Evaluation of the Promoting Autonomy for Literacy and Attentiveness Through Market Alliances (PALAM/A) Project Baseline Report Adria Molotsky, Chinmaya Holla, Hannah Ring, Pooja Nakamura, Andrea Coombes, Varsha Ranjit, and Ann Weber APRIL 2022 17665_04/22 Evaluation of the Promoting Autonomy for Literacy and Attentiveness Through Market Alliances (PALAM/A) Project Baseline Report Adria Molotsky, Chinmaya Holla, Hannah Ring, Pooja Nakamura, Andrea Coombes, Varsha Ranjit, and Ann Weber APRIL 2022 AIR® Headquarters 1400 Crystal Drive, 10th Floor Arlington, VA 22202-3289 +1.202.403.5000 | AIR.ORG Notice of Trademark: “American Institutes for Research” and “AIR” are registered trademarks. All other brand, product, or company names are trademarks or registered trademarks of their respective owners. Copyright © 2022 American Institutes for Research®. All rights reserved. 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For permission requests, please use the Contact Us form on AIR.ORG. iii | AIR.ORG Contents Executive Summary......................................................................................................................... 1 Study Design ............................................................................................................................... 2 Summary of Findings .................................................................................................................. 2 Recommendations...................................................................................................................... 4 Introduction .................................................................................................................................... 5 Background and Context ............................................................................................................ 6 PALAM/A Program.......................................................................................................................... 7 Program Description................................................................................................................... 7 Theory of Change........................................................................................................................ 9 Methodology................................................................................................................................. 13 Evaluation Criteria and Evaluation Questions.......................................................................... 13 Evaluation Design...................................................................................................................... 15 Baseline Findings........................................................................................................................... 20 1. Sample................................................................................................................................... 20 2. Sample Composition ............................................................................................................. 21 3. Sample Characteristics.......................................................................................................... 21 4. Awareness and Understanding of PALAM/A Project............................................................ 23 5. Baseline Status of School Facilities....................................................................................... 23 6. Literacy and Schooling .......................................................................................................... 30 7. Health, Nutrition, and WASH Practices ................................................................................ 42 8. School Feeding Program ....................................................................................................... 72 Limitations..................................................................................................................................... 76 Conclusions................................................................................................................................... 79 Recommendations and Next Steps............................................................................................... 80 References .................................................................................................................................... 82 Annex A. PALAM/A Indicators ...................................................................................................... 88 Annex B. Inter-Rater Reliability..................................................................................................... 91 Annex C. Terms of Reference........................................................................................................ 92 Annex D. Data Collection Instruments........................................................................................ 112 iv | AIR.ORG Exhibits Exhibit 1. Overview of MEL Approach ............................................................................................ 6 Exhibit 2. Theory of Change .......................................................................................................... 10 Exhibit 3. Sample Sizes From Each District for the Project Evaluation......................................... 16 Exhibit 4. Select Outcome Measures for Project Evaluation........................................................ 18 Exhibit 5. Baseline Respondent Types and Research Objectives.................................................. 19 Exhibit 6. Baseline Qualitative Data Collection Overview ............................................................ 20 Exhibit 7. Number of Individuals Surveyed................................................................................... 21 Exhibit 8. Sex Distribution of Individuals Surveyed ...................................................................... 21 Exhibit 9. Household Size and Preschool Attendance .................................................................. 22 Exhibit 10. Household Possession of Assets................................................................................. 22 Exhibit 11. Main School Infrastructure ......................................................................................... 24 Exhibit 12. Water Facilities ........................................................................................................... 26 Exhibit 13. Toilet Facilities ............................................................................................................ 28 Exhibit 14. School Meal Preparation ............................................................................................ 30 Exhibit 15. Attendance Trends in the Student Sample................................................................. 31 Exhibit 16. Reasons for Missing School......................................................................................... 32 Exhibit 17. Means of Getting to School ........................................................................................ 33 Exhibit 18. Time Taken to Reach School ....................................................................................... 34 Exhibit 19. Languages Spoken at Home........................................................................................ 35 Exhibit 20. Home Literacy Environment Indicators...................................................................... 36 Exhibit 21. Languages in Which Reading Materials Are Available at Home................................. 37 Exhibit 22. Letter Recognition....................................................................................................... 38 Exhibit 23. Distribution of Letter Recognition Scores................................................................... 39 Exhibit 24. Word Recognition ....................................................................................................... 39 Exhibit 25. Reading Comprehension............................................................................................. 40 v | AIR.ORG Exhibit 26. Writing and Spelling Ability......................................................................................... 40 Exhibit 27. Receptive Vocabulary ................................................................................................. 41 Exhibit 28. Importance of Children Eating At or Before School ................................................... 42 Exhibit 29. Proportion of Respondents Reporting It Is Important for Children to Have Different Types of Foods at Meals................................................................................................ 43 Exhibit 30. Proportion of Respondents Reporting It Is Difficult for Children to Have Different Types of Foods at Meals................................................................................................ 44 Exhibit 31. Knowledge of Food Groups Constituting Nutritious Meal ......................................... 44 Exhibit 32. What Makes a Child Grow?......................................................................................... 45 Exhibit 33. SMP Perceptions of Importance and Commonality of Nutrients............................... 45 Exhibit 34. SMP Identification of Signs of Nutrient Deficiency in Children .................................. 46 Exhibit 35. SMP Identification of Plant-Based Protein Sources.................................................... 47 Exhibit 36. Reasons Children Should Avoid Too Much Sugar....................................................... 48 Exhibit 37. Proportion of SMPs Who Agree or Strongly Agree Symptom Can Affect Safety of Food Being Prepared ................................................................................................................ 49 Exhibit 38. SMP Knowledge of Proper Handwashing Behaviors .................................................. 50 Exhibit 39. SMP Meal Preparation Area Cleaning Behaviors – Before Preparation..................... 51 Exhibit 40. SMP Meal Preparation Area Cleaning Behaviors – After Preparation ....................... 52 Exhibit 41. SMP Proper Food Storage Methods ........................................................................... 52 Exhibit 42. Perceived Likelihood of Children Getting Sick from Food that Was Not Stored Properly......................................................................................................................................... 54 Exhibit 43. Proportion of SMPs Who Know About Raw Meat Contamination............................. 54 Exhibit 44. SMP’s Potential for Contamination ............................................................................ 55 Exhibit 45. SMP Knowledge of When Food is Cooked, Safe, and Ready to Serve........................ 56 Exhibit 46. SMP Knowledge of How to Prep Raw Fruits and Vegetables..................................... 57 Exhibit 47. SMP Cooking Water Sources....................................................................................... 57 Exhibit 48. SMP Student Beverage Water Sources....................................................................... 58 Exhibit 49. Perceived Importance of Safe Water - SMPs.............................................................. 59 Exhibit 50. Perceived Benefits of Boiling Drinking or Cooking Water - SMPs.............................. 60 Exhibit 51. School Drinking Water Sources................................................................................... 61 vi | AIR.ORG Exhibit 52. Perceived Importance of Safe Water - Teachers........................................................ 61 Exhibit 53. Perceived Benefits of Boiling Drinking or Cooking Water - Teachers......................... 62 Exhibit 54. Reported Behaviors for Children’s Proper Latrine Usage........................................... 63 Exhibit 55. Moments Children Should Usually Brush Their Teeth................................................ 64 Exhibit 56. Perceived Importance of Children Brushing Their Teeth ........................................... 64 Exhibit 57. Proportion of Teachers Describing Proper Handwashing Technique......................... 65 Exhibit 58. Proportion of Teachers Who Know Five Key Moments to Wash Hands.................... 65 Exhibit 59. Perceived Importance of Children Washing Their Hands........................................... 66 Exhibit 60. Teacher Familiarity and Knowledge of Trachoma ...................................................... 67 Exhibit 61. Teacher Familiarity and Knowledge of Dengue Fever................................................ 68 Exhibit 62. Teacher Familiarity and Knowledge of Intestinal Worms........................................... 68 Exhibit 63. Teacher Familiarity and Knowledge of Bilharzia......................................................... 69 Exhibit 64. Teacher Familiarity and Knowledge of Covid-19 ........................................................ 69 Exhibit 65. Reported Reactions to a Student Testing Positive for Covid-19................................. 70 Exhibit 66. Feeding Assistance...................................................................................................... 72 Exhibit 67. Actors and Their Roles in the Government Meal Program......................................... 73 1 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Executive Summary While Sri Lanka has made commendable progress toward universal enrollment in primary school, there is wide variation in students’ academic outcomes. Student performance in the Northeast lags more developed regions of the country (Little et al., 2011; O’Donnell et al., 2018) and has worsened in recent years (National Education Research and Evaluation Centre [NEREC], 2015). Nutrition and sanitation challenges—also more pronounced in the Northeast—may constitute added obstacles for children attending school. Children in Sri Lanka who are stunted and wasted have below-average test scores (Aturupane et al., 2014), and many Sri Lankan children also lack vital micronutrients such as iron and vitamin A (Jayatissa et al., 2014; Abeywickrama et al., 2018). Water, sanitation, and hygiene (WASH) facilities in Sri Lankan primary schools also remain a challenge: Seventeen percent of schools do not have drinking water facilities, and only half have adequate sanitation infrastructure (Clarke et al., 2016). Program Description In response to the nutrition and sanitation challenges in Sri Lankan primary schools, Save the Children (SC) is launching the Promoting Autonomy for Literacy and Attentiveness Through Market Alliances (PALAM/A) project. PALAM/A will work to ensure that Sri Lanka’s school meal program is well targeted and responsive to children’s needs by strengthening government capacity and partnerships to ensure contribution and accountability of local communities and program stakeholders. The two primary objectives of the PALAM/A project are (a) to improve the literacy of school-age children and (b) to improve their nutritional status and diet diversity and decrease health-related absences. The PALAM/A project aims to improve literacy outcomes by improving student attentiveness and teacher capacity, as well as by providing opportunities for engaging in reading with caregivers and after school. Student attendance and attentiveness in school will increase based on improved food safety and nutrition practices, connections to supply partners, and facilities that schools use to provide children with nutritious meals. The increased presence and attention in the classroom will also improve students’ opportunities to learn. By producing new literacy materials and providing teachers with training and recognition, the PALAM/A project aims to improve the capacity of schools and teachers to teach early grade reading. Finally, the project will also build capacity among parents and caregivers on strategies to improve literacy and provide an opportunity for children to engage in after school reading activities in Children’s Literacy Clubs. 2 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Study Design SC contracted the American Institutes for Research (AIR) to conduct mixed-methods monitoring and evaluation (M&E) for the PALAM/A program. AIR’s main objectives are to examine the relevance, effectiveness, and sustainability of the program while also exploring the fidelity of implementation, supporting the monitoring, evaluation, and learning (MEL) of the program, and assessing the quality and equity of program outputs and outcomes. This report presents findings from the baseline evaluation of the program. Quantitative tools captured information on students’ literacy and the knowledge, attitudes, and practices (KAP) of teachers and SMPs with respect to appropriate child health and nutrition practices. We assessed the KAP of SMPs regarding safe food preparation and storage practices. Quantitative methods provide objective measures of these outcomes, and statistical analysis of such data will help explain trends in these outcomes over the life of the PALAM/A project. The project evaluation is similar to program monitoring, and thus we report descriptive statistics on all performance indicators and assess trends and changes over time. Assessment data was analyzed descriptively to identify baseline values of students’ literacy outcomes. Similarly, we descriptively assess health and nutrition KAP of teachers and SMPs. The qualitative component of the evaluation identifies and analyzes the structural and contextual factors (economic, sociocultural, governance, etc.) that affect and help explain the relevance, effectiveness, equity, and sustainability of the PALAM/A program. The baseline qualitative sample includes 14 schools or communities (two schools or communities per program district). At baseline, we interviewed school principals, SMPs, SDS members, and government officials at the district and local levels. The qualitative baseline phase focused on understanding the initial state (i.e., prior to program implementation) of school meal provision, attendance and literacy rates, school infrastructure (e.g., kitchen and WASH facilities), and nutrition and dietary knowledge and practices among students, teachers, and parents. Summary of Findings Baseline results largely confirmed the relevance of the literacy and nutrition programming planned under the PALAM/A project, particularly regarding the appropriateness of the following planned aspects of program implementation:  Widespread infrastructure improvements, especially designated kitchen spaces and distribution of additional kitchen equipment. Respondents emphasized the need to improve the delivery of school meals, particularly through designating areas in schools for food preparation and improving the availability of kitchen equipment and utensils. 3 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report  Teachers need training on nutrition and WASH best practices that go beyond basic information. Most respondents considered teachers to be the best means of disseminating information to both students and parents, and thus training in nutrition and food diversity to improve their knowledge will likely increase the amount of nutritional and dietary information possessed by students and parents. Below we summarize key baseline findings related to school facilities, literacy, attendance, and nutrition. School Facilities Respondents emphasized the need for more physical space within classrooms and clean water supplies. Overall, only 46% of the schools had classrooms that were in good physical condition. Kilinochchi fared well on this metric, where 76% of the schools had classrooms in a good physical condition. As for infrastructure to support learning, most schools (69%) also had inadequate space. Less than half of the schools surveyed (36%) had any library space. Further, the water supply was not clean and affected the safety of students, teachers, and principals. Literacy Baseline data from the student assessment revealed that while students generally showed proficiency in emergent literacy skills such as oral vocabulary knowledge, letter recognition, and word recognition, Grade 2 students’ reading comprehension skills remain low. We define competency on the comprehension assessment as the ability to answer at least 80% of the questions correctly. Overall, only 24% of the students could comprehend the text based on this definition of competency. Attendance Baseline data indicate that attendance was consistently high, except for in Kilinochchi. However, attendance consistently dropped during rainy season in all areas. The most cited reason, by far, for missing school was sickness. Seventy-five percent of the students who had missed a day of school in the week prior to the survey identified sickness as their reason for doing so. In addition, there seemed to be room for improvement in attendance monitoring. Nutrition Monitoring of indicators related to children’s nutrition seemed to be relatively consistent, and respondents were aware of some of the basic indicators that were important for children’s health and nutrition. However, while teachers and SMPs reported receiving information and training on children’s health and nutrition, their knowledge was inconsistent and varied widely across PALAM/A project districts. 4 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Respondents identified several key strengths of the government meal program, most notably that meals were nutritious and well-liked by students. There were also some challenges, however, mostly with the allocation of 30 Rs per child meal, which respondents indicated was not sufficient given current food prices. There was also widespread agreement that payments to SMPs were routinely delayed and sometimes not made at all. Given that PALAM/A will operate through the same structures as the government meal program, it is relevant to consider these strengths and challenges as the program launches. Recommendations Based on the baseline data collection, we recommend that SC consider the following recommendations for program implementation:  Plan stopgap measures for increasing attendance during rainy season. Because attendance was relatively consistent except for during rainy season, the program could consider approaches to increasing attendance during rainy season, or potentially planned lending of materials to students when travel is not possible.  Build on the current system to ensure the continuation of attendance, literacy, and nutrition monitoring. Because attendance monitoring seemed to be inconsistent, the program could build on the existing efforts to ensure the sustainability of attendance monitoring, as well as the monitoring of other indicators associated with literacy and nutrition.  Provide tailored training on children’s nutrition, health, and WASH based on teachers’ and SMPs’ baseline knowledge. While all teachers and SMPs were knowledgeable about children’s health and nutrition to some extent, there was wide variation in the level of knowledge and reporting of correct practices being implemented across the program districts. Instead of targeting all districts with the same information, districts should be targeted with the knowledge they are lacking to maintain interest and improve KAP.  Work with the Government of Sri Lanka to determine whether an adjustment to the price per meal is feasible. Respondents widely agreed that the current allotment (Rs 30 per student meal) is insufficient given current food prices. School meal providers pointed to how allocations for school meals have not reflected the changes in food prices in the past decade. For example, the price of an egg is Rs 25, and capping the allowance per meal at Rs 30 makes providing meals unmanageable. A respondent suggested that increasing the allowance from Rs 30 per meal to Rs 45–50 will help school meal providers meet their responsibility. Further, reducing delays in compensating school meal providers is recommended. 5 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Introduction While Sri Lanka has made commendable progress toward universal enrollment in primary school, there is wide variation in students’ academic outcomes. Student performance in the Northeast lags more developed regions of the country (Little et al., 2011; O’Donnell et al., 2018) and has worsened in recent years (National Education Research and Evaluation Centre [NEREC], 2015). Nutrition and sanitation challenges—also more pronounced in the Northeast—may constitute added obstacles for children attending school. Children in Sri Lanka who are stunted and wasted have below-average test scores (Aturupane et al., 2014), and many Sri Lankan children also lack vital micronutrients such as iron and vitamin A (Jayatissa et al., 2014; Abeywickrama et al., 2018). Water, sanitation, and hygiene (WASH) facilities in Sri Lankan primary schools also remain a challenge: Seventeen percent of schools do not have drinking water facilities, and only half have adequate sanitation infrastructure (Clarke et al., 2016). In response to the nutrition and sanitation challenges in Sri Lankan primary schools, Save the Children (SC) is launching the Promoting Autonomy for Literacy and Attentiveness Through Market Alliances (PALAM/A) project. PALAM/A will work to ensure that Sri Lanka’s school meal program is well targeted and responsive to children’s needs by strengthening government capacity and partnerships to ensure contribution and accountability of local communities and program stakeholders. The two primary objectives of the PALAM/A project are (a) to improve the literacy of school-age children and (b) to improve their nutritional status and diet diversity and decrease health-related absences. SC contracted the American Institutes for Research (AIR) to conduct mixed-methods monitoring and evaluation (M&E) for the PALAM/A program. AIR’s main objectives are to examine the relevance, effectiveness, and sustainability of the program while also exploring the fidelity of implementation, supporting the monitoring, evaluation, and learning (MEL) of the program, and assessing the quality and equity of program outputs and outcomes. Exhibit 1 presents an overview of our approach. 6 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 1. Overview of MEL Approach The baseline report begins with a short literature review and background information on the status of education and the provision of school meals in Sri Lankan primary schools. We then briefly describe the PALAM/A program, introduce the PALAM/A program’s theory of change (TOC), and provide a detailed explanation of our approach to the evaluation before presenting the baseline results. Background and Context Although enrollment in primary school (Grades 1–5) is near universal in many provinces in Sri Lanka, wide disparities in student performance exist. More developed regions continue to perform better than the Northeast, which is still recovering from wartime infrastructural losses, including destruction of schools and hospitals, and suffering from a shortage of qualified teachers (Little et al., 2011; O’Donnell et al., 2018). These issues have been linked to high dropout rates and lack of progress in learning outcomes (UNICEF, 2013). According to the most recent national assessment, primary language literacy indicators in the Northeast have declined since 2013 (NEREC, 2015). Plantation workers from the estate sector (Central and Uva Provinces), are a hard-to-reach population that depend on the estate management for their basic housing, health, and education needs; and they also perform below average on key literacy indicators (Shekar et al., 2007; Jayawardena, 2014; NEREC, 2015). While literacy rates remain nominally high in Sri Lanka, 84% of children who sat for their Grade 5 examinations in 2017 received zero points on the essay question (Room to Read, 2018). Moreover, a Room to Read study found that one in four women in plantation communities are illiterate. These results point to often overlooked nuances in national literacy rates that cloud the disparities in 7 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report education quality and literacy instruction persisting across the country and most prominently in plantation and estate communities. Nutrition and sanitation may present significant barriers to attending and staying in school in Sri Lanka, where 21% of children under age 5 are underweight, 17% are stunted, and 15% are wasted (Adukia, 2017; Allison et al., 2019). Undernutrition is largely concentrated in the estate sector and the Northeast, where rates of stunting reach 30% (Department of Census and Statistics [DCS] and Ministry of Health, Nutrition and Indigenous Medicine, 2017). Moreover, poor childhood nutrition contributes to persistent illnesses that reduce time spent in school, which in turn results in poor performance on cognitive tests (Wisniewski, 2010). Lack of vital micronutrients such as iron and vitamin A is also prevalent in Sri Lanka (Jayatissa et al., 2014; Abeywickrama et al., 2018). In addition to adverse effects on cognitive development, micronutrient deficiencies lower children’s immune function, which increases health-related absences. Programs targeting these deficiencies have been shown to increase school attendance among Sri Lankan primary school students (Mahawithanage et al., 2007). WASH in schools also remains a major challenge in Sri Lanka: Close to 17% of schools do not have drinking water facilities, and only half have adequate sanitation infrastructure (Clarke et al., 2016). Additionally, while deworming interventions lowered the overall prevalence of intestinal worms in Sri Lanka, the estate sector population continues to have a relatively high prevalence of worms due to poor sanitation (Drake et al., 2014). PALAM/A Program Program Description The PALAM/A project offers an opportunity to ensure that Sri Lanka’s school meal program is well targeted and responsive to children’s needs. The strategic objectives of the PALAM/A project are to improve (a) the literacy of school-age children and (b) school children’s nutritional status and diet diversity and decrease health-related absences. The program addresses these objectives in two ways: through the provision of training and coaching to teachers, school meal providers (SMPs), and government officials and through the construction and rehabilitation of school kitchens and latrines. The following section on the theory of change provides more details on the role and expected outcomes of training and construction. The current iteration of the government feeding program contracts SMPs to provide a meal in schools with a student population of less than 100 in all provinces except for the Northern Province while the government milk program provides a glass or packet of fresh milk to all Grade 1–5 students. In the Northern Province, students in Grades 1–9 were eligible for the program due to the World Food Program’s presence in the region. School eligibility for 8 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report government feeding assistance is determined by average attendance instead of enrollment. As of 2019, 8,584 schools were estimated to be benefiting from the program. The Ministry of Education provides SMPs with a menu containing information about ingredients, appropriate portion sizes, and suggested dishes. SMPs are required to follow the menu, but substitutions for ingredients can be made for religious reasons as well as to accommodate locally available ingredients and seasonality. For example, animal-based foods can be replaced by plant-based protein for Hindu students. Additionally, provision of at least two eggs a week is required, but eggs may be replaced by tofu and mushrooms for Hindu students. Further, zonal and/or provincial nutrition committees can modify the suggested menu after obtaining approval from the Ministry of Education. Most schools in program districts do not have food preparation facilities, and SMPs are expected to prepare the meals in their own houses. Each SMP is contracted to provide meals for up to 100 students. SMPs deliver meals and/or fresh milk within an hour of the start of school, typically between 7:30 and 8:30 a.m. SC, in consultation with the Ministry of Education and the Ministry of Health, will promote the nutritional value of pink salmon and yellow split peas to SMPs and parents through PALAM/A. In addition to the promotion of nutritious school meals, the PALAM/A project will rehabilitate and construct kitchens and latrines in program schools as well as codevelop supplementary texts and other reading materials for primary classrooms. All intervention schools will receive packs of books containing high-quality, targeted texts promoting national cohesion; positive gender norms; and improved health and nutrition knowledge, behavior, and attitudes. SMPs will also receive food preparation and storage products to equip their kitchens. Over the last three years, the PALAM/A project encountered several major challenges which severely constrained program implementation. These challenges included a political crisis, delays in signing government-to-government Memorandums of Understanding (MOUs), the global COVID-19 pandemic, and national elections. In October 2018, the Sri Lankan President dismissed the country’s Prime Minister, installing the former President in his place. This government change up led to three months of political uncertainty and caused major delays in obtaining the duty-free entry of the commodities from USDA for the PALAM/A project as well as the selection of project schools, school access, and other start-up coordinating activities. Immediately following the formal resolution of the constitutional crisis in Sri Lanka, the United States government shutdown (from December 22, 2018 until January 25, 2019) during which time SC and USDA staff were unable to work together to move the PALAM/A project forward. Then, in fall of 2019, SC requested approval to move forward with preparation and planning, specifically in relation to procurement and rehabilitation for baseline activities; however, 9 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report despite receiving verbal confirmation the project could move forward, approval was withheld until the government-to-government MOU was officially signed. This MOU was not signed for another six months, causing even further delays to the project. Subsequently, as with many project globally, the PALAM/A project’s school-level activities were significantly delayed by the outbreak of COVID-19. The Government of Sri Lanka closed schools on March 16, 2020 and schools did not fully reopen until late-fall of 2021. Lastly, national elections took place in Sri Lanka for president at the end of 2019 and for parliament in 2020. The newly elected regime increased their level of scrutiny on NGOs including the level of reporting and government approvals necessary to continue with activities. During this time, the PALAM/A project realized a shift in government priorities, with a focus on increasing the budget for infrastructure improvements within the project scope. SC worked with the government to balance these new requests with the fidelity of the original design. A major project redesign was completed and approved by the Government of Sri Lanka in August 2021. Therefore, in light of all these obstacles, the PALAM/A project will be at least three years delayed in its implementation. Theory of Change Policy-relevant research and evaluation should be based on a theory of change (ToC) that outlines the causal chain among activities, inputs, outputs, outcomes, and impacts and the underlying assumptions (White, 2009). To inform our study design, AIR developed a ToC for the PALAM/A project based on the description of the project components, the results framework, and performance monitoring plan provided in the RFP (see Exhibit 2). The ToC is based on the description of the various components of the program in the terms of reference (TOR) coupled with emerging evidence on the linkages between student nutrition and literacy outcomes. 