and skills of teachers remain quite low, in terms of the targets established for the USDA MGD programme. Since the inception of the project, not much has changed in this regard, reflecting the scale of the challenge facing the government. While WFP is attempting to fill gaps by providing trainings on specific issues to teachers and other educators, the underlying issue must be addressed head-on by government. WFP needs to focus more on providing technical assistance to address these structural issues in the final year of the USDA MGD project if there is to be substantial improvements in literacy in the near term. Progress in improving health and dietary practices: Successes and remaining obstacles As figure 53 illustrates, improvements have been seen across the key determinants of increased use of health and dietary practices since baseline, with the most significant improvements seen in the willingness of government to provide staff to support the school feeding programme (in food safety, nutrition and health) and in terms of access to preventive health interventions. Notably, the number of children dewormed has increased since baseline as has the number of schools with access to soap and water. The provision of school meals has also greatly expanded the number of children receiving micronutrient fortified food (fortified oil and salt) on a daily basis. Daily fortification will be enhanced further in the third year of the project as WFP will introduce fortified rice into throughout the school feeding programme. Notably, improvements in school infrastructure have also led to improvements in the number of schools with access to improved sanitation, something which should continue to improve given that the bulk of the USDA MGD funded infrastructure projects are scheduled for year 2 and 3 of the project. The key remaining obstacles to achievements of USDA targets again appear to be structural and skills-based, with the government yet to define water and sanitation standards for the primary schools while cooks and storekeepers continue to have limited knowledge on nutrition and safe food preparation and storage. Knowledge deficits are made worse by the continued problems schools are facing in terms of accessing the necessary food preparation and storage tools and equipment, hampering food safety issues further. Focus on provision of clean water and improved sanitation must also be maintained, as achievements in these areas remain low compared to targets. Annex 1: Strategic Objective 1: Improve Literacy of School Age Children Annex 2: Strategic Objective 2: Increase Use of Health and Dietary Practices Annex 3: USDA Midline Survey Methodology Annex 4: Socieconomic Characteristics of Midline Survey Respondensts Annex 5: Food and Nutrition Security Situation Page 19 USDA Midline Survey April 2015 Figure 52: Programme Theory on Improving the Literacy of School-Aged Children: Progress at Baseline and Midline Baseline Midline Page 20 USDA Midline Survey April 2015 Figure 53: Programme Theory on Increasing the Use of Health and Dietary Practices: Progress at Baseline and Midline Baseline Midline