10 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 2. Theory of Change 11 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report The PALAM/A project’s guiding theory suggests that simultaneous investments in children’s nutrition and early grade reading instruction, alongside the provision of training for service providers and cost efficiencies in school meal provision, can help achieve the program’s two strategic objectives of (a) improving the literacy of school-age children and (b) improving schoolchildren’s nutritional status and diet diversity and decreasing health-related absences. The PALAM/A project aims to improve literacy outcomes by improving student attentiveness and teacher capacity, as well as by providing opportunities for engaging in reading with caregiers and after school. Student attendance and attentiveness in school will increase based on improved food safety and nutrition practices, connections to supply partners, and facilities that schools use to provide children with nutritious meals. The increased presence and attention in the classroom will also improve students’ opportunities to learn. By producing new literacy materials and providing teachers with training and recognition, the PALAM/A project aims to improve the capacity of schools and teachers to teach early grade reading. Finally, the project will also build capacity among parents and caregivers on strategies to improve literacy and provide an opportunity for children to engage in after school reading activities in Children’s Literacy Clubs. The PALAM/A project will train SMPs with the goal of increasing their knowledge of child health and nutrition. Assuming the training is effective, the increased knowledge should result in increased use of appropriate practices by SMPs (i.e., safe preparation, storage, and provision of nutritious meals). The combination of school feeding interventions and rehabilitation or construction of school kitchens and latrines will ensure that children will arrive at school ready to study and will receive proper instruction to improve their core reading skills. The ToC is supported by empirical evidence showing a link between improved health and more time spent at school and in the classroom as well as a link between nutrition and literacy outcomes (Powell et al., 1998; King et al., 2005; Walker et al., 2005; Fernando et al., 2006; Glewwe & Miguel, 2008; Ebenezer et al., 2013; Verguet et al., 2020). For instance, Aturupane and colleagues (2014) found that children in Sri Lanka who are stunted had below-average test scores and that wasted children scored slightly lower than average. Moreover, poor childhood nutrition in Sri Lanka contributes to persistent illnesses that reduce time spent in school, which in turn leads to poor performance on cognitive tests (Wisniewski, 2010). Lastly, Chakraborty and Jayaraman (2019) found that the long-term provision of midday meals in Indian public primary schools improved students’ math and reading test scores. School health and nutrition programs can increase the time students spend in school by targeting some of the major constraints affecting school participation and learning outcomes, such as short-term hunger, iron deficiency, worm infections, diarrhea, and malaria (Bundy, 2011). Studies consistently demonstrate the important connection between nutrition and 12 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report schooling (Ebenezer et al., 2013; Powell et al., 1998) and between health status and educational outcomes (Fernando et al., 2006). Improved health and hygiene practices on their own may, however, not be able to meaningfully improve learning outcomes if children also face short￾term hunger that is preventing them from concentrating on the material. A study by AIR showed that a remedial education program in Kenya had larger effects on learning outcomes for food-secure households, highlighting the importance of addressing this constraint (de Hoop et al., 2018). A systematic review of school feeding programs by Kristjansson and colleagues (2007) found that such interventions led to weight gain, more consistent school attendance, and better performance on some short-term cognitive tasks among program participants in lower income countries. This finding is consistent with the results of a systematic review that showed positive effects of school feeding programs on learning outcomes (Snilstveit et al., 2016). Furthermore, qualitative research from Sri Lanka suggests that the provision of midday meals may incentivize school attendance (UNICEF, 2013). A number of key assumptions underlie this ToC and the link between children’s nutrition and improved literacy outcomes. First, AIR’s research suggests that the link between nutrition and literacy depends on baseline levels of malnutrition and food insecurity. In other words, if the rates of malnutrition in the implementation region are relatively low to begin with, school feeding programs may not have a large impact on enrollment and on literacy outcomes. A systematic review of early grade reading in Latin America and the Caribbean conducted by AIR showed evidence of positive effects of nutrition interventions on early grade reading outcomes in contexts where malnutrition rates were high (Maluccio et al., 2009; Stone et al., 2018). A systematic review by Snilstveit and colleagues (2016) also showed that school feeding interventions increased attendance and literacy outcomes and had a positive effect on enrollment and dropout rates in contexts where food insecurity was high and school participation was low. School officials must also buy into health and nutrition promotion interventions to directly benefit children. If the schools do not take advantage of the improved school infrastructure or strengthened classroom practices that promote reading, then an impact on increased literacy will not carry over to children. In fact, local ownership has been singled out as an important component of a successful school health and nutrition intervention in the Sri Lankan context (He, 2010). Moreover, the strength of the effect of the PALAM/A project on student literacy and health and nutrition is likely moderated by factors such as a student’s underlying academic ability, their socioeconomic background and the alignment of the language spoken at home with the language of instruction in school. For example, students from poorer households likely have higher rates of morbidity than their less socioeconomically disadvantaged counterparts. Accordingly, these students might, for example, require more rounds of deworming medication to affect their health outcomes and school attendance. Likewise, children from poorer 13 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report households or plantation estates might have higher rates of malnutrition than their peers and may require a higher “dosage” of the PALAM/A interventions to realize the same impact as their better nourished classmates. In other words, the program may differentially affect students with different characteristics along these dimensions. Based on the ToC and the program description, AIR has designed a rigorous mixed-methods MEL approach to test the underlying assumptions; track program implementation; and measure program outputs and outcomes. The next section describes our approach in detail. Methodology Evaluation Criteria and Evaluation Questions AIR’s evaluation assesses PALAM/A’s progress toward the expected outcomes using the results framework and identifies potential issues with the project’s capacity and approach. The research questions (RQs) fall into four primary categories: (a) relevance of the program, (b) effectiveness of the program, (c) sustainability of the program, and (d) equity considerations of the program. We explain and describe the RQs for each theme below. Relevance. Investigating the relevance of the PALAM/A project in this context means assessing the extent to which the project design incorporates the needs of primary school children in Sri Lanka as well as the needs of schoolteachers, administrators, and meal providers. Further, it entails analyzing whether project objectives and strategies were formulated in a realistic and culturally appropriate way. The RQs under this theme test ToC assumptions about program inputs, such as the cultural appropriateness of school meals and literacy interventions ). 1.1. Do project stakeholders (e.g., students, parents, School Development Society (SDS) members, teachers, principals, and SMPs) feel that the PALAM/A project is meeting their needs? Why or why not? 1.2. Are the in-school meals that include split peas and pink salmon culturally appropriate according to parents? 1.3. Do parents, teachers, and principals perceive the educational and instructional materials as culturally appropriate and age-appropriate for primary school students? 1.4. Do teachers and principals perceive that the educational and instructional materials improve literacy skills and support the teaching of literacy in the classroom? 14 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Effectiveness. Analyzing effectiveness means evaluating the extent to which project inputs and activities led to outputs such as higher quality materials and to what extent they led to outcomes such as improved quality of literacy instruction. The effectiveness of the various elements of PALAM/A will be measured by the extent to which they achieve their objectives relative to the results framework. 2.1. To what extent has the project achieved its output and outcome targets? 2.2. What factors have inhibited or facilitated the achievement of project goals, objectives, and expected results? Sustainability. This theme requires us to assess the delivery of inputs and project activities as well as the linkage between activities and desired outputs to determine to what extent the benefits of the intervention are likely to be sustained and replicated. We will draw lessons from other components of the study (relevance and effectiveness) to assess if the intervention has strengthened capacity in such a way that the benefits of the project are likely to be sustained in the future. 3.1. Do stakeholders feel that PALAM/A’s school meal, literacy, and nutrition activities can be sustained at current levels after the project’s conclusion? What additional inputs are necessary to achieve sustainability? 3.2. What are the current barriers to achieving sustainability? Equity. Disparities in education exist across multiple dimensions above and beyond attendance and nutrition. There are disparities in the accessibility of learning materials in the classroom, inclusive classroom teaching practices, and classroom disciplinary practices, to name a few. Thus, we will assess equity and exclusion of individuals in Sri Lankan classrooms. 4.1. To what extent are PALAM/A activities targeted equally at all schools, students, teachers, and SMPs? Are there differences by sex, ethnicity, school performance, geography, or rurality? 4.2. Are there any observable trends with respect to the accessibility of learning materials, inclusive teaching practices, and classroom discipline in PALAM/A schools? Are the materials equally accessible to all students regardless of sex, ethnicity, school congeniality index, school performance, geography, or rurality? Are the classroom practices equitably targeted at students regardless of sex, ethnicity, school congeniality index, school performance, geography, or rurality? 15 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 4.3. Are schools, teachers, students, and SMPs all equally benefiting from the rehabilitation and construction of school kitchens and latrines? Are there any differences by sex, ethnicity, school performance, geography, or rurality? The project evaluation’s main objective is to establish how performance indicators changed in PALAM/A schools over time. We will employ both quantitative and qualitative methods for the project evaluation. We have designed a mixed-methods approach to answer all RQs, creating synergies in the process. For example, quantitative methods are typically better suited to answering questions about what happened, whereas qualitative methods can better reveal why or how something happened. Below we describe our specific approaches in greater detail. We will first describe our mixed-methods approach to the PALMA/A project evaluation. Evaluation Design The main objective of the evaluation is to assess the extent to which the PALAM/A project is on track to achieving its goals in relation to the literacy, health, and nutrition outcomes (relevance, effectiveness, equity, and sustainability). Insights gleaned from the project evaluation will ultimately be used to identify program components requiring corrective action to better align them with program objectives. Accordingly, we will leverage extant monitoring data continuously collected by SC and its partners during implementation to supplement the primary data collected to assess progress along key performance indicators. The specific indicators used to assess PALAM/A performance have been agreed upon in consultation with SC and USDA during the inception phase. Quantitative Methods Quantitative tools captured information on students’ literacy and the knowledge, attitudes, and practices (KAP) of teachers and SMPs with respect to appropriate child health and nutrition practices. We assessed the KAP of SMPs regarding safe food preparation and storage practices. Quantitative methods provide objective measures of these outcomes, and statistical analysis of such data will help explain trends in these outcomes over the life of the PALAM/A project. Quantitative Sampling. For the project evaluation, we randomly selected schools in each of the seven project districts in accordance with the district’s relative project size, along with proportional sampling relative to the receipt of the intensive literacy programming. Using a planned sample size of 840 students, we randomly selected approximately 10 students (five girls and five boys) from each of 84 schools across the seven districts for the project evaluation, as laid out in Exhibit 3. At baseline, we sampled Grade 2 students at the end of the school year, while at endline we will sample Grade 3 students near the beginning of the school year to serve as a proxy for measuring Grade 2 student outcomes. 16 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 3. Sample Sizes From Each District for the Project Evaluation District Number of schools in PALAM/A Number of schools selected for project evaluation Planned Number of Grade 2 students (10 per school) Actual Number of Grade 2 students Nuwara Eliya 251 23 230 232 Trincomalee 115 11 110 118 Kilinochchi 37 3 30 42 Mulaitivu 53 5 50 65 Ratnapura 156 15 150 156 Badulla 202 19 190 194 Monaragala 73 8 80 62 TOTAL 887 84 840 869 AIR and EML administered the literacy and KAP assessment to each sampled Grade 2 teacher (97 teachers) and administered KAP surveys to 20% of all SMPs for the 84 sampled schools (58 SMPs). At follow-up rounds, we will revisit these same 84 schools and will administer assessments to the same sample of Grade 2 teachers and SMPs. Since there is no comparison group for the project evaluation, we provide estimates of means and frequencies by district and for all PALAM/A schools sampled. Accordingly, in lieu of power calculations, we present margin of error calculations using the formula below. The margin of error tells us the maximum variation in our estimates from the true value. In other words, we can be 100*(1-α)% confident that an estimate will not differ from the true value by more than the margin of error. The margin of error depends partly on the intracluster correlation (ICC), which measures the extent to which students within schools resemble each other relative to the extent to which they resemble students in other schools. Therefore, we calculate the margin of error as follows: 𝑀𝐸 = 𝑧𝛼\2 ∗ √𝑟(1 − 𝑟) ∗ ( 1 + (𝑚 − 1) ∗ 𝐼𝐶𝐶 𝑚𝐽𝐷 ) where m is the number of students per school, J is the number of schools per district, D is the total number of districts, ICC represents the amount of variation within a school compared to the variation across schools for a given outcome variable, r is the rate (mean) of the performance indicator of interest, and 𝑧𝛼\2 represents the desired level of confidence. We will sample 10 children per school, and there are, on average, 12 schools in each of the PALAM/A project’s seven districts. Assuming an ICC of 0.25 for children missing school due to an illness, 17 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 95% confidence (𝑧𝛼\2 = 1.96), and an indicator rate of 50%, our monitoring approach can obtain an overall margin of error of 0.061. Therefore, based on our sample of Grade 2 students, we can be 95% certain that the estimate we obtain from the results of the literacy assessments will not differ from the true value by more than about 6%. Quantitative Instruments and Data Collection. We used four different quantitative instruments to capture literacy, health, and nutrition outcomes at baseline. All assessments, including the observation tool, were administered electronically by local enumerators in Sinhala and Tamil. AIR staff conducted a week-long training of approximately 100 quantitative enumerators in Sri Lanka with support from our local partner, EML Consultants, including training on the administration of all tools and pilot testing of all instruments on the tablets. We used a modified version of the SC literacy boost tool to capture child literacy outcomes. This assessment encompasses the basic literacy boost tool, which has been locally validated in Sinhala and Tamil, supplemented with field-tested modules covering concept of print and oral language knowledge. Through this tool, we assessed children’s letter awareness, single-word recognition, reading fluency and accuracy, reading comprehension, and oral language knowledge. Additionally, we included questions to identify the language(s) spoken at the child’s home and the language with which the student and their teacher are most familiar to help us provide more context for the literacy results. These innovative testing elements allowed us to assess emergent literacy skills such as students’ understanding of how print functions (skills children often master prior to letter awareness and word recognition). We captured the health and nutrition KAP of teachers and SMPs through surveys administered at the schools. Included are teachers’ and SMPs’ KAP related to children’s health and nutrition and also SMPs’ KAP regarding safe food preparation and storage. We also completed a school and classroom observation checklist in all 887 PALAM/A schools at baseline. The observation checklist will be readministered at endline only to those schools selected for inclusion in the student sample. This checklist collected information on the schools’ GPS coordinates; student enrollment profile; teacher profile; government school meal program status; principal contact; language medium; school type; school grade levels; congeniality index classification; physical infrastructure, including the availability and quality of WASH resources; and school meal distribution facilities. When schools reopen at endline, we will also assess classroom pedagogy and management. In future rounds, we will leverage existing M&E data collected at regular intervals by SC and also data from the Ministry of Education to supplement the information obtained via the aforementioned tools. For instance, teachers will collect student attendance data and 18 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report administer a nutrition survey to students, reporting all of this information back to the PALAM/A project’s MEAL officers. Such information can be used to confirm and explain the results obtained through our health and nutrition assessment. Outcome Measures. Exhibit 4 shows our main outcome measures for this evaluation. Exhibit 4. Select Outcome Measures for Project Evaluation Outcome Data source Description Literacy outcomes Student literacy scores Literacy assessment • Percentage of students who demonstrate they can read and understand the meaning of grade-level texts • Student raw scores for each assessed subskill • Percentage of students who demonstrate mastery of each assessed subskill Learning-enabling outcomes Student attendance School records • Percentage of students attending at least 4 of the last 5 days of school • Average student attendance rate Nutrition/health outcomes Teacher knowledge of health and nutrition Teacher health and nutrition KAP • Percentage of teachers who can identify the components of a healthy diet for children Teachers using correct health and nutrition practices Teacher health and nutrition KAP; school observations • Percentage of teachers who demonstrate use of at least one new child health and nutrition practice SMP knowledge of child health and nutrition SMP health and nutrition KAP • Percentage of SMPs who can identify the components of a healthy diet for children SMPs using correct health (food safety) and nutrition practices SMP health and nutrition KAP; school observations • Percentage of SMPs who demonstrate use of at least one new child nutrition practice • Percentage of SMPs who demonstrate use of at least one new safe food preparation and storage practice Quantitative Analysis. The project evaluation is similar to program monitoring, and thus we report descriptive statistics on all performance indicators and assess trends and changes over time. Assessment data was analyzed descriptively to identify baseline values of students’ literacy outcomes. Similarly, we descriptively assess health and nutrition KAP of teachers and SMPs. Qualitative Methods The qualitative component of the evaluation identifies and analyzes the structural and contextual factors (economic, sociocultural, governance, etc.) that affect and help explain the 19 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report relevance, effectiveness, equity, and sustainability of the PALAM/A program. The baseline qualitative sample includes 14 schools or communities (two schools or communities per program district). At baseline, we interviewed school principals, SMPs, SDS members, and government officials at the district and local levels. See Exhibit 5 for a summary of baseline respondents and what we aimed to learn from each respondent type. Exhibit 5. Baseline Respondent Types and Research Objectives Respondent type Method Objectives School meal providers (SMPs) Focus group discussion (FGD) To obtain an in-depth understanding of the current state of school meal provision, students’ nutrition and literacy, and school facilities prior to program intervention and to learn about the role of SMPs School Development Society (SDS) members Key informant interview (KII) To understand the role of SDS members in supporting positive nutrition, health, and literacy outcomes for students as well as the current state of schools’ infrastructure, particularly kitchens and WASH-related facilities, prior to program intervention Principals KII To understand the current state of schools’ support for children in terms of nutrition, health, and literacy prior to program intervention; what the teaching and learning environment looks like and where the gaps are; and who provides what services to the schools District and local government officials KII To understand the current policy and program landscape of school meal, nutrition, and literacy programs from a district perspective The qualitative baseline phase focused on understanding the initial state (i.e., prior to program implementation) of school meal provision, attendance and literacy rates, school infrastructure (e.g., kitchen and WASH facilities), and nutrition and dietary knowledge and practices among students, teachers, and parents. The endline phase will build on baseline findings to focus on how stakeholders perceive changes to these conditions as the PALAM/A program interventions are implemented. Qualitative Methods. We used two primary methods for qualitative data collection: 1. Key informant interviews (KIIs). We conducted KIIs with SDS members (14), principals (14), and local- and district-level government officials (14). 2. Focus group discussions (FGDs). We conducted seven FGDs with SMPs. Exhibit 6 provides an overview of the baseline qualitative sample. 20 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 6. Baseline Qualitative Data Collection Overview Round Activity Respondent Count Total Baseline (2021) FGDs and actor mapping component School meal providers 7 7 FGDs KIIs and actor mapping component School Development Society members 14 42 KIIs Principals 14 District government officials 14 Qualitative Sampling. In consultation with SC, we purposively selected 14 schools or communities (2 schools or communities in each of seven program districts: Nuwara Eliya, Trincomalee, Kilinochchi, Mulaitivu, Ratnapura, Badulla, and Monaragala) from the quantitative project evaluation random sample. This sampling approach allowed us to analyze key areas of variation relevant to the PALAM/A evaluation. We selected schools or communities based on the criteria below:  ethnicity;  geographic distribution (including estate and non-estate areas);  accessibility; and  rurality. Qualitative Data Analysis. AIR researchers created a coding structure based on the interview and focus group protocols that served as a preliminary guide for data analysis. By reviewing the coding interview and focus group transcripts (using the qualitative data analysis software NVivo), we were able to identify patterns of response that emerged across categories and individuals (Maxwell, 2005). To ensure the validity of the data analysis, we involved multiple coders in the coding process and undertook qualitative comparisons of coding across coders. After analyzing the data, we synthesized and summarized the findings and interpreted them while triangulating with other data sources. Baseline Findings 1. Sample To set benchmark values for performance indicators and to measure progress toward desired outcomes over time, the team selected 840 Grade 2 students across 84 schools in seven districts of Sri Lanka: Badulla, Kilinochchi, Monaragala, Mulaitivu, Nuwara Eliya, Ratnapura, and Trincomalee. Although we aimed to survey 10 students in Grade 2 in each selected school, 21 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report challenges in the field related to COVID-19 school closures required the survey team to oversample students in larger schools to meet the quota. In each school, we also intended to survey one Grade 2 teacher to gain insight into their KAP related to children’s health. Additionally, we surveyed a portion of all SMPs covering the 840 selected schools. 2. Sample Composition Exhibit 7 shows the total numbers of students, teachers, and SMPs who participated in the student and KAP surveys by district. Of the 97 teachers surveyed, 82 were Grade 2 teachers while 15 were Grade 3 teachers. Exhibit 7. Number of Individuals Surveyed Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Total Surveyed students 194 42 62 65 232 156 118 869 Surveyed teachers 20 4 7 7 32 16 11 97 Surveyed SMPs 11 4 1 9 13 11 9 58 Further disaggregating this information by sex, we see that the project student sample has a relatively balanced sex ratio, as shown in Exhibit 8. Among the 869 students, 51.21% were male while 48.79% were female. However, both the teachers and SMPs consist of more females than males. Exhibit 8. Sex Distribution of Individuals Surveyed Male Female % n % n Surveyed students 51.21 445 48.79 424 Surveyed teachers 14.43 14 85.57 83 Surveyed SMPs 22.41 13 77.59 45 3. Sample Characteristics The average household size reported by second graders across districts was 4.38 members (Exhibit 9). Kilinochchi had the highest average number of members per household (4.76), 22 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report while Ratnapura had the lowest (3.92). The spread between minimum and maximum household sizes was quite small (the households ranged between 1 and 12 members). Almost all the students surveyed (94% of the sample) stated that they had attended preschool, highlighting that access to preschool is widespread. Preschool is defined as school that children attend before entering Grade 1. In all the districts, at least 90% of the students indicated that they had attended preschool. In Kilinochchi, 100% (n = 42) of the students had attended preschool. Exhibit 9. Household Size and Preschool Attendance Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Average size of household 4.71 4.76 4.67 4.46 4.33 3.92 4.24 4.38 Percentage of students attending preschool 91% 100% 93% 98% 93% 96% 92% 94% Observations 194 42 61 65 232 156 118 868 The households of students surveyed mostly have access to electricity, but there is considerable variation in ownership of mobile phones, radios, and bicycles (Exhibit 10). Overall, 95% of the student households have access to electricity, with Nuwara Eliya having the lowest access, at 91%. Of all the students surveyed, 78% noted that at least one person in the household has a mobile phone. This figure, however, varies between 60% in Nuwara Eliya and 90% in Ratnapura. While 64% of the students surveyed mentioned that at least one member in the household has a bicycle, the percentage in Nuwara Eliya is quite low (31%). However, we should interpret these numbers with caution because it is possible that for these products households have substituted more expensive assets such as TVs and motor bikes. For example, in Mulaitivu, even though only 32% households have a radio, 83% have a TV. Exhibit 10. Household Possession of Assets Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Electricity 96% 93% 94% 98% 91% 100% 93% 95% Roof 85% 83% 85% 91% 75% 96% 92% 86% 23 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report TV 93% 74% 76% 83% 77% 92% 73% 83% Mobile phone 76% 88% 82% 86% 60% 90% 89% 78% Water source at home 82% 57% 61% 82% 36% 92% 100% 70% Bicycle 60% 98% 77% 88% 31% 73% 89% 64% Radio 64% 29% 68% 32% 67% 71% 40% 59% Observations 194 42 62 65 232 156 118 869 4. Awareness and Understanding of PALAM/A Project Qualitative respondents had inconsistent awareness and understanding of the PALAM/A program. Zonal officials and principals were more likely to be familiar with the program than SMPs and SDSs, but still not all were aware of it. Some recognized that the PALAM/A program provided dry foods (such as dahl and fish) to schools donated through the USDA. Others said they had heard of the program, but could not describe exactly what it was. 5. Baseline Status of School Facilities Schools and Classrooms Schools suffered from varying levels of physical infrastructure and classroom deficiencies by district (Exhibit 11). Overall, only 46% of the schools had classrooms that were in good physical condition (i.e., were free from cracks, holes in the roof, walls, or floors, broken windows, or peeling paint). Kilinochchi fared well on this metric, where 76% of the schools had classrooms in a good physical condition. As for infrastructure to support learning, most schools (69%) also had inadequate space. Less than half of the schools surveyed (36%) had any library space. School grounds, while mostly clean, are not safe for children. School grounds are observed to be safe in only 57% of the schools. In Trincomalee, 39% of the school grounds are reported as being safe, with dangerous materials1 being accessible to students in 55% of the school grounds. Overall, 83% of the school grounds are reported to be clean. In Trincomalee, only 52% of the school grounds were observed to be clean. Standing water on school grounds and in school buildings appears to be an issue of concern, with only 69% of the schools reported to be 1 Dangerous materials include but are not limited to chemicals, bleach, highly flammable liquids like kerosene and petrol, paint thinner, etc. 24 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report free of standing water. A principal from Badulla explained that due to small indoor classroom spaces, teachers conducted lessons outdoors, sometimes where farm animals such as cows grazed, and the environment was unsanitary. Exhibit 11. Main School Infrastructure Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall School grounds are clean 82% 88% 93% 61% 90% 98% 52% 83% School grounds are safe 53% 59% 64% 57% 51% 77% 39% 57% Dangerous materials are inaccessible to students 76% 71% 53% 84% 74% 66% 45% 68% School grounds and school buildings are free of standing water 71% 68% 57% 76% 75% 80% 46% 69% Classrooms are in good physical condition 49% 76% 60% 67% 57% 67% 46% 57% Students have adequate space for learning activities 59% 91% 67% 81% 42% 67% 55% 59% School has a library or reading room 33% 85% 58% 88% 20% 35% 24% 36% Classrooms have reading corners 20% 79% 38% 88% 9% 24% 10% 25% More than 20 reading materials are available (of the schools that have a library or a reading room) 76% 96% 52% 98% 55% 53% 73% 74% Laptop or desktop at school 61% 74% 51% 80% 67% 57% 85% 66% 25 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Observations 187 34 72 49 215 151 112 820 Similarly, qualitative data suggest that basic school infrastructure is limited. For example, school representatives from Badulla and Nuwara Eliya listed some of the challenges, which included lack of space in the school, lack of space in the classrooms, unsanitary grounds, limited drainage, little to no library space, and no clean water supply. Regarding classroom space, both school- and zonal-level representatives mentioned the existence of classrooms that were extremely crowded. For example, a zonal officer from Nuwara Eliya explained that across schools in the area, each school building usually only accommodated five classrooms, and there was an average of 45 students per classroom. Similarly, a school in Badulla accommodated 85 students in a 40′ x 20′ space. Speaking about other challenges, a principal from Badulla explained that even basic infrastructure necessary to a school is unavailable. The principal said, “We don’t have a spacious hall. We don’t have a library. For the past six years we conduct classes in two buildings. We also utilize classroom facilities at the main Kendagolla Maha Vidyalaya too. We have no separate pathway to the school. We do not even have a safety parapet wall. Those are our shortcomings.” Multiple respondents expressed the importance of building a parapet wall around the school for safety reasons, such as to keep animals off school premises. Further, new schools established as recently as 2019 had even more limited infrastructure, as funds were reallocated due to the COVID-19 pandemic. Further, qualitative data indicates that perceptions of school and classroom infrastructure quality differed between districts. For example, in the districts of Kilinochchi, Mulaitivu, Ratnapura, and Monaragala, school-level officials observed school and classroom infrastructure to be sufficient and reasonable, whereas school officials in Badulla, Nuwara Eliya, and Trincomalee highlighted several challenges in infrastructure. To address some of the challenges described above, parents who are part of the SDS reportedly built a temporary parapet wall to prevent their children from falling from the elevated area where the school was built. Parents of students in a school in Monaragala also helped clean school premises, which is considered part of their contribution towards fee-free education. School officials from districts prioritized needs differently. For example, school officials in Badulla district prioritized obtaining adequate space, as lack of space ultimately hindered the development of a positive learning environment for both students and teachers. A principal from Badulla explained that teachers cannot apply best teaching practices due to limited space 26 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report (40’ x 20’ for 85 students). Although teachers are encouraged to teach some lessons outside to make learning fun, teachers resort to teaching outdoors because of space constraints. Further, the same principal pointed to outdoor spaces as environmentally unsafe for students. An SDS representative from Badulla said, “Main concern is that the school lacks in building facilities. The school does not have a library, nor a playground.” The small space (24 perches of land) limited the construction of additional building facilities, and to address this barrier a school official suggested adding another plot of land to the current school premises. In Monaragala, building school walls was a priority. Interviews indicated a gap in understanding of funding responsibilities for infrastructure and maintenance, which should flow from the principal to the zone, and then to the province, who allocates funds based on availability. An SDS representative stated, “The school does not consist of a large area of space, [and hence] the school is not entitled in receiving funds for construction and development related projects. Therefore, there are no development projects executed.” A zonal officer also acknowledged that there are limited funds available. WASH Survey data suggest that school infrastructure to meet other non-learning-based basic needs such as access to drinking water and working toilets was also limited. Almost 30% of the schools had no access to any source of drinking water, and of the schools that had access to drinking water, only 77% had access to treated and safe water (Exhibit 12). The issue of access to drinking water appears to be particularly severe in Nuwara Eliya, where 52% of the schools do not have a single source of drinking water. However, we observe some inconsistency in the data, which indicates that even with a limited number of schools having a source of water in Nuwara Eliya, 77% of schools provide access to enough drinking water. Overall, 81% of the schools provided access to enough drinking water. Most schools (97%) ensure that when a drinking water source is available, it is accessible to the smallest students. Exhibit 12. Water Facilities Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall School has access to a source of drinking water 68% 79% 64% 80% 48% 72% 90% 67% Observations 187 34 72 49 215 151 112 820 Drinking water is treated to make it safe 69% 63% 78% 72% 80% 83% 84% 77% 27 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Students have access to a sufficient amount of clean drinking water 67% 96% 76% 95% 77% 87% 89% 81% Average number of available drinking points (in schools with a source of drinking water) 5.8 5.3 6.9 5.3 5.6 6.1 7.5 6.2 Drinking water source is accessible to smallest students 96% 100% 89% 97% 96% 98% 98% 97% Observations 127 27 46 39 104 109 101 553 Note: The type of water source was not collected during baseline. Most schools were found to have clean and functioning latrines, separate for boys and girls, within a 5-minute walk from the school building (Exhibit 13). Overall, 91% of the schools had one or more functioning latrines. Most districts had functioning latrines in 85% or more schools, except for Monaragala, where only 75% of the schools had a functioning latrine. In 97% of the schools, the latrines were within a 5-minute walk from the school. Most schools maintained their latrines to keep them clean and sanitary (87%). We observe that the percentage of schools maintaining clean and sanitary latrines ranged from 99% in Ratnapura to 69% in Mulaitivu. Similarly, interview data from school-level officials confirmed that a positive aspect within school infrastructure was the presence of latrines. For example, a principal said, “We only have toilet facilities”. In 88% of the schools, there were separate toilets for boys and girls, with at least 80% of the schools in all districts having separate toilets. We observe two issues regarding latrines that require attention: (a) accessibility of toilets by students with disabilities and (b) proper segregation of waste. Almost 37% of the latrines were not accessible to students with disabilities, even though across districts almost all toilets were accessible by small students. This problem is particularly acute in Trincomalee and Badulla, where, respectively, 68% and 46% of the latrines are inaccessible to students with disabilities. Only 56% of the schools segregate and store waste by type. Schools in Ratnapura (77%) are performing well on this indicator. 28 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Most schools provide soap for handwashing and have a functioning drainage system at the handwashing points. Overall, 85% of the schools have handwashing soap available, and 77% have a functioning drainage system at the handwashing points, though in Kilinochchi and Mulaitivu only 18% of the schools have a drainage system. Exhibit 13. Toilet Facilities Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Has one or more functioning latrines in school 91% 97% 75% 98% 89% 97% 89% 91% Observations 187 34 72 49 215 151 112 820 Number of functioning latrines on the school grounds 4.1 4.7 5.4 4.8 4.0 4.5 4.2 4.3 Functioning latrines are within a 5- minute walk of the school buildings 98% 97% 94% 98% 97% 97% 98% 97% The latrines can be used by the smallest students 98% 97% 94% 100% 95% 98% 97% 97% The latrines are accessible to students with disabilities 54% 89% 72% 96% 70% 67% 32% 63% The functioning latrine stalls are clean and sanitary 88% 79% 89% 69% 88% 99% 78% 87% Observations 170 33 54 48 191 147 100 743 29 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall There are separate, private functioning latrines for girls and boys 87% 94% 89% 85% 91% 88% 83% 88% There are separate, private functioning latrines for male and female teachers 44% 48% 67% 27% 58% 40% 42% 47% Clean water for handwashing is located in close proximity to the latrines 80% 94% 92% 98% 82% 91% 79% 85% Soap is available for handwashing 63% 91% 83% 84% 84% 89% 46% 75% There is functioning wastewater drainage system in use at hand￾washing and drinking water points 83% 18% 78% 18% 89% 91% 66% 77% WASH facilities are cleaned regularly 83% 82% 86% 78% 94% 93% 66% 85% Solid waste is segregated and stored by type 58% 35% 61% 18% 56% 77% 42% 56% Observations 187 34 72 49 215 151 112 820 Kitchens School meal preparation takes place on school grounds in only 8% of schools (Exhibit 14). Other than Mulaitivu (57%) and Kilinochchi (56%), school meal preparation takes place on school 30 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report grounds in less than 5% of the schools. In Mulaitivu, we observed that in 29% of the schools where meal preparation takes place on the grounds, there is debris, dirt, or standing water in the food preparation area, and in 21% of the schools, there were animals in the preparation area. The comparable figures for Kilinochchi are 21% and 32%. Exhibit 14. School Meal Preparation Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall School meal preparation takes place on school grounds 1% 56% 3% 57% 4% 0% 4% 8% Observations 187 34 72 49 215 151 112 820 There is no debris, dirt, or standing water in food preparation area 100% 79% 50% 71% 88% NA 75% 76% The food preparation area is free of free-roaming animals 100% 68% 100% 79% 75% NA 100% 77% The food preparation area is separate from the eating, classroom, play, and toilet areas 100% 95% 50% 96% 88% NA 75% 92% Observations 1 19 2 28 8 0 4 62 Note: The number of SMPs surveyed is quite small, especially in Badulla, Monaragala, and Ratnapura, limiting the generalizability of these results as they reflect the views of only a few individuals. 6. Literacy and Schooling Attendance Trends Attendance, as measured by the percentage of students who attended school on all days in the week prior to the survey, was high. Overall, 86% of the students surveyed said that they had attended school on all days the previous week (Exhibit 15). However, in the Kilinochchi sample, 31 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report we observe that only 64% did not miss a single day of school in the previous week, indicating that students there may be facing hardships in attending school. Students who missed at least 1 day of school in the week prior to the survey missed an average of 2.37 days. Among the students who missed at least 1 day, the number of days of school missed ranged from 1.65 in Nuwara Eliya to 3.15 in Badulla. This indicates that in Badulla, even though a small percentage of students missed school, the magnitude of schooling missed by those students is quite high. The most cited reason, by far, for missing school was sickness (Exhibit 16). Seventy-five percent of the students who had missed a day of school in the week prior to the survey identified sickness as their reason for doing so. According to students, safety concerns due to COVID-19 (6%) and rain (5%) were other main reasons for missing school. Students reached school mostly by walking (Exhibit 17). Forty-eight percent of the students surveyed indicated that they reached school by walking. The proportion of students reaching school by walking was highest in Nuwara Eliya (77%), followed by Badulla (49%) and Trincomalee (49%). Bicycling was the second most popular mode of transportation to school, with 23% of the students surveyed indicating that they reached school by bicycle. Exhibit 15. Attendance Trends in the Student Sample Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Attended school on all days in previous week 92% 64% 82% 80% 88% 83% 92% 86% Observations 194 42 62 65 232 156 118 869 Average number of days missed in the last week 3.15 2.41 2.55 2.15 1.65 2.95 1.66 2.37 Observations 13 12 9 13 23 23 9 102 Attend after￾school reading activities 8% 2% 31% 17% 9% 8% 9% 10% Observations 194 42 62 65 232 156 118 869 32 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 16. Reasons for Missing School Source: Authors’ calculations; Total N = 102; Badulla N = 13, Kilinochchi N= 12, Monaragala N = 9, Mulaitivu N = 13, Nuwara Eliya N = 23, Ratnapura N = 23, Trincomalee N = 9. 75% 5% 2% 6% 1% 1% 2% 4% 0% 10% 20% 30% 40% 50% 60% 70% 80% Child was sick Rain/poor weather Did not want to go Safety concerns due to COVID Taking care of siblings Teacher was absent Transport issues/lack of transport Other 33 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 17. Means of Getting to School Source: Authors’ calculations; Total N = 869; Badulla N = 194, Kilinochchi N= 42, Monaragala N = 62, Mulaitivu N = 65, Nuwara Eliya N = 232, Ratnapura N = 156, Trincomalee N = 118. Most students (53%) indicated that they took less than 15 minutes to reach school, and 37% indicated that they took between 15 and 30 minutes (Exhibit 18). Very few students took more than an hour to reach school (2%). 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Overall Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Bicycle Other, specify School van Three wheeler Walking 34 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 18. Time Taken to Reach School Source: Authors’ calculations; Total N = 869; Badulla N = 194, Kilinochchi N= 42, Monaragala N = 62, Mulaitivu N = 65, Nuwara Eliya N = 232, Ratnapura N = 156, Trincomalee N = 118. Overall, respondents in most zones did not see student attendance as a big challenge, except in special circumstances, such as the rainy season and COVID-19. Multiple respondents said that problems with attendance are more common in poorer areas. For example, a zonal respondent from Mulaitivu said, “Children are less likely to go to school when they go to work early in the morning.” Attendance also seems to be connected to the regular provision of school meals. A zonal respondent from Trincomalee said, “Whenever the meal is not supplied that the attendance will gradually down. Girls’ attendance better than boys.” Finally, one respondent from Rathnapura said that absences in Tamil schools seem to be higher than in Sinhala schools. School attendance monitoring is taking place in most of the zones in the study. Most respondents said teachers monitor attendance and report their findings up to the zonal level, and respondents in Kilinochchi, Nuwara Eliya, Rathnapura, and Badulla described specific attendance monitoring committees at the school level. However, respondents also said that approaches to monitoring could be improved. A zonal respondent from Kilinochchi said, “We have school attendance monitoring body with outside officials, such as Grama Niladary and Police officers, but functioning of the attendance committee is not in the expected level.” 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Overall Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee 0-15 mins 15-30 mins Don't know Over an hour 35 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Language of Instruction There is considerable regional variation in the languages spoken at home by children. In the whole sample, 57% of students reported that they speak Tamil at home, and 43% noted that they speak Sinhala at home (Exhibit 19). Only 1% of the students indicated that they speak English at home. While 90% of the children surveyed in Mulaitivu said that they speak Tamil at home, only 23% speak Tamil at home in Ratnapura. Similarly, while 81% of the students in Monaragala indicated that they speak Sinhala, only 5% in Kilinochchi speak Sinhala at home. A small proportion of the sample (2.2%) speak more than one language at home. Exhibit 19. Languages Spoken at Home Outcome Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Tamil spoken at home 33% 95% 18% 90% 82% 23% 81% 57% Sinhala spoken at home 66% 5% 81% 12% 21% 75% 22% 44% English spoken at home 1% 0% 3% 1% 0% 3% 0% 1% Observations 194 42 62 65 232 156 118 869 Respondents perceived students as doing well in learning Tamil or Sinhala as their primary language. In Trincomalee and Mulaitivu, where students learn in Tamil, with Sinhala as a second language, respondents perceived students as having less difficulty with Sinhala than English as a second language. English instruction begins as a subject in Grade 3 in all zones, though respondents also said that teachers introduce English words to students in the first and second grades. However, respondents said that English is difficult for students, especially because of a lack of teachers qualified to teach English. In addition, a respondent from Nuwara Eliya said that there is “no equipment [and] books are scarce but not suitable for beginners.” Home Literacy Environment Almost all the students surveyed stated they have at least one type of reading material at home. The most common type of reading material available at home are textbooks, with 83% of the students indicating that they have access to textbooks (Exhibit 20). Magazines are the 36 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report least available form of reading material. Only 15% of the students report that they have magazines at home. Storybooks (62%), religious books (55%), and picture books (50%) are other accessible forms of reading material for students. Exhibit 20. Home Literacy Environment Indicators Reading materials in the home Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Textbooks 91% 95% 82% 100% 70% 89% 72% 83% Storybooks/ comic books 66% 40% 67% 47% 60% 76% 53% 62% Religious books 45% 71% 64% 84% 47% 41% 77% 55% Picture/letter posters 53% 50% 43% 63% 57% 42% 37% 50% Newspapers 59% 7% 67% 20% 27% 69% 26% 43% Coloring books 41% 4% 69% 7% 17% 53% 32% 34% Magazines 9% 0% 8% 0% 23% 19% 22% 15% None of the above 0% 0% 1% 0% 6% 0% 0% 2% Observations 194 42 62 65 232 156 118 869 As shown in Exhibit 21, overall, the most commonly available reading materials at home are in Tamil (58%). While 44% of the students said that they have reading materials available in Sinhala at home, only 6% said they have access to reading materials in English. There is wide variation in availability by language between districts. For example, in Kilinochchi, 95% of the students indicated that the reading materials available to them are in Tamil, with only 5% saying that they have access to reading materials in Sinhala. By contrast, in Monaragala, 81% of the students mentioned that they have access to Sinhalese reading materials, whereas only 18% indicated that they have Tamil reading materials at home. 37 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 21. Languages in Which Reading Materials Are Available at Home Source: Authors’ calculations; Total N = 869; Badulla N = 194, Kilinochchi N= 42, Monaragala N = 62, Mulaitivu N = 65, Nuwara Eliya N = 232, Ratnapura N = 156, Trincomalee N = 118. Student Assessment Results We administered a modified version of the Literacy Boost Reading Assessment (LBRA) to evaluate the students’ language skills. LBRA is a modified version of the Early Grade Reading Assessment. The PALAM/A team developed the LBRA in collaboration with the MOE/NIE using Sri Lanka’s second-grade curricula and tested it for appropriateness for the Sri Lankan context. The assessment was administered either in Sinhala or Tamil, depending on the medium of instruction in the school. The version of LBRA used for this baseline study consists of six subtests: 1. Letter knowledge: the number of letter sounds the student could identify out of 25. 2. Silly phrases: the number of phrases that the student could identify as nonsensical when provided with a set of phrases that contained one nonsensical phrase and three sensible phrases. 3. Word recognition: the number of words out of the 15 most-used words from leveled textbooks that the student could read correctly. Recognition is defined as the student’s ability to read the word. 58% 35% 95% 18% 89% 81% 27% 81% 44% 66% 5% 81% 14% 21% 78% 20% 6% 2% 0% 5% 5% 3% 13% 8% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Overall Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Tamil Sinhala English 38 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 4. Reading comprehension: Enumerators asked nine comprehension questions related to a short story that the students were asked to read aloud. After the students had read the whole passage, they were asked eight comprehension questions: a. Summary: one question that tests each student’s ability to identify the main ideas of a reading passage. b. Literal: five questions whose answers are clearly and explicitly stated in the passage. c. Inferential: one question whose answer is implied rather than clearly stated in the passage. d. Evaluative: one question that requires some level of cognitive and/or emotional judgment. To answer such a question, each student needs to draw on their opinions. 5. Writing: the number of words out of four that the student could spell correctly in written form. (the ability a student has to listen to a short sentence, and write the sentence correctly I.e. spelling, direction and punctuation) 6. Receptive vocabulary: the number of pictures the student was able to correctly match to a word after hearing the word that described the picture. We now present the results for each of these subtests. Letter Knowledge To assess students’ letter knowledge, enumerators showed them a chart of 25 letters in Tamil or Sinhala and asked them to name each letter. Most students (80%) could identify at least 75% of the letters. Overall, students recognized an average of 21 letters, 36% were able to identify all 25 letters, but there was no student who could not identify a single letter. Exhibit 22 shows the percentage of letters that students in each district identified correctly. Exhibit 23 shows the distribution of letter recognition scores for the sample of students. There were no significant differences in the outcomes by gender, primary language at home, or district. Exhibit 22. Letter Recognition Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Letter knowledge (% correct) 86% 91% 86% 88% 81% 90% 85% 86% Observations 194 42 62 65 232 156 118 869 39 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 23. Distribution of Letter Recognition Scores Source: Authors’ calculations; Total N = 869; Badulla N = 194, Kilinochchi N= 42, Monaragala N = 62, Mulaitivu N = 65, Nuwara Eliya N = 232, Ratnapura N = 156, Trincomalee N = 118. Word Recognition Overall, most of the students (71%) were able to read words correctly (Exhibit 24). There are disparities, however, in word recognition across districts. In Nuwara Eliya, students could read only 55% of the words correctly, whereas in Mulaitivu, students could read 81% of the words correctly. We also note that only 40% of the students in Nuwara Eliya were able to read more than 75% of the words correctly, compared to Ratnapura, where students successfully read 85% of the words. Exhibit 24. Word Recognition Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Word recognition (% correct) 74% 78% 67% 81% 55% 85% 72% 71% Observations 194 42 62 65 232 156 118 869 Reading Comprehension Reading comprehension is very low among students. We define competency on the comprehension assessment as the ability to answer at least 80% of the questions correctly. 40 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Overall, only 24% of the students could comprehend the text based on this definition of competency (Exhibit 25). There is considerable variation in reading comprehension by gender and district. Female students (27%) are likelier to have comprehended the text than male students (22%), and 41% of the students in Ratnapura were able to comprehend the text, whereas only 7% of the students in Nuwara Eliya were able to do so. Exhibit 25. Reading Comprehension Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Competent in reading comprehension 37% 5% 40% 20% 7% 41% 15% 24% Observations 194 42 62 65 232 156 118 869 Writing Writing skills among the students surveyed are weak. Overall, only 40% of the students were able to write the full sentence with the correct spelling. Students in Mulaitivu and Nuwara Eliya performed poorly on this subtask, on average scoring 12% and 19%, respectively. Students in Monaragala emerged as the best performers, with students on average able to write 64% of the words with the correct spelling. Exhibit 26a. Writing and Spelling Ability Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Wrote words with correct spelling (% correct) 61% 23% 64% 12% 19% 63% 22% 40% Observations 194 42 62 65 232 156 118 869 41 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 26b. Writing and Spelling Ability Receptive Vocabulary Test Receptive vocabulary performance was uniformly high across districts (Exhibit 27). Overall, students matched 99% of the picture–word pairs correctly. We do not see any variation in student performance across districts, with the spread ranging from 97% in Monaragala to 99% in Badulla, Mulaitivu, Ratnapura, and Trincomalee. Exhibit 27. Receptive Vocabulary Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Oral vocabulary test (% correct) 99% 98% 97% 99% 98% 99% 99% 99% Observations 194 42 62 65 232 156 118 869 Existing Literacy Interventions and Policies Respondents in all zones except Rathnapura described existing literacy interventions and policies, including more formal programs and informal assistance for students who are struggling with learning. Interventions included a program to “build a pleasant school environment for children” (Badulla), “a program called Literacy Boost,” which was part of the Save the Children programme, but funded by a different donor, (Kilinochchi), and the USAID “Room to Read programme” (Nuwara Eliya and Trincomalee). 8% 8% 11% 3% 30% 40% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% Did not write Scribbled with order of forms like letters Scribbled without order Wrote letters Wrote word Wrote word with correct spelling 42 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Otherwise, schools seem to be implementing policies in line with divisional and zonal educational plans. For example, a zonal respondent in Badulla said, “The main objectives here are to find ways of increasing literacy levels and how the process could be monitored.” In Mulaitivu, a zonal respondent said, “Schools are identifying students with low levels of literacy and implementing programs that we monitor.” A principal in Trincomalee described the process of helping students to acquire literacy: “So far we have conducted detection tests to improve. Next we have done the worksheets on the subject. Next, subject-wise, we have instructed schools.” Lastly, one principal from Mulaitivu mentioned the use of reading camps for improving reading, and many respondents mentioned reading rooms, though mostly in the context of needing infrastructure improvements. 7. Health, Nutrition, and WASH Practices In this section, we present SMP’s and teacher’s KAP related to children’s health, nutrition, and WASH practices at baseline as well as information from stakeholders on existing programming and policies related to these topics in PALAM/A target districts. SMP and Teacher KAP Children’s Nutrition Both teachers and SMPs were asked about children’s nutrition. Specifically, we asked about the importance of students eating before school, the importance of eating multiple meals a day, the importance of children getting multiple types of food in their diet, knowledge of nutritious foods, as well as SMPs current practices regarding the MoES recommended school meals. First, we asked about the importance of children eating at or before school as well as the difficulty for children in doing so. Exhibit 28 provides the average responses for teachers and SMPs by district. Most teachers believe it is important for students to eat before school and to have three meals plus a snack every day. Similarly, 98% of all SMPs surveyed noted it was very important for children to eat at school. However, there is variation in the perceived difficulty for students to attain these goals. For instance, only 10% of teachers in Badulla reported it was difficult for children to each before school while 75% of teachers in Kilinochchi, 50% of teachers in Nuwara Eliya, and 45% of teachers in Ratnapura reported the same. Exhibit 28. Importance of Children Eating At or Before School Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Teachers 43 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Important for children to eat before school 100% 100% 100% 100% 97% 100% 100% 98% Difficult for children to eat before school 10% 75% 14% 14% 50% 45% 18% 30% Important for children to have 3 meals + snack daily 75% 100% 100% 71% 81% 94% 82% 83% Difficult for children to have 3 meals + snack daily 20% 100% 14% 57% 50% 19% 64% 40% Observations 20 4 7 7 32 16 11 97 SMPs Important for children to eat at school 100% 100% 100% 89% 100% 100% 100% 98% Observations 11 4 1 9 13 11 9 58 Note: The number of SMPs surveyed is quite small, especially in Kilinochichi and Monaragala, limiting the generalizability of these results as they reflect the views of only a few individuals. For SMPs only, we asked what they believed the consequences were if children skip a meal at school and go hungry. 57% believe students will get sleepy or lethargic and 52% believe students will not be able to study well. 41% believe children skipping a meal will have shorter attention spans and not be able to concentrate. Finally, 34% think it will lead to poor school performance. Relatedly, teachers were asked about the consequences of children not eating before school. 82% believe children will not be able to study well, 68% believe children will have short attention spans or low concentration, and 41% believe students will not do as well as they could at school. SMPs and teachers were also asked about the importance of children consuming nutritious foods, especially meals with different types of food. Exhibit 29 presents the proportion of SMPs and teachers noting it is important for children to have different types of foods at meals. Exhibit 29. Proportion of Respondents Reporting It Is Important for Children to Have Different Types of Foods at Meals Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall SMPs 100% 100% 100% 100% 100% 100% 100% 100% 44 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Teachers 90% 100% 100% 86% 94% 100% 91% 93% Note: 58 total SMP observations: Badulla=11, Kilinochchi=4, Monaragala=1, Mulaitivu=9, Nuwara Eliya=13, Ratnapura=11, and Trincomalee=9. 97 total teacher observations: Badulla=20, Kilinochchi=4, Monaragala=7, Mulaitivu=7, Nuwara Eliya=32, Ratnapura=16, and Trincomalee=11. While most teachers and SMPs think it is important for children to have different types of foods at meals, two-thirds of SMPs surveyed think it is difficult for children to get different types of foods at meals, mainly citing the expense of buying different ingredients to be prohibitive (see Exhibit 30). Exhibit 30. Proportion of Respondents Reporting It Is Difficult for Children to Have Different Types of Foods at Meals Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall SMPs 91% 75% 100% 89% 54% 55% 78% 66% Teachers 20% 75% 29% 71% 56% 25% 64% 44% Note: 58 total SMP observations: Badulla=11, Kilinochchi=4, Monaragala=1, Mulaitivu=9, Nuwara Eliya=13, Ratnapura=11, and Trincomalee=9. 97 total teacher observations: Badulla=20, Kilinochchi=4, Monaragala=7, Mulaitivu=7, Nuwara Eliya=32, Ratnapura=16, and Trincomalee=11. Next, both types of respondents were asked about their knowledge of nutritious foods, especially for children, and SMPs were further asked about their knowledge of certain nutrient deficiencies. First, teachers we asked to list the food groups which make up a nutritious meal. 84% of teachers surveyed were able to list at least three of the five key food groups while only 15% were able to list all five. Exhibit 31 shows the breakdown by district. Exhibit 31. Knowledge of Food Groups Constituting Nutritious Meal Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Named 3 components 95% 100% 86% 86% 63% 94% 100% 84% Named all 5 components 15% 75% 29% 29% 9% 6% 9% 15% Observations 20 4 7 7 32 16 11 97 Note: The five components of a healthy meal include: starch/carbohydrate, protein, fiber, fat, vitamins/minerals. Teachers and SMPs were then asked to identify some important nutritional components of foods that make children grow. Exhibit 32 shows the distribution of SMPs’ and teachers’ 45 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report responses to this question. Vitamin-rich foods and balanced meals appear as the most common answers across all districts. The importance of a diverse diet varies widely by geography as does the importance of children getting enough food. Exhibit 32. What Makes a Child Grow? Source: Authors’ calculations; 58 total SMP observations: Badulla=11, Kilinochchi=4, Monaragala=1, Mulaitivu=9, Nuwara Eliya=13, Ratnapura=11, and Trincomalee=9. 97 total teacher observations: Badulla=20, Kilinochchi=4, Monaragala=7, Mulaitivu=7, Nuwara Eliya=32, Ratnapura=16, and Trincomalee=11. Both KAP surveys then assessed respondents’ knowledge of nutrients in foods, particularly Vitamin A, iron, protein, and calcium. SMPs were asked about the importance of these nutrients in food, the rarity of nutrient deficiencies in school children as well as signs of nutrient deficiency in children. Teachers and SMPs were asked to identify nutrient-rich foods, for the latter specifically in relation to examples of foods they use in school meals. Exhibit 33 provides the results of the SMP KAP about their perceptions of the importance of various nutrients. Close to 100% of SMPs believe it is important to include nutrient rich ingredients in food. Fewer than half, however, believe a deficiency in any of these nutrients is common in schoolchildren. Exhibit 33. SMP Perceptions of Importance and Commonality of Nutrients Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% SMP Teacher SMP Teacher SMP Teacher SMP Teacher SMP Teacher SMP Teacher SMP Teacher Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Diverse diet Enough food Vitamin-rich food Balanced meals 46 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Believe iron￾rich foods are important 100% 100% 100% 100% 100% 100% 100% 100% Believe protein-rich foods are important 100% 100% 100% 100% 100% 100% 100% 100% Believe Vitamin A-rich foods are important 100% 100% 100% 100% 92% 100% 100% 98% Believe iron deficiency is common in schoolchildren 9% 50% 0% 44% 62% 55% 56% 45% Believe Vitamin A deficiency is common in schoolchildren 18% 50% 0% 44% 38% 36% 56% 38% Believe protein deficiency is common in schoolchildren 9% 50% 0% 44% 54% 45% 33% 38% Observations 11 4 1 9 13 11 9 58 Exhibit 34 shows the proportion of SMPs who could name at least one sign of nutrient deficiency for each of the key nutrients and the average number of signs identified by district. On average, over half of all SMPs surveyed can identify at least one sign of Vitamin A, iron or protein deficiency in children. However, SMPs could only identify one or two signs, on average. Exhibit 34. SMP Identification of Signs of Nutrient Deficiency in Children Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Identified 1 sign of Vitamin A deficiency 64% 50% 0% 56% 62% 91% 33% 60% Average number of signs of Vitamin A deficiency identified 1 1 0 1 1 2 1 1 Identified 1 sign of iron deficiency 64% 50% 0% 67% 62% 91% 44% 64% 47 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Average number of signs of iron deficiency identified 2 2 0 2 1 3 1 2 Identified 1 sign of protein deficiency 64% 50% 0% 44% 54% 91% 56% 60% Average number of signs of protein deficiency identified 1 2 0 1 1 2 1 1 Observations 11 4 1 9 13 11 9 58 Note: There were six possible signs of each deficiency SMPs could have noted. SMPs were also asked to identify plant-based substitutes for animal proteins which could be provided to vegetarian students. 90% of all SMPs could name at least one plant-based protein substitute for animal protein and, on average, could name two including mushrooms, tofu, dhal, eggs, and hathmaluwa. Exhibit 35 shows the frequency with which each plant-based protein source was named by SMPs. Eggs and dhal were the most commonly mentioned protein sources for vegetarian students while hathmaluwa was the least mentioned. Exhibit 35. SMP Identification of Plant-Based Protein Sources Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Eggs 73% 50% 100% 67% 46% 82% 33% 60% Dhal 73% 25% 100% 67% 15% 45% 78% 52% Mushrooms 45% 25% 100% 11% 46% 55% 22% 38% Tofu (soya meat) 45% 25% 100% 33% 23% 27% 67% 38% Hathmaluwa 9% 0% 0% 0% 23% 27% 11% 14% Observations 11 4 1 9 13 11 9 58 Next, we asked both teachers and SMPs why children should avoid too much sugar-rich food such as sweets and candies. Exhibit 36 provides their responses. The majority of respondents are aware that too much sugar can cause tooth decay, but fewer than half mentioned it was not nutritious, and fewer than one-third mentioned it can interfere with a child’s appetite. 48 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 36. Reasons Children Should Avoid Too Much Sugar Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Teachers Can cause tooth decay 90% 100% 71% 71% 88% 88% 100% 88% Not nutritious 45% 25% 57% 29% 56% 38% 55% 47% Interfere with appetite 40% 0% 43% 29% 28% 38% 36% 33% Observations 20 4 7 7 32 16 11 97 SMPs Can cause tooth decay 64% 100% 0% 89% 77% 91% 78% 79% Not nutritious 55% 50% 0% 33% 46% 18% 56% 41% Interfere with appetite 27% 0% 0% 0% 23% 27% 22% 19% Observations 11 4 1 9 13 11 9 58 Lastly, SMPs were asked about how much the alignment of their menus with the recommendations from the MoES as well as what currently constitutes their school meals. Overall, 74% of SMPs said they always provide the MoES recommended menu to schools. 16% reported they mostly do, 9% sometimes, and 2% said they never do. Only one SMP from Kilinochchi mentioned they never provide the MoES recommended menu while a handful of SMPs from Badulla and Nuwara Eliya reported they only sometimes do. For those that reported they always serve the recommended menu, 19 (44%) said they never make adaptations to the menu while 13 (30%) said they always adapt the menu, and 11 (26%) said they sometimes do so. Of that 14 SMPs that sometimes or mostly provide the MoES recommended menu, 4 (29%) said they most often adapt the recommended menu, and 9 (64%) said they sometimes adapt the menu. Across all SMPs, the most common reasons for adapting the recommended menu were because ingredients were unavailable or were too expensive (43% mentioned these reasons). As for what SMPs reported including in meals, each student across all districts receives one egg, on average. SMPs in all districts, with the exception of Mulaitivu, reported serving beverages with their school meals. About half of the SMPs in Mulaitivu noted they do not include beverages with school meals. Of those that reported serving beverages, milk was the most 49 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report common beverage provided (57%) followed by a powdered drink (29%) and juice (14%). No SMPs reported serving chai with meals. Food Safety For food safety, SMPs were asked about personal hygiene and food, cleaning the food preparation area, food storage practices, knowledge of common food contamination issues, cleaning up after cooking/serving meals, water safety for drinking and cooking, and whether they have been observed or supervised during school meal preparation. 93% of SMPs reported they never missed any days of meal prep because they were sick in the most recent school year. Of the 4 SMPs that did miss at least one day, they all mentioned that they missed because they felt bad and they know it potentially affects food safety. However, a little fewer than one-third of SMPs (28%) agreed that their staff always help prepare meals even when they are sick (i.e., with flu, cold, diarrhea, coughing, etc.). SMPs were then provided with seven ailments or symptoms and asked whether they agree or disagreed that it could affect the safety of the food being prepared. Exhibit 37 shows the proportion of SMPs reporting they agreed or strongly agreed that the symptom could affect the safety of the food. Overall, SMPs seem to be aware of symptoms which could put the food at risk of contamination, though there is some minor discrepancy across districts and across symptoms. Diarrhea was not consistently seen as a potential food safety risk across districts even though it poses a relatively high risk if proper hygiene is not followed. Exhibit 37. Proportion of SMPs Who Agree or Strongly Agree Symptom Can Affect Safety of Food Being Prepared Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Sneezing 91% 100% 100% 100% 92% 100% 100% 97% Coughing 91% 100% 100% 100% 92% 91% 100% 95% Having an Open Wound 100% 100% 100% 89% 92% 100% 89% 95% Fever 91% 100% 100% 100% 92% 91% 100% 95% Vomiting 91% 100% 100% 100% 77% 91% 100% 91% Diarrhea 91% 100% 100% 89% 62% 91% 89% 84% 50 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Headache 64% 50% 100% 44% 23% 45% 0% 38% Observations 11 4 1 9 13 11 9 58 SMPs were asked about handwashing behaviors including at which moments they wash their hands, how they wash their hands when they do so, and for how long. Exhibit 38 shows the proportion of SMPs who were able to correctly describe how to wash their hands (including both using clean water and soap or ashes), how long one should wash their hands, as well as those identifying key moments to wash their hands. Of the SMPs interviewed, only 33% correctly identified each of the six key moments SMPs should wash their hands. This result ranges from no teachers in Kilinochchi and Monaragala to 67% of teachers in Trincomalee. Further, only 24% of SMPs, on average, could correctly describe how to wash their hands though 83% knew hands should be washed for a minimum of twenty seconds. Exhibit 38. SMP Knowledge of Proper Handwashing Behaviors Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Can describe proper handwashing technique 36% 25% 0% 0% 8% 18% 67% 24% Know to wash hands for 20 seconds 100% 100% 100% 78% 62% 91% 78% 83% Know should wash hands… Before preparing meals 100% 100% 100% 89% 92% 100% 100% 97% Before serving meals 73% 75% 100% 67% 92% 82% 89% 81% After using the toilet 82% 50% 100% 56% 85% 82% 78% 76% After handling raw meat/poultry 73% 25% 0% 44% 69% 55% 78% 60% After touching/taking out garbage 82% 25% 100% 56% 54% 45% 78% 60% After touching money 55% 25% 100% 44% 38% 55% 89% 53% 51 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Knows all 6 key moments 55% 0% 0% 33% 15% 18% 67% 33% Observations 11 4 1 9 13 11 9 58 We then asked SMPs about their prep areas. Of those interviewed, 69% reported they prepare school meals in a separate, dedicated room in their house. 24% prepare meals in a separate but undedicated room in their house and 2% reported they prepare meals outside in a covered area. All SMPs noted that they believe it is important to maintain a clean cooking environment. They were then asked how and when they clean their prep areas. Exhibit 39 shows their responses. While SMPs stated they understand the importance of cleaning food prep areas, not quite 100% mentioned cleaning theirs prior to prepping meals and only about two-thirds reported cleaning after preparing meals. Similarly, only two-thirds reported cleaning food prep surfaces with water and soap while a little over half reported cleaning with water only. The majority (71%) reported sweeping the floor prior to prep, while almost 60% remove trash and 55% clean utensils. Exhibit 39. SMP Meal Preparation Area Cleaning Behaviors – Before Preparation Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Clean before preparing meals 91% 100% 100% 100% 85% 100% 100% 95% Sweep/wipe the floor 64% 75% 100% 67% 77% 64% 78% 71% Clean after preparing meals 73% 50% 100% 78% 46% 64% 89% 67% Clean prep surfaces with soap and clean water 64% 75% 100% 11% 92% 82% 67% 67% Remove trash 64% 100% 100% 56% 31% 55% 78% 59% Clean prep surfaces with water only 64% 100% 0% 67% 62% 27% 44% 55% Clean utensils 64% 50% 100% 56% 38% 64% 56% 55% Observations 11 4 1 9 13 11 9 58 52 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report SMPs were also asked about cleaning and drying their food preparation areas and cooking implements. Exhibit 40 presents the proportion of SMPs reporting each behavior. SMPs generally seem to be cleaning off extra food into the trash (71%) and cleaning items with hot water (60%) and soap (69%) and then letting them air dry (76%). 43% reporting drying items off with a towel, though there is variation across the districts. Exhibit 40. SMP Meal Preparation Area Cleaning Behaviors – After Preparation Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Let air dry 100% 50% 100% 89% 54% 73% 78% 76% Scrape excess food into rubbish bin 100% 75% 100% 33% 46% 91% 78% 71% Wash with detergent 91% 50% 100% 78% 69% 36% 78% 69% Wash with clean or hot water 45% 75% 0% 56% 54% 82% 67% 60% Dry with a clean towel 82% 50% 0% 11% 54% 27% 33% 43% Observations 11 4 1 9 13 11 9 58 SMPs were next asked about their food storage practices. Firstly, we asked about how they store various types of foods including meat, poultry, fish, foods from the sea or lake, dairy products, and cooked foods. Exhibit 41 shows the proportion of respondents mentioning at least one proper storage (i.e., in the refrigerator or cool box, covered, or separated from cooked or ready-to-eat foods). Most SMPs reported they correctly use at least one storage technique, but no SMP mentioned using all three proper storage methods for any type of food. The most commonly cited storage method for each food type was using a refrigerator or cool box. Exhibit 41. SMP Proper Food Storage Methods Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall At least one proper method – fish 100% 100% 100% 89% 85% 100% 100% 95% 53 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall At least one proper method – cooked food 100% 50% 100% 89% 85% 91% 100% 90% At least one proper method – sea/lake 100% 50% 100% 78% 92% 91% 89% 88% At least one proper method – poultry 100% 50% 100% 78% 92% 82% 89% 86% At least one proper method – meat 100% 50% 100% 67% 92% 82% 89% 84% At least one proper method – dairy 100% 50% 100% 89% 69% 91% 89% 84% Observations 11 4 1 9 13 11 9 58 Further, 98% of SMPs believe it is important to keep meat, poultry, fish, seafood or cooked food in a cool place such as a cool box or refrigerator. 47% also reported that it is difficult for them to do so because they do not have a fridge or cool box and it is expensive to get one. SMPs were then asked about how much time passes between their preparation of hot foods for school meals and when it is delivered to students. Half of the SMPs interviewed said less than half an hour passes while another 30% mentioned it is less than an hour. Twelve percent mentioned one to two hours passing and 5% reported over two hours. It is recommended that food not sit out more than two hours when the temperature is less than 30C and no more than one hour when the temperature is over 30C. When asked if the time between preparation and delivery differs if the weather is hotter than 30C, thirteen SMPs (22%) said that the timing does differ. Eleven of those SMPs reported that it results in more time passing between preparation and delivery while two SMPs said it resulted in a shorter amount of time passing. When asked why it is important to not keep hot food out at room temperature for too long before serving, 67% of SMPs knew that bacteria can grow quickly and contaminate food; 38% reported it is important because the food can get cold. Relatedly, when asked whether they should avoid serving leftovers which were not kept in a cool place (i.e., stored at room 54 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report temperature for more than one to two hours, depending on the outside temperature), 57% said they should not be served because food can spoil, 45% the food is not safe to serve anymore, and 24% high temperatures can make germs grow quickly on the food. Only 13 (22%) of the SMPs surveyed mentioned they ever reheat leftovers or food that was prepared earlier. Of these 13 SMPs, only two mentioned they reheat food to at least 75C (considered a safe temperature). Three others mentioned heating to less than 75C and the remaining seven did not know. Even so, 95% of all SMPs believe it is likely children will get sick or seriously sick from eating food that was not stored properly. Exhibit 42 provides the breakdown by district. Exhibit 42. Perceived Likelihood of Children Getting Sick from Food that Was Not Stored Properly Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Believe children will likely become sick from eating food that was not stored properly 100% 100% 100% 89% 85% 100% 100% 95% Believe children will likely become seriously sick from eating food that was not stored properly 100% 75% 100% 89% 92% 100% 100% 95% Observations 11 4 1 9 13 11 9 58 Exhibit 43 shows the proportion of SMPs by district who know they should prevent raw meat, offal, poultry, and seafood from touching other foods such as those that are cooked or ready to eat because the raw foods often contain germs which can contaminate other foods. Exhibit 43. Proportion of SMPs Who Know About Raw Meat Contamination Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Know raw animal foods often 91% 50% 100% 78% 69% 82% 78% 78% 55 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall contain germs which can transfer to other foods SMPs were then asked a series of questions about behaviors that could potentially cause contamination and to report whether they agreed or disagreed with the statements. Exhibit 44 provides the results of this module. Most SMPs report behaviors that reduce the risk of contaminating food such as using separate, clean utensils for different types of food (93%) and cleaning the prep surface after cutting raw meat (88%). However, 17% reported using the same, dirty utensils for raw meat and other foods, and 16% reported preparing raw meat that has pests on it. Exhibit 44. SMP’s Potential for Contamination Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall I use separate (clean) utensils to handle different types of food. 91% 100% 100% 89% 92% 91% 100% 93% I clean the food prep surface after cutting raw meat and before cutting fruits or vegetables. 100% 100% 100% 100% 85% 73% 78% 88% I use the same (dirty) utensils to hand raw meat and other foods. 9% 0% 0% 0% 31% 36% 11% 17% I prepare raw meat 0% 25% 0% 0% 31% 27% 11% 16% 56 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall that has pests on it. Observations 11 4 1 9 13 11 9 58 Next, we asked how likely SMPs think it is for children to get sick from eating undercooked meat. All SMPs interviewed reported they believe it is likely children will get sick from eating undercooked meat, and 93% believe it is likely children will get super sick from eating undercooked meat. A few SMPs do not believe children will get super sick from these foods. Moreover, SMPs were asked about their knowledge of signs that food is cooked, safe and ready to be served. Exhibit 45 shows that 72% of SMPs are able to identify when soups and stews are ready to serve and 64% know how to tell when meat and seafood is ready to be served. Exhibit 45. SMP Knowledge of When Food is Cooked, Safe, and Ready to Serve Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Know soups and stews are ready when they are boiling and well cooked 73% 50% 100% 56% 69% 82% 89% 72% Know meat and seafood is cooked and safe when there is no blood or pink flesh inside 91% 50% 0% 56% 31% 73% 89% 64% Observations 11 4 1 9 13 11 9 58 SMPs were also asked what they should do before serving children raw fruits and vegetables. Exhibit 46 shows their responses. The majority of SMPs wash raw fruits and vegetables with clean water only prior to serving them to students. One-third peel them and 29% wash them with both clean water and soap. 57 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 46. SMP Knowledge of How to Prep Raw Fruits and Vegetables Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Wash them with clean water only 82% 50% 100% 89% 62% 73% 100% 78% Peel them 36% 25% 0% 56% 23% 27% 33% 33% Wash them with clean water and soap 27% 50% 0% 11% 54% 27% 11% 29% Observations 11 4 1 9 13 11 9 58 On average, SMPs deliver meals to schools in the morning with 66% delivering food before 8:30am and 81% delivering before 10am. Per the MoES guidelines, meals should be provided within the first hour of the start of school or between 7:30-8:30am. One factor contributing to the delivery time is how long it takes to reach the school from one’s home. It takes SMPs on average 34 minutes to deliver the meals to the school with delivery times ranging from 17 minutes in Nuwara Eliya to almost an hour (57 minutes) in Mulaitivu. This delivery time is also an important consideration for food safety purposes. Next, we asked SMPs for their knowledge and practices related to safe water (Exhibit 47 and 48). Most water SMPs are using for cooking comes from water tanks (43%) or wells (33%). Likewise, most water used for creating students’ beverages comes from water tanks (33%), wells (21%), and protected springs (22%). Exhibit 47. SMP Cooking Water Sources Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Tank 36% 25% 100% 67% 38% 18% 67% 43% Well 18% 75% 0% 33% 23% 64% 11% 33% Protected spring 55% 0% 0% 11% 54% 18% 0% 28% Borehole 18% 25% 0% 22% 15% 9% 33% 19% Pond/lake 0% 0% 0% 0% 8% 0% 0% 2% 58 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Unprotected spring 0% 0% 0% 0% 0% 9% 0% 2% Dam 0% 0% 0% 0% 0% 0% 0% 0% Stream/river 0% 0% 0% 0% 0% 0% 0% 0% Roof catchment 0% 0% 0% 0% 0% 0% 0% 0% Observations 11 4 1 9 13 11 9 58 Exhibit 48. SMP Student Beverage Water Sources Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Tank 18% 25% 0% 67% 38% 18% 33% 33% Well 9% 25% 0% 33% 15% 45% 0% 21% Borehole 18% 25% 0% 33% 15% 9% 22% 19% Protected spring 45% 0% 0% 0% 46% 18% 0% 22% Roof catchment 0% 50% 0% 0% 0% 0% 0% 3% Pond/lake 0% 0% 0% 0% 8% 0% 0% 2% Unprotected spring 0% 0% 0% 0% 0% 9% 0% 2% Dam 0% 0% 0% 0% 0% 0% 0% 0% Stream/river 0% 0% 0% 0% 0% 0% 0% 0% Observations 11 4 1 9 13 11 9 58 Next, SMPs were asked about their perceptions about safe water for drinking and cooking and their knowledge of the importance of boiling water for safety. Exhibit 49 shows how SMPs responded. All SMPs believe it is important to boil water used for drinking, slightly less believe the same about water used for cooking (93%), and most believe it is likely children will get sick from drinking unboiled water (98%). Only 19% of the SMPs surveyed know they should boil water between one to three minutes to ensure it is safe. 59 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 49. Perceived Importance of Safe Water - SMPs Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Believe important to boil water used for drinking 100% 100% 100% 100% 100% 100% 100% 100% Believe important to boil water used for cooking 100% 100% 100% 89% 92% 82% 100% 93% Believe children will likely become sick from drinking unboiled water 100% 100% 100% 89% 100% 100% 100% 98% Know to boil water for 1-3 minutes to ensure it is safe 9% 25% 0% 22% 46% 9% 0% 19% Observations 11 4 1 9 13 11 9 58 Exhibit 50 depicts SMPs’ understanding of the benefits of boiling water before using for drinking or cooking. Over half of all SMPs in each district reported boiling water is important to kill germs and microorganisms in the water. There was wide variation in the proportion reporting that boiling water makes it safe to drink and reduces the likelihood of illness. 60 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 50. Perceived Benefits of Boiling Drinking or Cooking Water - SMPs Source: Authors’ calculations; 58 total SMP observations: Badulla=11, Kilinochchi=4, Monaragala=1, Mulaitivu=9, Nuwara Eliya=13, Ratnapura=11, and Trincomalee=9. Now that we understand more about SMPs’ knowledge of and beliefs about food safety, we asked about their perceptions of who is bears the responsibility of ensuring food is safe. 88% of SMPs believe it is the cooks’ responsibility for preventing food poisoning and foodborne illness, and 86% believe it is the servers’ responsibility. Lastly, SMPs were asked about their experience with supervision and oversight of meal prep. 72% of SMPs reported having had someone supervise them as they prepare school meals. With the exception of Badulla, this result was fairly consistent across districts; in Badulla 27% (3 SMPs) reported being supervised. The supervisors tended to be PHIs (76%) or school principals or administrators (57%). Rarely were other ministry officials (29%), parents of students (12%) or WFP staff (2%) reported as serving as supervisors. Of those SMPs that reported being supervised, one-third are supervised one a month, one-third are supervised one a week, and the rest are split between daily, every three months and every six months. 93% of these supervised visits are not arranged beforehand, but instead are random drop-ins. WASH For WASH components, we asked teachers about safe water, sanitation and latrines, oral hygiene and handwashing knowledge and behaviors. Beginning with safe water, teachers listed all sources of drinking water at their school. As seen in Exhibit 51, the majority of schools in our sample get their drinking water from piped water sources followed by water tanks and wells. 0% 20% 40% 60% 80% 100% 120% Badulla Kilinochchi Monaragal Mulaitivu Nuwara Eliya Ratnapura Trincomalee Kills germs Makes water safe to drink Reduces chance of illness Gives water better taste 61 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Overall, this suggests relatively clean drinking water availability for students and teachers at school. Exhibit 51. School Drinking Water Sources Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Boiled water 4 0 1 0 4 1 0 10 Unboiled water 2 0 0 0 0 0 0 1 Piped water 10 2 2 1 19 7 0 52 Water tank 0 0 1 2 14 5 1 23 Well 5 0 2 2 1 5 1 16 Filtered 0 1 0 0 0 0 0 1 Bring water from home 3 0 0 1 0 1 0 5 Next, we assessed teachers’ knowledge of the importance of providing safe water to children. Exhibit 52 shows that except for teachers in Badulla District, all teachers believe that it is important to boil water used for drinking or cooking, and the majority believe that children are likely to become sick from drinking unboiled water. However, only 35% of teachers in our sample know that you must boil water for at least one minute (three minutes at high altitude) for it to be considered safe for consumption. Even so, all seven teachers interviewed in Mulaitivu correctly identified the minimum time required to boil water to kill germs. Exhibit 52. Perceived Importance of Safe Water - Teachers Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Believe important to boil water used for drinking or cooking 22% 100% 100% 100% 100% 100% 100% 98% Believe children will likely become sick 22% 100% 86% 100% 88% 94% 100% 92% 62 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report from drinking unboiled water Know to boil water for 1-3 minutes to ensure it is safe 49% 50% 29% 100% 41% 0% 27% 35% Observations 20 4 7 7 32 16 11 97 Exhibit 53 depicts teachers’ understanding of the benefits of boiling water before using for drinking or cooking. Almost all teachers mentioned it was important to boil water in order to kill germs and microorganisms that could be in it. Some teachers in each of the districts except Kilinochchi and Mulaitivu also mentioned it makes water safer to drink and reduces the chance of illness. Exhibit 53. Perceived Benefits of Boiling Drinking or Cooking Water - Teachers Source: Authors’ calculations; 97 total teacher observations: Badulla=20, Kilinochchi=4, Monaragala=7, Mulaitivu=7, Nuwara Eliya=32, Ratnapura=16, and Trincomalee=11. We then asked teachers about school sanitation and children’s latrine usage. Of the 98 teachers interviewed, 89% reported that children use the latrines at school. While the other ten percent noted students do not use latrines at school, they did not provide additional information about why children are not using the latrines or whether they instead use a bush, the river or go home. Teachers were then asked to describe the proper way for a child to use the toilet from when they enter the latrine to when they exit. Exhibit 54 shows the proportion of teachers mentioning each appropriate behavior by district. The majority of teachers in each district correctly identified the proper latrine usage behaviors with 74% of teachers being able to 0% 20% 40% 60% 80% 100% 120% Badulla Kilinochchi Monaragal Mulaitivu Nuwara Eliya Ratnapura Trincomalee Kills germs Makes water safe to drink Reduces chance of illness Gives water better taste 63 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report correctly identify five of the six behaviors; however, none of the teachers mentioned washing hands after using the toilet in their descriptions. Exhibit 54. Reported Behaviors for Children’s Proper Latrine Usage Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Clean themselves after defecating/urinating with toilet paper or water 100% 100% 86% 100% 97% 100% 100% 98% Flushing the toilet with water after use 100% 100% 86% 86% 100% 100% 100% 98% Defecate/urinate in the toilet bowl 100% 100% 86% 86% 94% 100% 73% 93% Not throwing solid objects into the toilet 90% 100% 71% 57% 97% 94% 82% 89% Throwing toilet paper in toilet or basket 100% 100% 71% 86% 75% 100% 45% 82% Washing hands after using the toilet 0% 0% 0% 0% 0% 0% 0% 0% Observations 20 4 7 7 32 16 11 98 84% of teachers reported their school having a trash bin or waste pit, and 93% of those teachers also reported disposing of trash in the bin or pit. Of the three main waste disposal methods (i.e., putting in bin/pit, throwing on ground, and burning), burning was reported by all teachers as one of the methods used at their school while only 8% of teachers reported disposing of waste by throwing it on the ground. We then asked teachers about children’s oral hygiene. Exhibit 55 shows the moments teachers noted children should usually brush their teeth while Exhibit 56 shows the reasons teachers mentioned it was important for children to brush their teeth. 96% of teachers said children should brush their teeth in the morning and 91% said at night after the last meal. Teachers mentioned brushing one’s teeth is important for preventing tooth decay (81%) and removing plaque (78%). Brushing also prevents a bad smell (69%), prevents cavities (53%), and removes sugar (35%). 64 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 55. Moments Children Should Usually Brush Their Teeth Source: Authors’ calculations; 97 total teacher observations: Badulla=20, Kilinochchi=4, Monaragala=7, Mulaitivu=7, Nuwara Eliya=32, Ratnapura=16, and Trincomalee=11. Exhibit 56. Perceived Importance of Children Brushing Their Teeth Source: Authors’ calculations; 97 total teacher observations: Badulla=20, Kilinochchi=4, Monaragala=7, Mulaitivu=7, Nuwara Eliya=32, Ratnapura=16, and Trincomalee=11. Lastly, we asked teachers about their knowledge of and perceptions about children’s handwashing behaviors. 98% of teachers stated that it is important for children to wash their hands throughout the day, but only 32% of teachers could describe how to appropriately wash 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% In the morning At night after the last meal After every meal 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Removes sugar Removes plaque Prevents cavities Avoids bad smell Prevents tooth decay 65 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report your hands.2 Exhibit 57 shows the breakdown in the proportion of teachers describing the proper handwashing technique by district. As seen in the table, there is a large discrepancy across districts in the proportion of teachers who correctly described how to wash one’s hands. All four teachers in Kilinochchi were able to describe this, but only 19% of the 32 teachers (6 teachers) were able to do so in Nuwara Eliya. Exhibit 57. Proportion of Teachers Describing Proper Handwashing Technique Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Can describe proper handwashing technique 20% 100% 43% 43% 19% 19% 73% 32% Further, teachers were asked about the five key moments in which students should wash their hands. These five moments include: 1) before eating, 2) after defecation, 3) after feeding or caring for animals, 4) after cleaning or wiping a baby, and 5) before preparing food. Of the teachers interviewed, only 13% correctly identified each of these key moments. This result ranges from no teachers in Monaragala and Nuwara Eliya to 75% of teachers in Kilinochchi (see Exhibit 58). Exhibit 58. Proportion of Teachers Who Know Five Key Moments to Wash Hands Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Before eating 95% 100% 100% 100% 84% 94% 100% 93% After defecation 85% 100% 86% 71% 66% 75% 100% 78% After feeding or caring for animals 55% 100% 14% 57% 13% 13% 55% 33% Before preparing food 55% 100% 29% 29% 13% 31% 27% 32% After cleaning or 30% 75% 0% 14% 0% 13% 9% 13% 2 For this study, proper handwashing required teachers to mention both 1) using a clean water source (either from a tap or someone pouring water onto to one’s hands from a jug) and 2) using soap or ashes. 66 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall wiping a baby Knows all 5 key moments 30% 75% 0% 14% 0% 13% 9% 13% Observations 20 4 7 7 32 16 11 98 All teachers noted that handwashing stations are available at their school whether in the form of a sink, tap with bucket, or tippy tap. Even so, 81% of teachers surveyed responded that all of their students wash their hands before meals while 12% noted most of them do so and 6% said only some of them do so. No teachers reported that none of their students wash their hands before meals. Relatedly, 55% of teachers reported that all of their students, 25% reported that most of their students, and 19% reported that some of their students wash their hands after using the bathroom. Teachers were also asked why they believe it is important for children to wash their hands. Exhibit 59 presents teachers’ perceptions on why this form of hygiene is important. Teachers were able to select as many reasons as they thought were important. The most common reason cited was that handwashing prevents children from getting sick (89%). Next, teachers mentioned handwashing is good hygiene (68%) and removes germs (68%). Over half of all teachers also mentioned handwashing preventing dirt from getting in one’s mouth (61%), cleaning hands (58%), and preventing dirt from getting in food (53%). Exhibit 59. Perceived Importance of Children Washing Their Hands Source: Authors’ calculations; 97 total teacher observations: Badulla=20, Kilinochchi=4, Monaragala=7, Mulaitivu=7, Nuwara Eliya=32, Ratnapura=16, and Trincomalee=11. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Prevents from getting sick Is good hygiene Removes germs Prevents dirt from getting into mouth Cleans hands Prevents dirt from getting into food Looks and feels clean Smells good 67 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Children’s Health Teachers were also asked about their knowledge of common diseases and health issues such as trachoma, dengue fever, intestinal worms, bilharzia, and COVID-19. Specifically, they were asked about their familiarity with different diseases including being able to identify causes of the illness, whether a child has the affliction, and what can be done to prevent infection. Exhibits 60-64 shows the proportion of teachers by district who were familiar with each affliction along with the proportion of teachers who correctly reported at least one cause of the infection, those who identified at least one symptom of each disease as well as the proportion who were able to identify all potential symptoms. Across all diseases, when teachers have heard of the disease, they are more likely to report knowing at least one cause and at least one symptom. However, on average, teachers do not know all symptoms of these diseases. Aside from COVID-19, teachers are most familiar with Dengue Fever and least familiar with Bilharzia. Exhibit 60. Teacher Familiarity and Knowledge of Trachoma Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Trachoma Heard of trachoma 50% 100% 71% 71% 44% 50% 55% 54% N 20 4 7 7 32 16 11 97 Knows at least one cause 100% 100% 100% 80% 100% 100% 100% 98% N 10 4 5 5 14 8 6 52 Knows at least one symptom 100% 75% 100% 80% 93% 100% 100% 94% N 10 4 5 5 14 8 6 52 Number of symptoms known (out of 3) 1 1 2 1 1 1 1 1 N 20 4 7 7 32 16 11 97 Knows at least one way to prevent 100% 100% 100% 100% 100% 100% 100% 100% N 10 4 5 5 14 8 6 52 NOTE: Teachers were only asked follow-up questions about their knowledge of causes and/or symptoms if they noted they had heard of the infection. 68 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Exhibit 61. Teacher Familiarity and Knowledge of Dengue Fever Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Heard of dengue 100% 100% 86% 100% 78% 94% 100% 91% N 20 4 7 7 32 16 11 97 Knows at least one cause 100% 100% 100% 100% 96% 100% 100% 99% N 20 4 6 7 25 15 11 97 Knows at least one symptom 100% 100% 100% 57% 96% 100% 100% 95% N 20 4 6 7 25 15 11 97 Number of potential symptoms known (out of 7) 4 2 2 1 2 4 3 3 N 20 4 7 7 32 16 11 97 Knows at least one way to prevent 100% 100% 100% 100% 100% 100% 100% 100% N 20 4 6 7 25 15 11 97 NOTE: Teachers were only asked follow-up questions about their knowledge of causes and/or symptoms if they noted they had heard of the infection. Exhibit 62. Teacher Familiarity and Knowledge of Intestinal Worms Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Heard of intestinal worms 75% 100% 57% 57% 41% 88% 36% 60% N 20 4 7 7 32 16 11 97 Knows at least one cause 100% 100% 100% 50% 100% 100% 75% 95% N 15 4 4 4 13 14 4 58 Knows at least one way to prevent 100% 75% 100% 50% 100% 100% 75% 93% N 15 4 4 4 13 14 4 58 69 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report NOTE: Teachers were only asked follow-up questions about their knowledge of causes and/or symptoms if they noted they had heard of the infection. Teachers were also asked whether children at their school ever received deworming treatment. Teachers in Mulaitivu were the only ones to all report that students had never received deworming while there was a mix of responses in most other districts, and all teachers reported children have received deworming treatment in Monaragala and Trincomalee. Exhibit 63. Teacher Familiarity and Knowledge of Bilharzia Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Heard of intestinal bilharzia 10% 25% 14% 14% 0% 6% 0% 6% N 20 4 7 7 32 16 11 97 Exhibit 64. Teacher Familiarity and Knowledge of COVID-19 Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Knows at least one symptom of COVID-19 100% 100% 86% 100% 94% 100% 100% 97% N 20 4 7 7 32 16 11 97 Number of potential symptoms known (out of 9) 5 5 4 3 3 5 4 4 N 20 4 7 7 32 16 11 97 Knows at least one way to prevent 100% 100% 100% 100% 100% 100% 100% 100% N 20 4 7 7 32 16 11 97 Lastly, teachers were asked how, if at all, one can treat COVID-19 and what they should do if a child in their classroom tests positive for COVID-19. Sixty-four percent of all teachers surveyed believe a hospital intervention is necessary to treat COVID-19 while 54% reported prescription medicines being another viable treatment option. 11% of teachers reported that COVID-19 is untreatable, 16% mentioned over-the-counter medication and 11% noted traditional medicine as treatment options. Exhibit 65 shows the proportion of teachers by district reporting each response to a positive case in their classroom. Most teachers said they would contact the 70 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report students’ parents (81%), tell the principal (67%), make the student stay home from school for 10 days (60%), contact the parents of the other students in their class (59%), and tell the PHI (58%). Of the teachers interviewed, 45% said they would get a COVID-19 test themselves and 41% would self-quarantine for 10 days. Exhibit 65. Reported Reactions to a Student Testing Positive for COVID-19 Source: Authors’ calculations; 97 total teacher observations: Badulla=20, Kilinochchi=4, Monaragala=7, Mulaitivu=7, Nuwara Eliya=32, Ratnapura=16, and Trincomalee=11. Existing Health/Nutrition/WASH Interventions and Policies Respondents in some zones described school meal programs, but it seems that such programs stopped during COVID-19 or had just started again. When nutrition programs, such as programs providing school meals, were available, respondents said they helped increase student weight. One Mulaitivu respondent at the zonal level described the connection between interventions and improved outcomes for students: “Currently the school nutrition program has been re￾launched and student attendance has increased when it has been successfully implemented in the past.” Poorer students were perceived as more likely to come to school without breakfast or without bringing their lunch and to be underweight. Respondents also agreed that students who are hungry have difficulty concentrating in class. All areas regularly monitor child health indicators. A few respondents (e.g., from Ratnapura, Nuwara Eliya, and Trincomalee) mentioned that Ministry of Health officials measure student BMI and monitor nutrition programs. A zonal respondent from Kilinochchi said, “Public health officials will come, they will come to get vaccinated and in addition it is currently the corona period so public health officers will come [for students] to get tested.” A respondent from Trincomalee said, “Medical officer inspects student health such as height, weight, hearing, 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Contact their parents Tell the principal or administrator Make them stay home from school for 10 days Contact the parents of other students in your class Tell the PHI Get a Covid-19 test yourself Self-quarantine for 10 days 71 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report viewing and heart beat and general check-up during the months of January or February of each year. In addition, the dental check-up also being conducted by the medical officer. Midwife check girls’ health and providing necessary advice on the sexual aspect.” Teachers share nutrition, health, and WASH practices with parents and students. For example, a principal in Badulla said, “We share information on the values of a nutritious meal and how to prepare a nutritious meal at home. We also highlight the importance of leading a healthy lifestyle.” Teachers also share WASH information with parents and students, especially as a result of COVID-19. Parents in an FGD in Kilinochchi confirmed that “we observed in the morning meeting time they sharing the information on the hand washing.” A Nuwara Eliya zonal respondent said, “Teachers are instructed through the Director in charge of Health and Physical Education to improve the hygiene habits of the students.” Many teachers and SMPs reported currently receiving trainings on various health, nutrition, and food safety topics. For instance, half of the SMPs interviewed mentioned they received training on children’s health and nutrition: 32% within the past six months, 25% within the past year, 25% over a year ago. All of these trainings were provided by PHI and half of the attendees did not find the material too difficult to understand. 66% of teachers mentioned receiving information on children’s nutrition through teacher trainings and 60% mentioned from health workers once or twice a month. To then train children, teachers have access to print materials (71%), lectures (60%), and posters (57%). Teachers also reported receiving information on handwashing mainly through teacher trainings (65%), health workers (59%) and the broader community (56%) every day either in regular lessons or health clubs. Similarly, teachers receive information on WASH through the same three main mechanisms (66%, 58%, and 51%, respectively). For handwashing, teachers generally have access to print materials (74%), lectures (66%), and posters (59%). Few teachers mentioned access to games for active learning around handwashing (8%). For WASH, teachers also have access to print materials (73%), lectures (64%), and posters (59%) with only 6% reporting access to active learning materials like games. Similarly, half of the SMPs reported receiving information on food safety techniques within the past six months from PHIs and other ministry officials. However, only one-third of SMPs have had formal training on food safety techniques. For those that received training, it was within the past six months and also led by PHIs. Those attending these trainings did not feel they were difficult to understand. 72 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 8. School Feeding Program Current Government Meal Program More schools report that they have received school meal assistance from sources other than the government (Exhibit 66), even though almost all of them indicate that they are listed to receive support from the government meal program. A small fraction of schools (7%) reported that they receive feeding assistance from the government. The fraction of schools indicating that they received feeding assistance from the government was highest in Kilinochchi (15%). No schools in Monaragala reported that that they received government feeding assistance, but 13% reported receiving assistance from other sources. The schools reporting nongovernmental assistance are highest in Mulaitivu (92%) and Kilinochchi (56%). This observation should be interpreted with caution, however, because most (86%) of the schools reporting a nongovernmental source of assistance specify that they receive assistance from either the zonal office or the “Nutrition Programme.” It is possible that the respondents are failing to identify the source of assistance correctly. Exhibit 66. School Meal Assistance Badulla Kilinochchi Monaragala Mulaitivu Nuwara Eliya Ratnapura Trincomalee Overall Receives school meal assistance from government 6% 15% 0% 2% 10% 3% 11% 7% Receives school meal assistance from other sources 15% 56% 0% 92% 0% 9% 4% 13% Covered by Government feeding program: Meal 97% 88% 100% 90% 97% 97% 100% 97% Covered by Government feeding program: Meal and milk/yoghurt 3% 9% 0% 10% 1% 0% 0% 1% Covered by Government feeding 0% 3% 0% % 2% 3% 0% 2% 73 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report program: Milk/yoghurt Qualitatively, some respondents reported that no school meals had been provided since the end of 2019, while others said school meals had since resumed, in one case as recently as the day prior. A zonal director from Badulla said that the government meal program had only been operating in rural schools at the time of data collection, but this was not corroborated by other respondents. Children attending schools without active government meal programs mostly bring water and meals from home. Actors Involved Several actors are involved in the coordination, preparation, and delivery of government school meals. SDSs appeared to have primary responsibility for identifying and selecting SMPs and ultimately were responsible for compensating them with funds received from the government. SMPs prepare and deliver meals according to the government meal schedule or menu, and their work is monitored by zonal officers, principals, teachers, and school food/nutrition committees. Exhibit 67 lists the primary role(s) played by each actor involved in the government school meal program. Exhibit 67. Actors and Their Roles in the Government Meal Program Actor Role SMP • Prepares and distributes meals according to the government meal schedule Zonal officer • Determines meal schedule • Provides training on meal preparation and food safety • Monitors meal provision (both cooking and distribution) Public health inspector • Monitors meal provision and food safety Principal • Coordinates with SDS and SMP to ensure meal delivery to school • Sometimes is responsible for buying/delivering ingredients (Mulaitivu SDS) • Monitors meal provision Teacher • Monitors meal provision and ensures food quality School food/nutrition committee • Monitors meal provision and ensures food quality SDS • Connects principals to SMPs • Helps select SMPs • Coordinates and pays SMPs 74 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Types and Sourcing of Food Respondents reported that SMPs adhered to the government-stipulated menu for school meals with relatively few deviations. A school principal from Nuwara Eliya said, “Food is provided as per the government diet schedule. Sometimes minor changes are made without compromising quality.” The increased cost of food has made it more difficult to follow the government schedule, however, and some noted that requirements such as serving eggs a certain number of days per week can no longer be met given the increase in prices. Foods were primarily obtained from local markets, and meals featured a wide range of foods, including milk, fish, eggs, fruit, chickpeas, rice, peanuts, grains, and leafy vegetables. Funding Funding for the government school meal program came from the zonal education office, according to respondents. SDSs paid SMPs based on the number of students served per school, although their payments were frequently delayed. Many respondents emphasized the lengthy delays (often several months) in paying SMPs, and some said that occasionally SMPs never received payment at all. A Kilinochchi SDS member stated that “most of the time the cooking person is working as a volunteer due to lack of [money] in the SDS account to [make] payment.” A member of the SMP in Monaragala said, “There is a two-to-three-month delay in getting paid for the food provided for one month,” a pattern that informants from other districts corroborated. Members of multiple SMPs reported using their personal jewelry as collateral to purchase food to continue to prepare meals while waiting for payment from previous months. Changes Due to COVID-19 The government school meal program appears to have been paused for most of the past 2 years due to the COVID-19 pandemic. However, some schools reported distributing dry food in place of school meals. A member of the SMP in Kilinochchi said, “During COVID-19 we hand over dry food to the parents and they cook it at home.” Other respondents mentioned NGOs— including Save the Children, through the PALAM/A program—that supported schools with dry food distribution while the government program was paused. Food Safety Measures Respondents reported several different procedures adopted to ensure food safety, including an initial assessment of SMPs’ meal preparation and delivery process, routine monitoring by the zonal office, circulars on food preparation, and the use of well-sealed containers to transport food. There were also some ad hoc practices reported, such as teachers sampling food before students to ensure safety. A Mulaitivu SDS member said that meals “should be given to students only after the teachers have tasted it for safety reasons.” While some principals reported sharing the responsibility for monitoring food safety, the zonal education office bore primary 75 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report responsibility for monitoring and oversight. That said, the food safety policies and guidelines used by the schools appear to vary. When asked about food safety policies, a Badulla zonal official said the following: “Well, we have not stipulated such policies or guidelines. But we have advised the meal providers to follow hygienic guidelines at all times. We monitor whether the plates and cups of children are clean through the teachers in charge of nutrition. We also check if the meal providers and their staff are clad in clean clothing at the time of serving food to children. Even the cleanliness of their hands, legs and fingernails are also closely scrutinized. We look into all aspects, but the modes and systems are different from school to school.” SMPs, for their part, were not consistently clear on the guidelines they were meant to follow, but did consistently reference receiving food safety instructions from principals and being “inspected” by zonal officials. Messaging There did not appear to be any explicit nutrition-related messaging associated with the government school meal program, but respondents reported that schools delivered messages related to nutrition and the need to wash hands before eating. Teachers and principals were primarily responsible for sharing this information and said that any nutrition-related concerns were brought up during parent–teacher meetings. PHIs monitored children’s height and weight regularly and also shared concerns about children’s nutritional status with teachers. A zonal official from Badulla stated that nutrition-related messages are also shared as part of the curriculum: “[D]uring the home science period of children, we educate them on preparing meals in a nutritious and creative manner. We guide them on good food habits.” Giving nutritional advice was not explicitly mentioned by other respondents. Strengths of Current Meal Program There was widespread agreement among respondents that children liked the food provided under the government meal program. A member of the Badulla SMP said, “The children love the food. No child has resisted it. If they are not satisfied with the portion, they come to us seeking more food.” SMPs from multiple districts reported that they cook “deliciously” and feed schoolchildren as they would their own. A Trincomalee SMP member commented, “My child also comes to this school. I bring the food considering all the children are mine,” which was a sentiment echoed by numerous other SMPs. SDS members commented about the quality of the food less frequently, but those that did concurred that students liked the meals. 76 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report In addition to mentioning that the children liked the food, SMPs and principals consistently described the food provided under the government meal program as “hot and fresh” and nutritious, as stipulated by the ministry’s menu. Respondents reported minimal food waste and indicated that extra food is shared equitably. Food waste only occurred on days where there were a lot of absences, and in Rathnapura the SMP said that they called schools ahead of time to confirm the exact number of students present before bringing meals to ensure the quantity was appropriate and to minimize waste. Lastly, respondents agreed that meals were served on schedule without delay. Challenges of Current Meal Program By far the number one challenge mentioned was the price of food, which respondents believed was a result of inflation and COVID-related supply disruptions. All respondents—especially SMPs—noted that it was difficult to adhere to the ministry’s required menu given the current food prices and the fact that they are allocated only Rs 30 per meal. Eggs, in particular, have become more expensive. A Rathnapura principal said, “A meal costs 30 rupees. When it costs 25 rupees for the egg you can’t provide all the remaining [food] for 5 rupees.” In Badulla, respondents indicated they had not been able to find anyone to provide meals given the Rs 30 allowance per student meal. The principal noted, “No one is volunteering to prepare the meals for the students as the cost allocated for the task is not sufficient to complete the task at all.” In addition to the cost of food, delayed payment to SMPs also appears to have been a significant challenge. SMPs reported waiting several months to receive payment or not receiving payment at all. An SMP member from Monaragala said, “There is a two-to-three￾month delay in getting paid for the food provided for one month.” Members of multiple SMPs reported using their personal jewelry as collateral to purchase food to continue to prepare meals while waiting to receive payment from previous months. To a lesser extent, respondents also complained that school kitchens were either nonexistent or were not sufficiently equipped for SMPs to prepare meals in. Supplies such as utensils were not readily available, and in some areas certain foods were not available for purchase. Limitations The study faced the following limitations in evaluation design and analysis. Reliance on self-reported data. The quantitative approach relies on self-reported data from children on socially and potentially culturally sensitive subjects such as food security or health￾related absences from school. Thus, the data should be interpreted with caution because it is 77 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report particularly susceptible to social desirability bias; young children, especially in Grade 2, may not always be emotionally and cognitively able to answer survey questions effectively. To minimize this limitation and improve data reliability, we devoted attention to cognitive testing of the survey instrument with children in Grade 2 before the PALAM/A baseline data collection. In consultation with our data collection partners, we adjusted question phrasing to make sure children could understand the questions and feel comfortable answering. Further, we thoroughly trained enumerators on best practices for administering surveys to children including ways to make them feel comfortable and to elicit more honest responses. As for the qualitative research, the data collected reflects individual perspectives, which are subject to bias and preconceptions. Recognizing this potential challenge, our experienced interviewers dedicated time to explain the questions to respondents, as needed. Another limitation is that parents who are motivated to support their children’s education may be more likely than others to participate in a focus group than those who are not as supportive. Thus, enthusiastic responses from parents about the importance of education should be interpreted with caution. Absence of electronic class lists. We will have to sample from students who are present at school rather than from the full classroom. While our approach ensures sampling consistency across schools and will achieve a random sample of students who are present on the day of data collection, the possibility of systematic absences might induce a risk of sampling bias by selecting only present students. For example, such a bias can arise from excluding information on children who are more likely to be absent from school, including those from vulnerable socio-economic backgrounds who may live further from school and have difficulties commuting to school on muddy roads during rainy seasons, or those who may be absent due to health issues. Subjectivity of classroom observations and lack of comparability. Snapshot observations measure a specific variable or indicator—in this case, student attention—at a specific point in time. They do not support conclusive statements about whether an intervention—in this case, school meals—caused observed changes since attention is impacted by various external factors not related to the program interventions. In addition, the subjective nature of the tool could create inconsistencies in findings due to the inherently difficult job of making observational judgements across changing settings. For example, the observers might be different from baseline to final evaluation and make a different judgment call for a distracted student. To mitigate this limitation, AIR will provide the observers with a consistent training across assessment phases to enhance the comparability of the findings. In addition, to increase the interrater reliability of the observations, the observers conducted the classroom observations in pairs in at least 10 percent of the sampled classrooms. This challenge could also be less of a 78 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report limitation if the observational outcomes will be mainly used for learning about one point in time rather comparing two points in time. Reduced instruction time due to COVID-19. In March 2020, after confirming its first cases of COVID-19, the Government of Sri Lanka announced a nationwide lockdown and closed all schools effective as of March 2020. After a two month lock down period, students returned to school to complete their disrupted school year and gain back instruction time that had been lost during the lockdown. However, schools closed again in 2021 due to the outbreak of the Omicron variant. All of these school closures and disruptions likely led to reduced learning for students, particularly students in Grade 2 in the most recent school year as they would have started their primary schooling the year of COVID-19 (2020). Therefore, it is possible that the results of the LBRA for the baseline of PALAM/A are actually lower than usual. If student scores are lower than normal due to less time in the classroom, especially for literacy instruction, it is possible that our use of a cross-sectional design could show larger changes over time in literacy outcomes for Grade 2 students as the next cohort assessed will have experienced two full years of uninterrupted education prior to the assessment such that their scores are naturally higher than the first Grade 2 cohort. In other words, there is potential for this assessment to overestimate changes over time in Grade 2 literacy outcomes. Small quantitative sample sizes limit generalizability. As mentioned, schools were coming out of the second wave of the COVID-19 pandemic in Sri Lanka when baseline data collection took place. As such, enumerators found it difficult to locate all SMPs associated with PALAM/A schools. This resulted in a smaller number of SMP KAP surveys administered thereby rendering the results of the survey less generalizable both within and across districts. Specifically, in cases where we were only able to interview one or two SMPs, the results of the KAP are not being adequately averaged across a representative sample of the population, and are instead reflecting one or two people’s opinions and knowledge. Therefore, special consideration should be given to the results from the baseline SMP KAP surveys. Lack of information on school water sources. While we gathered data on the presence of a source of drinking water, the enumerators did not assess the type of water source. Potentially, this washes out the differences in quality associated with water sources. For instance, a tap with a predictable water supply is easier for children and teachers to access than sourcing water from a well near the school. We will include a question in the endline questionnaire, to establish this nuance. 79 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Conclusions Baseline results largely confirmed the relevance of the literacy and nutrition programming planned under the PALAM/A project. This section summarizes high level conclusions with regard to school facilities, literacy, attendance, and nutrition. School Facilities Overall, respondents emphasized the need for more physical space within classrooms and clean water supplies. According to the classroom observation tool, there were schools in most districts that had inadequate space for learning and lacked library space and associated learning and reading materials. Further, the water supply was not clean and affected the safety of students, teachers, and principals. Literacy Baseline data from the student assessment revealed that while students generally boast proficiency in emergent literacy skills such as oral vocabulary knowledge, letter recognition, and word recognition, Grade 2 students’ reading comprehension skills remain low. Attendance Baseline data indicate that attendance was consistently high, except for in Kilinochchi. However, attendance consistently dropped during rainy season in all areas. In addition, there seemed to be room for improvement in attendance monitoring. Nutrition Monitoring of indicators related to children’s nutrition seemed to be relatively consistent, and respondents were aware of some of the basic indicators that were important for children’s health and nutrition. However, while teachers and SMPs reported receiving information and training on children’s health and nutrition, their knowledge was inconsistent and varied widely across PALAM/A project districts. The government meal program was just starting to resume at the time of baseline data collection. Respondents identified several key strengths of the program, most notably that meals were nutritious and well-liked by students. There were also some challenges with the program, however, mostly around the allocation of 30 Rs per child meal, which respondents indicated was not sufficient given current food prices. There was also widespread agreement that payments to SMPs were routinely delayed and sometimes not made at all. Given that PALAM/A will operate through the same structures as the government meal program, it is relevant to consider these strengths and challenges as the program launches. 80 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Recommendations and Next Steps - Baseline data collection confirmed the appropriateness of the following planned aspects of program implementation:  Widespread infrastructure improvements, especially designated kitchen spaces and distribution of additional kitchen equipment. Respondents emphasized the need to improve the delivery of school meals, particularly through designating areas in schools for food preparation and improving the availability of kitchen equipment and utensils.  Teachers need training on nutrition and WASH best practices that go beyond basic information. Most respondents considered teachers to be the best means of disseminating information to both students and parents, and thus training in nutrition and food diversity to improve their knowledge will likely increase the amount of nutritional and dietary information possessed by students and parents. A zonal education officer also suggested offering practical workshops on the school premises to parents on various WASH activities such as waste disposal methods that could be replicated in the home environment. Based on the baseline data collection, we recommend that Save the Children consider the following additional recommendations for program implementation:  Plan stopgap measures for increasing attendance during rainy season. Because attendance was relatively consistent except for during rainy season, the program could consider approaches to increasing attendance during rainy season, or potentially planned lending of materials to students when travel is not possible.  Build on the current system to ensure the continuation of attendance, literacy, and nutrition monitoring. Because attendance monitoring seemed to be inconsistent, the program could build on the existing efforts to ensure the sustainability of attendance monitoring, as well as the monitoring of other indicators associated with literacy and nutrition.  Provide tailored training on children’s nutrition, health, and WASH based on teachers’ and SMPs’ baseline knowledge. While all teachers and SMPs were knowledgeable about children’s health and nutrition to some extent, there was wide variation in the level of knowledge and reporting of correct practices being implemented across the program districts. Instead of targeting all districts with the same information, districts should be targeted with the knowledge they are lacking to maintain interest and improve KAP.  Work with the Government of Sri Lanka to determine whether an adjustment to the price per meal is feasible. Respondents widely agreed that the current allotment (Rs 30 per 81 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report student meal) is insufficient given current food prices. School meal providers pointed to how allocations for school meals have not reflected the changes in food prices in the past decade. For example, the price of an egg is Rs 25, and capping the allowance per meal at Rs 30 makes providing meals unmanageable. A respondent suggested that increasing the allowance from Rs 30 per meal to Rs 45–50 will help school meal providers meet their responsibility. 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New York, NY: Columbia University. Jayatissa, R., Gunathilaka, M.M., Herath P., & Fernando D.N. (2014). National Nutrition and Micronutrient Survey, Part II. Iron, zinc, calcium deficiency among children aged 6–59 months. Colombo, Sri Lanka: Ministry of Health and UNICEF Sri Lanka. Retrieved from https://www.unicef.org/srilanka/Nutrition_Survey__Iron_Zinc_Calcium_deficiency_amo ng_children.pdf 84 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Jayawardena, P. (2014). Can people in Sri Lanka’s estate sector break away from poor nutrition: What causes malnutrition and how it can be tackled (Health Economic Series No.1). Colombo, Sri Lanka: Institute of Policy Studies of Sri Lanka. Retrieved from http://www.ips.lk/wp-content/uploads/2017/02/Can-People-in-SL-Estate-Sector-Break￾Away.pdf Kim, J. O., & Mueller, C. W. (1978). Factor analysis: Statistical methods and practical issues. Beverly Hills, CA: Sage. King, G., & Nielsen, R. (2018). Why propensity scores should not be used for matching. Political Analysis. Retrieved from https://gking.harvard.edu/files/gking/files/psnot.pdf Kristjansson, B., Petticrew, M., MacDonald, B., Krasevec, J., Janzen, L., Greenhalgh, T., Wells, GA., MacGowan, J., Farmer, AP., Shea, B., Mayhew, A., Tugwell, P., &Welch, V. (2007). School feeding for improving the physical and psychosocial health of disadvantaged students. Cochrane Database of Systematic Reviews, 1. Art. No.: CD004676. Retrieved from https://www.cochrane.org/CD004676/BEHAV_school-feeding-for-improving-the￾physical-and-psychosocial-health-of-disadvantaged-schoolchildren Little, A., Upul Indika, H.N., & Rolleston, C. (2011). Access, attendance and achievement in rural schools in Sri Lanka (Create Pathways to Access, Research Monograph No. 73). Falmer, UK: University of Essex. Retrieved from http://www.create￾rpc.org/pdf_documents/PTA73.pdf Mahawithanage, S., Kannangara, K., Wickremasinghe, R., Chandrika, U., Jansz, E.R., Karunaweera, N., & Wickremasinghe A. (2007). Impact of vitamin A supplementation on health status and absenteeism of school children in Sri Lanka. Asia Pacific Journal of Clinical Nutrition, 16(1), 94–102. Retrieved from http://nutritionsocietyofsrilanka.org/wp-content/uploads/Mahawithanage-et-al￾2007.pdf Maluccio, J. A., Hoddinott, J., Behrman, J. R., Martorell, R., Quisumbing, A. R., & Stein, A. D. (2009). The impact of improving nutrition during early childhood on education among Guatemalan adults. The Economic Journal, 119(537), 734–763. Retrieved from https://www.jstor.org/stable/20485342#metadata_info_tab_contents Maxwell, J. A. (2005). Qualitative research design: An interactive approach. Thousand Oaks, CA: Sage Publishing. 85 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report National Education Research and Evaluation Centre [NEREC]. (2015). National Report – National Assessment of Achievement of Students Completing Grade 4 in Year 2015 in Sri Lanka. Colombo, Sri Lanka: University of Colombo. Retrieved from https://edu.cmb.ac.lk/nerec/?p=452 O’Donnell, A., Ghani Razaak, M., Kostner, M., & Perumpillai-Essex, J. (2018). Shadows of conflict in northern and eastern Sri Lanka: Socioeconomic challenges and a way forward. Washington, DC: World Bank Group. Retrieved from http://documents.worldbank.org/curated/en/784281539195433971/pdf/130701-PUB￾PUBLIC-document-date-10-26-18.pdf Powell, C. A., Walker, S. P., Chang, S. M., & Grantham-McGregor, S. M. (1998). Nutrition and education: A randomized trial of the effects of breakfast in rural primary school children. The American Journal of Clinical Nutrition, 68(4), 873–879. 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Retrieved from http://www.3ieimpact.org/evidence￾hub/publications/systematic-review-summaries/impact-education-programmes￾learning-school-participation-low-and-middle-income-countries Stone, R., de Hoop, T., Coombes, A., Goett, M., Morey, M., & Kamto, K. (2018). What works to improve early grade literacy in Latin America and the Caribbean: 2016 update of a systematic review. Washington, DC: American Institutes for Research (AIR) under the USAID-funded LAC Reads Program (LRCP). UNICEF. (2013). Country study: Out-of-school children in Sri Lanka. Retrieved from https://www.unicef.org/srilanka/2013_OSS.pdf 86 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Verguet, S., Limasalle, P., Chakrabarti, A., Husain, A., Burbano, C., Drake, L., & Bundy, D. (2020). The Broader Economic Value of School Feeding Programs in Low- and Middle-Income Countries: Estimating the Multi-Sectoral Returns to Public Health, Human Capital, Social Protection, and the Local Economy. 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PALAM/A Indicators Result Indicator Baseline Final Target SO1 MGD 1: Percent of students who, by the end of two grades of primary schooling, demonstrate that they can read and understand the meaning of grade level text 24% 58% SO2 MGD 19: Number of individuals who demonstrate use of new child health and nutrition practices as a result of USDA assistance 0 1,406 SO2 MGD 20: Number of individuals who demonstrate use of new safe food preparation and storage practices as a result of USDA assistance 0 1,800 SO1/SO2 MGD 30: Number of individuals participating in USDA food security programs 0 157,723 SO1/SO2 MGD 31: Number of individuals benefiting indirectly from USDA-funded interventions 0 501,807 SO1/SO2 MGD 32: Number of schools reached as a result of USDA assistance 0 887 1.1 Custom: Percentage of teachers in target schools using project-supported materials in schools 0 80% 1.1 MGD 4: Number of teachers/educators/teaching assistants in target schools who demonstrate use of new and quality teaching techniques or tools as a result of USDA assistance 0 134 1.3 MGD 2: Average student attendance rate in USDA supported classrooms/ schools 86% 92% 1.3.4 MGD 9: Number of students enrolled in schools receiving USDA assistance 108,940 285,806 89 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 2.6/2.4 MGD 8: Number of educational facilities (i.e. school buildings, classrooms, improved water sources, and latrines) rehabilitated/ constructed as a result of USDA assistance 0 76 2.6 Custom: Number of school meal providers supported to equip kitchens. 0 1100 2.4 MGD 27: Number of schools using an improved water source 6123 850 2.4 MGD 28: Number of schools with improved sanitation facilities 7394 825 1.3.5 Custom: Number of primary school-age children in targeted communities who participated in a reading event in the past year 0 4,200 1.4.4 MGD 13: Number of Parent-Teacher Associations (PTAs) or similar "school" governance structures supported as a result of USDA assistance 0 213 1.4.4 MGD 11: Value of new USG commitments, and new public and private sector investments leveraged by USDA to support food security and nutrition 0 610,522.66 1.1.2 MGD 3: Number of teaching and learning materials provided as a result of USDA assistance 0 80 1.2.1.1 MGD 16: Number of daily school meals (breakfast, snack, lunch) provided to 0 25,524,729 3 We did not ask about the type of water source used in schools. Instead, we asked about the availability of a source of drinking water (found in 67 percent of schools) and whether the water is treated to make it safe (found in 77 percent of schools). Using these proportions as proxies for improved water sources, we get between 569 and 654 schools with improved water sources or an average of 612 schools. 4 We did not ask about the type of sanitation facility schools had. Rather we asked whether there was one or more functioning latrine on school grounds (found in 91 percent of schools) and if there were separate, private functioning latrines for girls and boys (found in 88 percent of schools). Using these proxies for improved sanitation facilities, we get between 726 and 751 schools with improved sanitation facilities, or an average of 739 schools. 90 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report school-age children as a result of USDA assistance 1.2.1.1 MGD 17: Number of school-age children receiving daily school meals (breakfast, snack, lunch) as a result of USDA assistance 0 132,924 1.2.1.1 MGD 14: Quantity of take-home rations provided (in metric tons) as a result of USDA assistance 0 533.30 1.2.1.1 MGD 15: Number of individuals receiving take-home rations as a result of USDA assistance 0 106,659 1.2.1.1/ 1.3.1.1 MGD 18: Number of social assistance beneficiaries participating in productive safety nets as a result of USDA assistance\ 0 155,078 2.2 MGD 22: Number of individuals trained in safe food preparation and storage as a result of USDA assistance 0 2,250 2.3 MGD 23: Number of individuals trained in child health and nutrition as a result of USDA assistance 0 2,250 1.4.1 Custom: Number of government officials trained as a result of USDA assistance 0 78 1.1.4 MGD 5: Number of teachers/educators/teaching assistants trained or certified as a result of USDA assistance 0 168 1.1.5 MGD 7: Number of school administrators and officials trained or certified as a result of USDA assistance 0 168 91 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Annex B. Inter-Rater Reliability To measure the reliability and level of homogeneity of enumerators’ scores on children’s literacy skills, 5 percent of the overall second grade sample (42 out of 869) were assessed by two different enumerators simultaneously. Long one-way Analysis of Variance (ANOVA) techniques, which is used to determine whether the mean of a dependent variable is the same in two or more unrelated and independent groups, were used to calculate the intra-class correlation within pairs of assessors for a measure of inter-rater reliability. Adapted from Fleiss et al. (1973), we interpreted the intra-class correlations as it follows:  Less than 40% – Poor  Between 40% and 75% – Good or fair  Greater than 75% – Excellent Exhibit shows the percent of agreement between the raters, as well as inter-rater reliability ratings for the project evaluation sample. Overall, the inter-rater reliability (IRR) across the project evaluation sample was good for most of the literacy skills, showing high internal validity of the scores. Exhibit 68. IRR by Literacy Skill Subtests IRR Rating Letter Knowledge 91% Excellent MUW Recognition 89% Excellent Invented Word Recognition 65% Good Writing 72% Good Reading Comprehension 68% Good Listening Comprehension 70% Good Observations 42 Overall, the IRR was good or excellent. To maintain the good internal validity of the scores, and improve the administration and scoring of the assessment, we will provide further training at endline. 92 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Annex C. Terms of Reference Original Terms of Reference 93 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 94 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 95 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 96 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 97 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 98 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 99 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 100 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 101 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 102 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 103 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 104 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 105 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 106 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 107 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 108 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Revised TOR 1. Establish activities to promote literacy In order to provide children additional time to practice their reading, SC in collaboration with MoE will support to set up Children’s Reading Clubs in schools. With both MoE and NIE Primary Education departments, SC Literacy Boost (LB) Reading Clubs module to be contextualised and adapted to be facilitated by teachers keeping with the ethos of interactive and a fun learning approach to improve early grade literacy. Accordingly, SC with work with NIE to train ISA’s who will in turn train teachers to facilitate CRC’s supported by a community volunteer from the SDS. In addition, SDS volunteers will be trained in each school community on effective ways to coordinatie and support the administrative aspects of a CRC. SDSs will be oriented to the steps for developing a sustainable volunteer selection and an apprenticeship training system for the CLCs. Based on the contextualised and adapted SC LB Community Action parental awareness sessions which focus on the benefits of making learning participatory, SC will train SDS members from each school on tips and methods to support literacy improvement at home. The trained SDS members will be recognised as change agents who will be responsible to conduct awareness sessions with other SDS members and cascade learnings. SDS members will also work with school principals to organize literacy events or festivals in conjunction with a local celebration once per year. School community will be supported to organize events focus on promoting literacy and creating opportunity for children to engage in fun interactive activities that create a love for reading. This activity will commence post the implementation of Literacy Boost in schools and is planned to be initiated during the final year of the project. 2. Production of books and supplementary reading materials SC will collaboratively develop supplementary texts with the MOE and the National Institute of Education (NIE) to provide students with targeted fluency and reading comprehension practice while simultaneously promoting national cohesion, positive gender norms, and improved health and nutrition knowledge, behavior and attitudes. SC will work with key stakeholders in the MOE and NIE to collaboratively develop supplementary reading materials to fill identified content gaps. These supplementary reading materials will be easy for teachers and volunteers to use with children to improve fluency and reading comprehension skills. SC will work with the Publications and Resources Department to print copies of supplementary texts that will be distributed for 20 literacy intervention schools in each district. Using high-quality text identified through a Literacy Market Survey, SC will distribute packs of books to all intervention schools (140-schools) across all seven program districts and 25 established reading rooms within the PALAM/A project implementation area. 109 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 3. Training: Government Officials SC will work with the MoE and NIE to develop guidance and standards for the In-Service Advisor position so they can sustainably deliver improved literacy-focused training and coaching for teachers. SC will work with MOE and NIE to adapt teacher professional development trainings to be compliant with COVID-19 protocols and to support distance learning. SC will build on SC’s Literacy Boost and Student Needs Action Pack (SNAP) training materials for In-Service Advisors and teachers and will work with NIE/MOE to adapt these trainings to be more supportive of distance and self-learning modules, where possible, including short instructional videos and teaching tips that can be shared through social media and MOE/NIE websites. SC will collaborate with the Dubai Cares-funded Save the Children project to embed key elements of the Literacy Boost’s approach in the National Institute for Education teacher training curriculum. SC and the NIE will co-facilitate trainings for In-Service Advisors in all seven project districts. At the national level, SC staff will advocate with the Government of Sri Lanka to ensure that nutrition issues for primary school age children, currently outlined in the National Nutrition Strategy and the School Health Promotion Program are fully implemented. 4. Training: Teachers SC will give pedagogical focus to improving student fluency and reading comprehension. Training will also provide teacher strategies to help meet the needs of struggling learners and will offer practical tips for implementing positive discipline techniques in the classroom. In addition, teachers will receive training how to promoting health and nutrition practices in schools in fun and practical ways. In-Service Advisors will be responsible for training teachers, and SC will help equip them with the skill and extend the necessary logistical support. SC will provide In-Service Advisors with coaching and training support with the purpose of developing their capacity and demonstrating the effectiveness of more regular teacher training and coaching. Activities will be adapted to be compliant with COVID-19 protocols and support MOE and NIE in developing distance learning modalities for teacher professional development. SCHOOL HEALTH AND NUTRITION COMPONENT 5. Building/Rehabilitation Kitchens: This activity is to improve the quality of the school meal and strength the government school meal program and improve the quality of the school meal by enhancing the cooking procedures, adopting best cooking practices and to strength the government school meal program. SC will provide all School Meal Providers (SMPs) in all project schools with food preparation and storage equipment for their kitchens, including pots, pans, transportation containers, and other cooking utensils. SC will provide plates for all students in all selected project schools (approximately 887). Procurement 110 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report will be done by SCI as per the internal procedures and local level partner (Sarvodaya) will support distribution to the schools. To facilitate SMP coordination in larger schools, SC will construct school kitchens in project schools with more than 600 students (approximately 17).SC will work together with the MOE to hire the construction company and will request MOE provincial/zonal engineer oversight to ensure safety for students. By considering SCI guidelines on construction, SCI will mobilize and train school management and SDS members to support monitoring of construction. Clusters will be formed to ease the monitoring and awareness process and each district will have 2 clusters where Kilinochchi and Mulaitivu will be considered as one district. Training will be conducted by SCI staff for these 12 clusters by creating awareness on the role and responsibility of each party in this activity. Site Technical Officers and supervisory officers will organized the training at district level. 2 SDS members per school, 1st year initial training and 2nd year refresher training. 73 school sites x 2 people per school + 36 construction staff will participate for the said training. 6. Building/Rehabilitation Latrines: To ensure students have accessibility for improved sanitation facilities, SC will construct latrines in schools with between 125 and 160 students (approximately 56 schools). SC will use MOE standard designs for schools latrines. SC will work together with the MOE to hire the construction company and will request MOE engineer oversight to ensure safety for students. Based on the international standards, there are 25 girls per stall and 30 boys per stall with a urinal. Given the designs, each toilet block as given to us to use by the SHN Division in December is good for 75 students. Therefore, if we build a boys’ block and a girls’ block in each school, the designs are good for schools with 150 students. Based on the school observations conducted during the baseline, appropriate schools will be identified in consultation with MoE - SHN branch. Provincial MoE and SCI will collaboratively implement the activity via external construction company/ies. MoE (Provincial or zonal) will supervise the work via the regular government supervisory procedures and SCI will support to monitor the construction work through TOs and Site Supervisory Officers. Respective MOH office/PHI will be involved throughout the process for relevant approvals and guidance. 7. Training School Meal Providers (in Joint Distribution Points): This activity is to improve the quality of the school meal by enhancing the cooking procedures, adopting best cooking practices and strength the government school meal program. SCI will develop the training modules for SMPs in 07 districts (approx. 1100) in collaboration with and technical guidance of the MoH and MoE. SCI will conduct ToT for SCI Joint Distribution Point (JDP) Officers who will cascade the training for SMPs under each divisional directors/ SHN coordinators supervision. Training will be planned to coincide with the commodity distribution date. These trainings will be short, interactive sessions on food handling practices, safe kitchens and storage. PHIs will supervise SMPs kitchens and their cooking practices as a part of their regular supervisory schedule and School Principal and/or assigned teacher will monitor the quality of daily school menu which will be prepared by SMP as part of their regular monitoring. 8. Promote Good Health and Nutrition Practices: 111 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report To promote locally available nutritious ingredients and create awareness on different reparation methodologies to protect the nutrition value and to create awareness on nutrition value of commodities and best preparation methods. SCI in consultation with MoE and MoH will develop and disseminate a 2 sided leaflet on the nutritious value of pink salmon and YSPs as well as include a few recipes to create awareness on the best preparation methods of these commodities that protect the nutrition value. This leaflet will be distributed with the take home ration pack to approximately for 110,575 families. Subsequently, SCI with the support of SMP's will collate/adapt nutritionally high- valued and cost-effective recipes with locally available ingredients, which will be published in the form of a recipe book. This recipe book will be disseminated among families. 9. Training Teachers: In order to promote health and nutrition best practices among primary grades and in longer term to change attitudes and create a culture of healthy behaviors among primary grade students. In collaboration and technical support of the MoE/SHN branch, MoH and NIE Primary department will develop the SHN promotion module for ISA ToT. This SHN module complements the current primary grade curricular which also encourages practical application will be developed to further promote best SHN practices. ToT series will conduct for ISAs on Literacy Boost topics 7 Positive Class Room management, SNAP, and school health and nutrition promotion. The total budget is under Literacy component and SHN module will jointly deliver with Literacy component. In consultation with MoE SHN Branch, NIE and Provincial Education Department relevant ISA's and zonal/divisional coordinators (approx. 65) will be identified for a ToT training at national level in both languages. MoE and NIE will provide required technical expertise to conduct trainings and establish Provincial TOTs. SCI will facilitate the process in collaboration with MoE and NIE supported by the SCI District Education Managers. Above trained ISAs and Zonal/divisional coordinators will cascade the School HN Promotion training to teachers at their catchment schools. One teacher from each 887 schools will be selected and clustered for training based on their preferred language. Sarvodaya district coordinators, SCI District Education Mangers will organize the meetings and trained ISA will be the facilitator for training. Also, following year refresher trainings will be organized by Sarvodaya at divisional and zonal level collaboratively with District Education Managers. 112 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Annex D. Data Collection Instruments Qualitative Protocols PALAM/A – School Meal Providers FGD Protocol at Baseline Informed Consent Script Hello, my name is _________ and I am working with the American Institutes for Research (AIR) and EML Consultants to gather information about the PALAM/A project. The PALAM/A project aims to help lower the cost of providing nutritious school meals to primary school students and, as a result, improve learning outcomes. We are gathering information about the project from school principals, school meal providers (SMPs), school development society (SDS) members, and government officials at the zonal and divisional levels. This evaluation is funded by Save the Children. Participation We would like to conduct an interview OR we are asking you to participate in a focus group discussion. The focus group is a group interview with about 6-8 people from this school. We will ask you questions about your involvement in the PALAM/A project and your opinions on and experiences with the project. The interview or focus group will take about 1-2 hours. We will be taking notes and if you are comfortable, we would like to record this interview OR focus group discussion. We will use the audio recording to fill in any gaps in our notes and then immediately delete the recording. Risk There are no physical risks to you if you take part in this study. If any of the questions we ask are sensitive or make you uncomfortable, you do not have to answer them. The research is not evaluating you, your child, or your school. Benefits You will not receive any personal benefits (monetary or other gift) by participating in this study. However, the information you provide us will help researchers understand the challenges and successes of the PALAM/A project. This information can be used to improve the program in the future. Confidentiality You can speak openly and honestly in your responses. We will not include your name in any reports and we will not tell anyone that you have contributed to this research. If you are participating in a focus group discussion, it is important to respect other people’s privacy and not share what has been discussed with others outside of this discussion. All information will be stored securely on AIR and EML computers and will be deleted after all reports are approved by the funder at the end of the project in 2023. Voluntary Participation 113 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Your participation in these data collection activities is completely voluntary. You may choose not to answer any questions or stop the interview OR focus group discussion at any time. If you do not want to participate in the study, your decision will have no negative impact on you or your child’s participation in the program. More Information If you have questions about the study, please contact Nirodha Dissanayaka, the study coordinator at 77 581 2182, nirodha@emlconsultants.com or Dr. Pooja Nakamura, the project director of the evaluation, at pnakamura@air.org. If you have concerns or questions about your rights as a participant, contact AIR’s Institutional Review Board at IRB@air.org, toll free at 1-800-634- 0797, or by postal mail: AIR c/o IRB, 1000 Thomas Jefferson Street NW, Washington, DC 20007. Informed Consent If you have understood the information above and voluntarily agree to participate, please provide verbal consent by saying “I consent” aloud. --------------------------------------------------------------------------------------------------------------------- Interviewer: Thank you all for agreeing to participate in our study. We are here to study the PALAM/A program. If you have never heard of PALAM/A, the goal of the program is to help lower the cost of providing nutritious school meals to primary school students and, as a result, improve learning outcomes. The purpose of today’s conversation is to understand the current state of your school and how things work currently. We would like to begin our conversation today with introductions and then I will ask you a series of questions about your role as school meal providers. Introduction 1. Can each person state their name and how long you have been in your position? 2. Could someone please explain to me the role of the school meal provider? What are your specific activities and responsibilities? 3. Are you familiar with the PALAM/A program? If so, how did you hear about it? Enumerator Note: If no, skip to question 4. a. What have you heard the program will include? Health, Nutrition & WASH 4. Could one of you please describe how the current school meal model works? a. Where does the food for the school meals currently come from? b. What factors influence decisions about what kinds of food are sourced? i) To what extent is nutrition considered when making these decisions? c. What are the main challenges the current model faces in delivering nutritious food to students? What can be improved? 5. Who are the main actors involved in providing school meals to students? Please describe each of their roles. a. How are the key actors connected to one another? b. Who decides what type of food to use for school meals? c. Who buys the food for school meals currently? 114 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report i) If schools purchase the food, how do they get funding to buy food and other meal related commodities? d. Who has the most influence in how funding is allocated and spent? 6. What types of meals are offered at schools? i) Do you have a sense if the children like the school meals? Why or why not? ii) Do you consider the meals to be nutritious? Why or why not? 7. Does the school share any health/nutrition information with students? Enumerator note: Probe for any information about eating healthy foods, washing your hands, etc. a. What information and how do you share it? Enumerator note: Probe for differences by grade, whether different information is provided to girls and boys. b. Which actors are best positioned to share information related to nutrition and dietary practices to students and parents? 8. Does the schools you work with and meal providers follow certain standards to ensure that food is prepared and stored safely? If yes, please describe. If no, skip to question 9. a. How are these standards set? b. Who is responsible for monitoring if these standards are met? 9. Does the schools you work with typically have a kitchen? If yes, what is it used for? (Enumerator Note: If no, skip to question 10). a. If meals are cooked in the kitchen, what do typical meals consist of? Are the meals for teachers or students or both? b. Is the kitchen clean? c. Does the kitchen have adequate supplies (i.e., food and cooking utensils)? Please describe. d. Is the kitchen an appropriate size for the school (not too big or too small)? e. Do you think kitchen facilities are currently adequate to ensure food safety? Why or why not? 10. What do you think schools need in order to improve delivery of nutritious school meals? a. What specific support do school meal providers need to improve their ability to deliver nutritious school meals? Relevance 11. Based on what you know about the program, do you think the PALAM/A project is designed to help support school meal providers do their work? Why or why not? Enumerator note: If the respondents are unfamiliar with PALAM/A skip to question 12. a. What aspect of the project do you think will be the most helpful? Why? Effectiveness 12. What do you think will help PALAM/A achieve its objectives of delivering more nutritious meals to primary school students? a. What are some barriers the program might have to overcome? 13. Under the current school meal model, is it a struggle for schools to meet the costs of providing meals? Enumerator note: If the respondents don’t know this information, skip to question 14. a. What are the key factors that affect costs? Efficiency 115 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 14. Are food and other commodities usually delivered on time in the current food sourcing model? If not, what factors cause delays? 15. How much food and other commodities are wasted under the current model? What do you think schools can do to reduce waste? Conclusion 16. Is there anything else you’d like to tell me about the school environment that we haven’t already discussed? Thank you very much for answering all my questions. 116 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report PALAM/A –Zonal/Divisional Education Officers KII Protocol at Baseline Informed Consent Script Hello, my name is _________ and I am working with the American Institutes for Research (AIR) and EML Consultants to gather information about the PALAM/A project. The PALAM/A project aims to help lower the cost of providing nutritious school meals to primary school students and, as a result, improve learning outcomes. We are gathering information about the project from school principals, school meal providers (SMPs), school development society (SDS) members, and government officials at the zonal and divisional levels. This evaluation is funded by Save the Children. Participation We would like to conduct an interview OR we are asking you to participate in a focus group discussion. The focus group is a group interview with about 6-8 people from this school. We will ask you questions about your involvement in the PALAM/A project and your opinions on and experiences with the project. The interview or focus group will take about 1-2 hours. We will be taking notes and if you are comfortable, we would like to record this interview OR focus group discussion. We will use the audio recording to fill in any gaps in our notes and then immediately delete the recording. Risk There are no physical risks to you if you take part in this study. If any of the questions we ask are sensitive or make you uncomfortable, you do not have to answer them. The research is not evaluating you, your child, or your school. Benefits You will not receive any personal benefits (monetary or other gift) by participating in this study. However, the information you provide us will help researchers understand the challenges and successes of the PALAM/A project. This information can be used to improve the program in the future. Confidentiality You can speak openly and honestly in your responses. We will not include your name in any reports and we will not tell anyone that you have contributed to this research. If you are participating in a focus group discussion, it is important to respect other people’s privacy and not share what has been discussed with others outside of this discussion. All information will be stored securely on AIR and EML computers and will be deleted after all reports are approved by the funder at the end of the project in 2023. Voluntary Participation Your participation in these data collection activities is completely voluntary. You may choose not to answer any questions or stop the interview OR focus group discussion at any time. If you do not want to participate in the study, your decision will have no negative impact on you or your child’s participation in the program. More Information 117 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report If you have questions about the study, please contact Nirodha Dissanayaka, the study coordinator at 77 581 2182, nirodha@emlconsultants.com or Dr. Pooja Nakamura, the project director of the evaluation, at pnakamura@air.org. If you have concerns or questions about your rights as a participant, contact AIR’s Institutional Review Board at IRB@air.org, toll free at 1-800-634- 0797, or by postal mail: AIR c/o IRB, 1000 Thomas Jefferson Street NW, Washington, DC 20007. Informed Consent If you have understood the information above and voluntarily agree to participate, please provide verbal consent by saying “I consent” aloud. --------------------------------------------------------------------------------------------------------------------- Interviewer: Thank you for agreeing to participate in our study. We are here to study the PALAM/A program. If you have never heard of PALAM/A, the goal of the program is to help lower the cost of providing nutritious school meals to primary school students and, as a result, improve learning outcomes. The purpose of today’s conversation is to understand the current state of the schools in this district and how things work currently. We would like to begin our conversation today with introductions and then I will ask you about your perspectives on the current state of nutrition and literacy levels in schools within your district. First, can you please state your name, title, how long you have been in your position, and what your primary responsibilities are? Introduction 1. Are you familiar with the PALAM/A program? If so, how have you heard about it? Enumerator Note: If no, skip to question 2. a. What have you heard the program will include? b. In what area do you anticipate PALAM/A will support your school the most? Why? Attendance and Learning 2. Does the zonal/divisional office monitor primary school students’ literacy rates? a. What are some of the current trends you have noticed? 3. Does the zone/division track attendance rates? If yes, is attendance rates consistent throughout the year? Enumerator Note: Probe for seasonality, typical attendance levels for girls vs. boys, other trends in attendance. 4. What zonal/divisional level policies or program activities promote increased levels of literacy? 5. What zonal/divisional level policies or program activities promote increased levels of school attendance? Health, Nutrition & WASH 6. Does the zone/division have health personnel (e.g., public health inspectors, medical officers, public health midwives, etc.) that regularly visit schools? If yes, what do they do? 7. Does the zone/division monitor students’ nutrition and health outcomes? If yes, How frequently? a. What are the current trends? 118 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 8. What zonal/divisional level policies or programs promote positive nutrition and dietary practices in schools? 9. Do the schools and food preparers have to follow certain standards to ensure that food is prepared and stored safely? If yes, please describe. Enumerator Note: If no, skip to question 10. a. How are these standards set? b. At the zonal/divisional level, is there any way to monitor if these standards are being met? 10. Please describe how the current school meal program works. a. Where do schools currently get food for their meals? b. Where do they get the funds to do so? c. Are you aware of any challenges the current program faces in delivering nutritious food to primary school students? If so, please describe. 11. Who are the main actors currently involved in providing school meals to primary students? Please describe each of their roles. a. How are the key actors connected to one another? b. Who buys the food for school meals currently? i) If schools purchase the food, how do they get funding to buy food and other meal related commodities? c. Who has the most influence in how funding is allocated and spent? 12. Does the zone/division share any health/nutrition information with schools? Enumerator note: Probe for any information about eating healthy foods, washing your hands, etc. a. What information and how do you share it? Enumerator note: Probe for differences by grade, whether different information is provided to girls and boys. b. Which actors are best positioned to share information related to nutrition and dietary practices to students and parents? 13. Can you describe the general state of school facilities and infrastructure across your zone/division? a. How do schools access funding to build or improve facilities? b. What challenges do schools face in accessing these funds? c. What kind of support does the zone/division provide, if any, to help schools upkeep their infrastructure? 14. What do you think schools need in order to improve delivery of nutritious school meals? a. How do you see the zone/division’s role in supporting schools to improve the delivery of nutritious school meals to their students? b. In what ways can the zone/division improve its support? Relevance 15. Based on what you know about the program, do you think the PALAM/A project is designed to meet the needs of the schools in your zone/division? Why or why not? Enumerator note: If the respondent is unfamiliar with PALAM/A skip to question 16. a. What aspect of the project do you think will be the most helpful? Why? Effectiveness 16. What factors do you think will help PALAM/A achieve its objectives of boosting literacy rates and delivering more nutritious meals to the schools in your zone/division? 119 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report a. What would be some challenges the program might have to overcome? Conclusion 17. Is there anything else you’d like to tell me about your zone/division’s schools that we haven’t already discussed? Thank you very much for answering all my questions. 120 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report PALAM/A – School Development Society Members KII Protocol at Baseline Informed Consent Script Hello, my name is _________ and I am working with the American Institutes for Research (AIR) and EML Consultants to gather information about the PALAM/A project. The PALAM/A project aims to help lower the cost of providing nutritious school meals to primary school students and, as a result, improve learning outcomes. We are gathering information about the project from school principals, school meal providers (SMPs), school development society (SDS) members, and government officials at the zonal and divisional levels. This evaluation is funded by Save the Children. Participation We would like to conduct an interview OR we are asking you to participate in a focus group discussion. The focus group is a group interview with about 6-8 people from this school. We will ask you questions about your involvement in the PALAM/A project and your opinions on and experiences with the project. The interview or focus group will take about 1-2 hours. We will be taking notes and if you are comfortable, we would like to record this interview OR focus group discussion. We will use the audio recording to fill in any gaps in our notes and then immediately delete the recording. Risk There are no physical risks to you if you take part in this study. If any of the questions we ask are sensitive or make you uncomfortable, you do not have to answer them. The research is not evaluating you, your child, or your school. Benefits You will not receive any personal benefits (monetary or other gift) by participating in this study. However, the information you provide us will help researchers understand the challenges and successes of the PALAM/A project. This information can be used to improve the program in the future. Confidentiality You can speak openly and honestly in your responses. We will not include your name in any reports and we will not tell anyone that you have contributed to this research. If you are participating in a focus group discussion, it is important to respect other people’s privacy and not share what has been discussed with others outside of this discussion. All information will be stored securely on AIR and EML computers and will be deleted after all reports are approved by the funder at the end of the project in 2023. Voluntary Participation Your participation in these data collection activities is completely voluntary. You may choose not to answer any questions or stop the interview OR focus group discussion at any time. If you do not want to participate in the study, your decision will have no negative impact on you or your child’s participation in the program. More Information 121 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report If you have questions about the study, please contact Nirodha Dissanayaka, the study coordinator at 77 581 2182, nirodha@emlconsultants.com or Dr. Pooja Nakamura, the project director of the evaluation, at pnakamura@air.org. If you have concerns or questions about your rights as a participant, contact AIR’s Institutional Review Board at IRB@air.org, toll free at 1-800-634- 0797, or by postal mail: AIR c/o IRB, 1000 Thomas Jefferson Street NW, Washington, DC 20007. Informed Consent If you have understood the information above and voluntarily agree to participate, please provide verbal consent by saying “I consent” aloud. --------------------------------------------------------------------------------------------------------------------- Interviewer: Thank you for agreeing to participate in our study. We are here to study the PALAM/A program. If you have never heard of PALAM/A, the goal of the program is to help lower the cost of providing nutritious school meals to primary school students and, as a result, improve learning outcomes. The purpose of today’s conversation is to understand the current state of your school and how things work currently. We would like to begin our conversation today with introductions and then I will ask you a series of questions about your role and school context. First, can you please state your name, how long you have been in your position, and what your primary responsibilities are? Introduction 1. Are you familiar with the PALAM/A program? If so, how have you heard about it? Enumerator Note: If no, skip to question 2. a. What have you heard the program will include? b. In what area do you anticipate PALAM/A will support your school the most? Why? Health, Nutrition & WASH 2. Please describe how the current school meal program works. a. Where does the food for the school meals currently come from? b. What factors influence decisions about what kinds of food are sourced? c. What is the role of the SDS in this process? How do they support the delivery of nutritious school meals to students? d. What are the main challenges the current program faces in delivering nutritious food to students? 3. Who are the main actors involved in providing school meals to students? Please describe each of their roles. a. How are the key actors connected to one another? b. Who buys the food for school meals currently? i) If schools purchase the food, how do they get funding to buy food and other meal related commodities? c. Who has the most influence in how funding is allocated? 4. Do schools and meal providers follow certain standards to ensure that food is prepared and stored safely? If yes, please describe. Enumerator Note: If no, skip to question 5. 122 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report a. How are these standards set? b. What specific practices do you follow to ensure that food is prepared and stored safely? c. Did anyone provide training to you on safe food preparation and storage? If so, please describe what you learned through this training. d. Who is responsible for monitoring if these standards are met? 5. Can you describe the general state of your school’s facilities and infrastructure? a. Who is responsible for infrastructure and maintenance related decisions in your school? b. What school facilities require the most immediate attention for upgrades? Enumerator probe for kitchens, bathrooms, hand washing stations, etc. c. How do schools fund projects to build or improve facilities? What challenges do schools face in accessing these funds? i) Is the SDS involved? Please describe. d. What kind of support do SDS members receive to develop and implement school maintenance plans? What further support is needed? 6. Does the school have a kitchen? If yes, what is it used for? (Enumerator note: If no, skip to question 7). a. If meals are cooked in the kitchen, what do typical meals consist of? Are the meals for teachers or students or both? b. Is the kitchen clean? c. Does the kitchen have adequate supplies (i.e., food and cooking utensils)? Please describe. d. Is the kitchen an appropriate size for the school (not too big or too small)? e. Do you think kitchen facilities are currently adequate to ensure food safety? Why or why not? 7. Does the school have potable water available to students for drinking? Please describe. 8. Are there enough toilets/latrines for students at this school? a. How would you characterize the cleanliness of the toilets/latrines? b. Is there soap and water for handwashing near all latrines? c. Are the girls’ and boys’ toilets/latrines separate from each other? Please describe. Relevance 9. Based on what you know about the program, do you think the PALAM/A project is designed to meet the needs of SDS members? Why or why not? Enumerator note: If the respondent is unfamiliar with PALAM/A skip to question 10. a. What specific component of the project do you think will be the most helpful? Why? Effectiveness 10. What do you think will help PALAM/A achieve its objectives of boosting literacy rates and delivering more nutritious meals in your school? a. What are some barriers the program might have to overcome? Conclusion 11. Is there anything else you’d like to tell me about your school or the school environment that we haven’t already discussed? Thank you very much for answering all my questions. 123 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report PALAM/A – Principals KII Protocol at Baseline Informed Consent Script Hello, my name is _________ and I am working with the American Institutes for Research (AIR) and EML Consultants to gather information about the PALAM/A project. The PALAM/A project aims to help lower the cost of providing nutritious school meals to primary school students and, as a result, improve learning outcomes. We are gathering information about the project from school principals, school meal providers (SMPs), school development society (SDS) members, and government officials at the zonal and divisional levels. This evaluation is funded by Save the Children. Participation We would like to conduct an interview OR we are asking you to participate in a focus group discussion. The focus group is a group interview with about 6-8 people from this school. We will ask you questions about your involvement in the PALAM/A project and your opinions on and experiences with the project. The interview or focus group will take about 1-2 hours. We will be taking notes and if you are comfortable, we would like to record this interview OR focus group discussion. We will use the audio recording to fill in any gaps in our notes and then immediately delete the recording. Risk There are no physical risks to you if you take part in this study. If any of the questions we ask are sensitive or make you uncomfortable, you do not have to answer them. The research is not evaluating you, your child, or your school. Benefits You will not receive any personal benefits (monetary or other gift) by participating in this study. However, the information you provide us will help researchers understand the challenges and successes of the PALAM/A project. This information can be used to improve the program in the future. Confidentiality You can speak openly and honestly in your responses. We will not include your name in any reports and we will not tell anyone that you have contributed to this research. If you are participating in a focus group discussion, it is important to respect other people’s privacy and not share what has been discussed with others outside of this discussion. All information will be stored securely on AIR and EML computers and will be deleted after all reports are approved by the funder at the end of the project in 2023. Voluntary Participation Your participation in these data collection activities is completely voluntary. You may choose not to answer any questions or stop the interview OR focus group discussion at any time. If you do not want to participate in the study, your decision will have no negative impact on you or your child’s participation in the program. More Information 124 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report If you have questions about the study, please contact Nirodha Dissanayaka, the study coordinator at 77 581 2182, nirodha@emlconsultants.com or Dr. Pooja Nakamura, the project director of the evaluation, at pnakamura@air.org. If you have concerns or questions about your rights as a participant, contact AIR’s Institutional Review Board at IRB@air.org, toll free at 1-800-634- 0797, or by postal mail: AIR c/o IRB, 1000 Thomas Jefferson Street NW, Washington, DC 20007. Informed Consent If you have understood the information above and voluntarily agree to participate, please provide verbal consent by saying “I consent” aloud. --------------------------------------------------------------------------------------------------------------------- Interviewer: Thank you for agreeing to participate in our study. We are here to study the PALAM/A program. If you have never heard of PALAM/A, the goal of the program is to help lower the cost of providing nutritious school meals to primary school students and, as a result, improve learning outcomes. The purpose of today’s conversation is to understand the current state of your school and how things work currently. We would like to begin our conversation today with introductions and then I will ask you a series of questions about the systems you have in place at your school. Introduction 1. Can you please state your name, how long you have been in your position, and what your primary responsibilities are? 2. What were the key challenges you faced during the school closures due to COVID-19? 3. What was the greatest challenge you faced to ensure continuous learning for the children in your community during school closures due to COVID-19? 4. Are you familiar with the PALAM/A program? If so, how have you heard about it? Enumerator Note: If no, skip to question 5. a. What have you heard the program will include? b. In what area do you anticipate PALAM/A will support your school the most? Why? Attendance and Learning 5. Is attendance in your school consistent throughout the year? Enumerator Note: Probe for seasonality, typical attendance levels for girls vs. boys, other trends in attendance. 6. What is the language of instruction in the classrooms? Enumerator Note: English is introduced as a second language starting in Grade 3. a. For students in grades 3 and above, how comfortable would you say students are with English? Sinhala/Tamil?: i) Speaking? ii) Reading? iii) Writing? 7. Let’s now talk a little bit about your school’s approach to teaching, reading, and writing: a. Do teachers use any activities to encourage reading/writing skills? Please describe. b. Do teachers receive any training on how to teach reading/writing? If yes, please describe. c. What challenges do teachers commonly face when they teach reading/writing? 125 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report d. What books or other learning materials are currently available in your school to help children learn to read and write? 8. How does your school monitor literacy (reading and writing ability) levels of students? Health, Nutrition & WASH 9. Are basic medical supplies (such as a first aid kit) available at the school? 10. Are there are health personnel (e.g., public health inspectors, medical officers, public health midwives, etc.) that regularly visit this school? If yes, what do they do? 11. Are students’ growth monitored at all at school? What about their weight? Enumerator Note: Probe for frequency, who does it, etc. 12. Do you have a sense of whether most of your students show up having eaten breakfast? Or are they hungry when they arrive at school? a. If many are hungry, do they have difficulty concentrating in class? b. Are many students here stunted, wasted, or underweight? Enumerator note: Provide definitions for each of these terms. We don’t need an exact # or %, just a general sense of whether it’s many children or just a few. 13. Does the school distribute any medication or vitamins/minerals to students? If yes, what is distributed? Enumerator Note: Probe for frequency, who does it, etc. 14. Do most children bring lunch to eat at school? 15. What types of meals are offered at school? Probe for type of food (e.g. fish, eggs, potatoes, vegetables, fruit, etc.). a. Do children tend to like the meals? Why or why not? b. Do you consider the meals to be nutritious? Why or why not? 16. Please describe how the current school meal model works. a. Where does the food for the school meals currently come from? b. What factors influence decisions about what kinds of food are sourced? i) To what extent is nutrition considered when making these decisions? c. What are the main challenges in delivering nutritious food to students under the current school meal program? What can be improved? 17. Who are the main actors involved in providing school meals to students? Please describe each of their roles. a. How are the key actors connected to one another? b. Who decides what type of food to use for school meals? c. Who buys the food for school meals currently? i) If schools purchase the food, how do they get funding to buy food and other meal related commodities? d. Who has the most influence in how funding for school meals is allocated and spent? 18. Does the school share any health/nutrition information with students? Enumerator note: Probe for any information about eating healthy foods, washing your hands, etc. a. What information and how do you share it? Enumerator note: Probe for differences by grade, whether different information is provided to girls and boys. b. Which actors are best positioned to share information related to nutrition and dietary practices to students and parents? 19. Are there district/zonal or national regulations your school must comply with related to the provision of school meals? If yes, please specify. 126 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 20. Does the school or food preparers follow certain standards to ensure that food is prepared and stored safely? If yes, please describe. If no, skip to question 21. a. How are these standards set? b. Who is responsible for monitoring if these standards are met? 21. What do you think your school needs in order to improve delivery of nutritious school meals? 22. Can you describe the general state of your school’s facilities and infrastructure? a. Who is responsible for infrastructure and maintenance related decisions in your school? b. What school facilities require the most immediate attention for upgrades? Enumerator note: Probe for kitchens, bathrooms, hand washing stations, etc. c. How do schools fund projects to build or improve facilities? What challenges do schools face in accessing these funds? i) Is the School Development Society (SDS) involved? If yes, please describe. 23. Does the school have a kitchen? If yes, what is it used for? (Enumerator note: If no, skip to question 24). a. If meals are cooked in the kitchen, what do typical meals consist of? Are the meals for teachers or students or both? b. Is the kitchen clean? c. Does the kitchen have adequate supplies (i.e., food and cooking utensils)? Please describe. d. Is the kitchen an appropriate size for the school (not too big or too small)? e. Do you think kitchen facilities are currently adequate to ensure food safety? Why or why not? 24. Does the school have potable water available to students for drinking? Please describe. 25. Are there enough toilets/latrines for students at this school? a. How would you characterize the cleanliness of the toilets/latrines? b. Is there soap and water for handwashing near all latrines? c. Are the girls’ and boys’ toilets/latrines separate from each other? Please describe. School Supports 26. Does the school have a development plan? a. If so, who is supporting the development and implementation of the plan? b. Do you incorporate a health and sanitation component into the plan? 27. How active is the SDS? How often do they meet? What types of projects have they completed at this school? 28. Apart from the SDS, are other groups or organizations active in your school? What do they do? Enumerator Note: Probe for religious groups, NGOs, government workers, etc. 29. What other type(s) of support (materials, capacity building, etc.) do you think this school needs most? Why? Relevance 30. Based on what you know about the program, do you think the PALAM/A project is designed to meet the specific needs of your school? Why or why not? Enumerator note: If the respondent is unfamiliar with PALAM/A skip to question 31. a. What specific component of the project do you think will be the most helpful? Why? 127 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Effectiveness 31. What do you think will help a program like PALAM/A achieve its objectives of delivering more nutritious meals in your school and boosting literacy rates? a. What are some barriers the program might have to overcome? 32. Under the current school meal model, is it a struggle for your school to meet the costs of providing meals? a. What are the key factors that affect costs? Efficiency 33. Are food and other commodities usually delivered on time in the current food sourcing model? If not, what factors cause delays? 34. How much food and other commodities are wasted under the current model? What do you think your school can do to reduce waste? Conclusion 35. Is there anything else you’d like to tell me about your school or the school environment that we haven’t already discussed? Thank you very much for answering all my questions. 128 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Quantitative Surveys 129 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 130 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 131 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 132 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 133 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 134 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 135 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 136 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 137 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 138 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 139 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 140 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 141 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 142 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 143 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 144 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 145 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 146 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 147 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 148 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 149 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 150 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 151 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 152 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 153 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report 154 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report SMP nutrition and food safety KAP Question Response Date of Interview dd/mm/yyyy (numbers only) Name of Village / District School Name / Number Name / code of interviewer Name of respondent Sex of respondent 1 - Female 0 - Male Module 1: Child health and nutrition Question Instruction Response How important is it for a child to eat while at school? - "Not important" means children do not have to eat while at school - "A little important" means children could eat while at school, but it is not that important - "Rather important" means children should eat at school if they can - "Very important" means children definitely should eat while at school 1 - Not important 2 - A little important 3 - Rather important 4 - Very important What can happen if a child skips a meal at school and goes hungry? Select all that apply 1 - Child can have a short attention span/low concentration 2 - Child cannot study well 3 - Child does not do as well at school as she could 4 - Child gets sleepy or lethargic 5 - Other, specify 88 - DK What are some of the important nutritional practices for school children? Select all that apply 1 - Eat different kinds of foods, diverse diet 2 - Eat enough food 3 - Eat food rich in vitamins 4 - Eat balanced meals (vegetables + starch + meat or fish) 5 - Other, specify 88 - DK If selected "3 - Rather difficult" or "4 - Very difficult", ask Why? Select all that apply. 1 - Difficult to obtain different ingredients 2 - Different ingredients are more expensive 3 - Children do not like eating different types of foods 4 - Other, specify What are some signs of vitamin A deficiency in children? Select all that apply. 1 - Dry skin 2 - Eye problems 3 - Night blindness 4 - Acne 5 - Poor wound healing 6 - Throat infection 7 -Other, specify 88 - DK What are some signs of iron deficiency in children? Select all that apply. 1 - Fatigue 2 - Weakness 3 - Pale skin 4 - Chest pain 5 - Headache/dizziness 6 - Cold hands or feet 7 - Other, specify 88 - DK What are some signs of protein deficiency in children? Select all that apply. 1 - Edema (swollen and puffy skin) 2 - Loss of muscle mass 3 - Stunted growth 4 - Increased incidence of infections 5 - Increased bone fractures 6 - Hair, skin or nail problems 7 - Other, specify 88 - DK What are some of the plant-based proteins that can substitute animal￾based protein for vegeterian students? Select all that apply. 1 - Mushroom 2 - Tofu (soya meat) 3 - Dhal 4 - Eggs 5 - Hathmaluwa (veg curry with cashews) 6 - Other, specify 88 - DK Why should you avoid serving too much of sticky and sugar-rich foods, such as sweets and candies? Select all that apply. 1 - Because they can cause tooth decay 2 - Because they are not nutritious 3 - Because they interfere with appetite 4 - Other, specify 88 - DK Do you provide the MoE recommended menu? 1 - Yes, always 2 - Yes, most times 3 - Yes, sometimes 4 - No, never Do you make adaptations to the MoE recommended menu? 1 - Yes 0 - No Why did you make adaptations to the MoE recommended menu? Select all that apply. 1 - Recommended ingredient unavailable 2 - Recommended ingredient too expensive 3 - Recommended ingredient is not good / not nutritious 4 - Adaptation for student's diets (e.g., for vegeterian students) 5 - Other, specify Which vegetables are you serving this week? Select all that apply. Select all that apply from a list of context-appropriate vegetables. Which fruits are you serving this week? Select all that apply. Select all that apply from a list of context-appropriate fruits. How many eggs did you provide to each student this week? Enter integer. Do you serve beverages with school meals? 1 - Yes 0 - No What kind of beverages do you serve? Select all that apply. 1 - Juice 2 - Milk 3 - Tea / chai 4 - Powdered drink 5 - Other, specify How confident do you feel preparing healthy and nutritious meals for school children? 1 - Not at all confident 2 - A little confident 3 - Mostly confident 4 - Very confident 155 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Module 1: Child health and nutrition Question Instruction Response How important is it for a child to eat while at school? - "Not important" means children do not have to eat while at school - "A little important" means children could eat while at school, but it is not that important - "Rather important" means children should eat at school if they can - "Very important" means children definitely should eat while at school 1 - Not important 2 - A little important 3 - Rather important 4 - Very important What can happen if a child skips a meal at school and goes hungry? Select all that apply 1 - Child can have a short attention span/low concentration 2 - Child cannot study well 3 - Child does not do as well at school as she could 4 - Child gets sleepy or lethargic 5 - Other, specify 88 - DK What are some of the important nutritional practices for school children? Select all that apply 1 - Eat different kinds of foods, diverse diet 2 - Eat enough food 3 - Eat food rich in vitamins 4 - Eat balanced meals (vegetables + starch + meat or fish) 5 - Other, specify 88 - DK If selected "3 - Rather difficult" or "4 - Very difficult", ask Why? Select all that apply. 1 - Difficult to obtain different ingredients 2 - Different ingredients are more expensive 3 - Children do not like eating different types of foods 4 - Other, specify What are some signs of vitamin A deficiency in children? Select all that apply. 1 - Dry skin 2 - Eye problems 3 - Night blindness 4 - Acne 5 - Poor wound healing 6 - Throat infection 7 -Other, specify 88 - DK What are some signs of iron deficiency in children? Select all that apply. 1 - Fatigue 2 - Weakness 3 - Pale skin 4 - Chest pain 5 - Headache/dizziness 6 - Cold hands or feet 7 - Other, specify 88 - DK What are some signs of protein deficiency in children? Select all that apply. 1 - Edema (swollen and puffy skin) 2 - Loss of muscle mass 3 - Stunted growth 4 - Increased incidence of infections 5 - Increased bone fractures 6 - Hair, skin or nail problems 7 - Other, specify 88 - DK What are some of the plant-based proteins that can substitute animal￾based protein for vegeterian students? Select all that apply. 1 - Mushroom 2 - Tofu (soya meat) 3 - Dhal 4 - Eggs 5 - Hathmaluwa (veg curry with cashews) 6 - Other, specify 88 - DK Why should you avoid serving too much of sticky and sugar-rich foods, such as sweets and candies? Select all that apply. 1 - Because they can cause tooth decay 2 - Because they are not nutritious 3 - Because they interfere with appetite 4 - Other, specify 88 - DK Do you provide the MoE recommended menu? 1 - Yes, always 2 - Yes, most times 3 - Yes, sometimes 4 - No, never Do you make adaptations to the MoE recommended menu? 1 - Yes 0 - No Why did you make adaptations to the MoE recommended menu? Select all that apply. 1 - Recommended ingredient unavailable 2 - Recommended ingredient too expensive 3 - Recommended ingredient is not good / not nutritious 4 - Adaptation for student's diets (e.g., for vegeterian students) 5 - Other, specify Which vegetables are you serving this week? Select all that apply. Select all that apply from a list of context-appropriate vegetables. Which fruits are you serving this week? Select all that apply. Select all that apply from a list of context-appropriate fruits. How many eggs did you provide to each student this week? Enter integer. Do you serve beverages with school meals? 1 - Yes 0 - No What kind of beverages do you serve? Select all that apply. 1 - Juice 2 - Milk 3 - Tea / chai 4 - Powdered drink 5 - Other, specify How confident do you feel preparing healthy and nutritious meals for school children? 1 - Not at all confident 2 - A little confident 3 - Mostly confident 4 - Very confident 156 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Access to health and nutrition information Did you ever attend a training on child health and nutrition? 1 - Yes 0 - No >> Next section When was the last time you attended one? 1 - In past week 2 - In past month 3 - In past 6 months 4 - In past year 5 - More than one year ago Was the training provided by Public Health Inspectors? 1 - Yes 0 - No If not, who provided the training? [insert response] Where did you receive information about child health and nutrition? Select all that apply. 1 - SMP training 2 - Public Health Inspectors 3 - Other SMPs 4 - MoH materials 5 - MoE materials 6 - Other, specify Did you have any difficulty understanding the content or training materials? 1 - No difficulty 2 - Little difficulty 3 - Some difficulty 4 - A lot of difficulty What is the most important action for preventing Covid-19 infection? 1 - Wash your hands with soap and water after being in a public place 2 - Avoid close contact with people who are sick 3 - Maintain a physical distance of 1 meter from anyone not in your household 4 - Cover your mouth and nose with a mask when around others 5 - Cover your cough and sneezes 6 - Clean frequently touched surfaces daily 7 - Other, specifcy 88 - DK 157 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Food Safety Personal hygiene Question Instruction Response Did you miss any days of meal prep because you were sick in the past 3 months? 1 - Yes 0 - No If yes, why did you miss days when you were sick? Select all that apply. Do not read options. 1 - I felt bad 2 - It affects food safety 3 - Other, specify My staff always help me to prepare meals even when they are sick (i.e., with flu, cold, diarrhoea, coughing, etc.). 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree Sneezing can affect the safety of the food being prepared. 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree Coughing can affect the safety of the food being prepared. 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree Back pain can affect the safety of the food being prepared. 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree An open wound on fingers/hand that comes in contact with food can affect the safety of the food being prepared. 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree Having a fever can affect the safety of the food being prepared. 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree Having a headache can affect the safety of the food being prepared. 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree Vomiting can affect the safety of the food being prepared. 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree Diarrhea can affect the safety of the food being prepared. 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree At what moments do you wash your hands? Select all that apply. Do not read options. 1 - Before preparing meals 2 - Before serving meals 3 - After handling raw meet or poultry 4 - After touching money 5 - After using the toilet 6 - After touching / taking out garbage 7 - Other, specify Describe how you wash your hands? Select all that apply. Do not read options. 1 - Washes hands in a bowl of water (sharing with other people) — poor practise 2 - With someone pouring a little clean water from a jug onto one’s hands — appropriate practise 3 - Under running water — appropriate practise 4 - Washes hands with soap or ashes 5 - Other, specify For the following statements, state how much you agree or disagree with the statement: 158 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report How long do you wash your hands for? In seconds. How important is it to wear clean clothes (or clean apron) when you cook? 1 - Not important 2 - A little important 3 - Rather important 4 - Very important Prep area Describe the area where you prepare meals. 1 - Separate (dedicated) room in house 2 - Shared (not dedicated) room in house 3 - Outside 4 - Other, specify Describe how you clean the area where you prepare meals. Select all that apply. 1 - Clean prep surfaces with soap and clean water 2 - Clean prep surfaces with water only (no soap) 3 - Sweep / wipe the floor 4 - Remove trash 5 - Clean utensils 6 - Other, specify When do you clean the area where you prepare meals? 1 - Before preparing each batch of meals 2 - After preparing each batch of meals 3 - Other, specify How important is it to maintain a clean cooking environment ? 1 - Not important 2 - A little important 3 - Rather important 4 - Very important Food Storage How do you store [FOOD TYPE]? Do not read options. Select all that apply. 1 - In the refrigerator (below 5 °C)/cool box 2 - Covered (protected from insects, rodents, pests and dust) 3 - Uncovered 4 - Separated from cooked or ready-to-eat foods 5 - Combined with all other food items (cooked or uncooked) 6 - Other, specify How important is it to keep meat, poultry, fish, seafood or cooked food in a cool place, for example in a cool box or in the refrigerator? 1 - Not important 2 - A little important 3 - Rather important 4 - Very important If selected "1 - Not important" or "2 - A little important", ask Why? [open-neded] How difficult is it for you to keep foods in a cool box or in the refrigerator? 1 - Not difficult 2 - A little difficult 3 - Rather difficult 4 - Very difficult If selected "3 - Rather difficult" or "4 - Very difficult", ask Why? Select all that apply. 1 - Do not have a fridge/cool box 2 - Fridge/cool box is expensive 3 - Do not have icex 4 - Do not have electricity 5 - Other, specify How much time usually passess between preparing hot food and delivering it to students? 1 - Less than 30 minutes 2 - Less than 1 hour 3 - Between 1 and 2 hours 4 - Over 2 hours Does this time differ depending on the weather (i.e., if it is >30C)? 1 - Yes 0 - No If so, how? 1 - Longer time between prep and delivery 2 - Shorter time between prep and delivery 3 - Other, specify Why is it important to not keep hot food out at room temperature before serving for too long? Select all that apply. 1 - Bacteria grows well at room temperature 2 - The food gets cold 3 - Other, specify 88 - DK Why should you avoid serving leftovers that were not kept in a cool place [if stored for more than 2 hours or 1 hour if it's warmer than 30C]? This does not apply to uncut fruit or breads. Select all that apply. 1 - Because food is not safe anymore 2 - Foods get spoiled (germs multiply very quickly and can cause illness) 3 - Higher temperatures make germs grow faster 4 - Other, specify 88 - DK Do you reheat leftovers or the food that has been prepared earlier before serving it? 1 - Yes 0 - No If yes, to what temperature? 1 - Less than 75C 2 - 75C 3 - Over 75C 88 - DK How likely are children to get sick from eating food that was not stored properly? 1 - Not likely 2 - A little likely 3 - Somewhat likely 4 - Highly likely How likely ar children to get seriously sick from eating food that was not stored properly? 1 - Not likely 2 - A little likely 3 - Somewhat likely 4 - Highly likely Contamination Why should you prevent raw meat, offal, poultry and seafood from touching other foods such as those that are cooked or ready to eat? 1 - Raw animal foods often contain germs (which may be transferred to cooked and ready-to-eat foods) 2 - Other, specify 88 - DK I use separate (clean) utensils to handle different types of food. 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree I use the same (dirty) utensils to handle raw meat / poultry and other foods (e.g., fruit or vegertables). 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree I prepare raw meat / poultry that has pests on it (i.e., flies, roaches, insects). 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree I clean the food prep surface (table, counter, chopping board) after cutting raw meet or poultry and before cutting fruits or vegetables. 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree Is it ready to eat? When cooking soups and stews, what sign shows that these are ready and safe to be served? 1 - They are boiling/well cooked 2 - Other, specify 88 - DK When cooking flesh meat, organ meat or seafood, what sign shows that these are ready and safe to be served? 1 - No blood / pink inside 2 - Other, specify 88 - DK How likely are children to get sick from eating undercooked meat or poultry? 1 - Not likely 2 - A little likely 3 - Somewhat likely 4 - Highly likely How likely is it for a child to get seriously sick from eating undercooked meat or poultry? 1 - Not likely 2 - A little likely 3 - Somewhat likely 4 - Highly likely What should you do before serving children raw fruits and vegetables? Select all that apply. 1 - Wash them with clean water and soap 2 - Wash them with clean water only 3 - Peel them 4 - Other, specify 88 - DK For the following statements, state how much you agree or disagree with the statement: 159 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Contamination Why should you prevent raw meat, offal, poultry and seafood from touching other foods such as those that are cooked or ready to eat? 1 - Raw animal foods often contain germs (which may be transferred to cooked and ready-to-eat foods) 2 - Other, specify 88 - DK I use separate (clean) utensils to handle different types of food. 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree I use the same (dirty) utensils to handle raw meat / poultry and other foods (e.g., fruit or vegertables). 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree I prepare raw meat / poultry that has pests on it (i.e., flies, roaches, insects). 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree I clean the food prep surface (table, counter, chopping board) after cutting raw meet or poultry and before cutting fruits or vegetables. 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree Is it ready to eat? When cooking soups and stews, what sign shows that these are ready and safe to be served? 1 - They are boiling/well cooked 2 - Other, specify 88 - DK When cooking flesh meat, organ meat or seafood, what sign shows that these are ready and safe to be served? 1 - No blood / pink inside 2 - Other, specify 88 - DK How likely are children to get sick from eating undercooked meat or poultry? 1 - Not likely 2 - A little likely 3 - Somewhat likely 4 - Highly likely How likely is it for a child to get seriously sick from eating undercooked meat or poultry? 1 - Not likely 2 - A little likely 3 - Somewhat likely 4 - Highly likely What should you do before serving children raw fruits and vegetables? Select all that apply. 1 - Wash them with clean water and soap 2 - Wash them with clean water only 3 - Peel them 4 - Other, specify 88 - DK Transportation / Delivery When do you deliver the meals to the school? 1 - Before 7:30 am 2 - Between 7:30 and 8:30 am 3 - Between 8:30 and 10 am 4 - After 10 am 5 - Other, specify How long does it take you to deliver the meals to students (in minutes)? Enter integer. Cleaning up After you have prepared a school meal, kitchen surfaces, pots, pans, plates and utensils are dirty. Can you describe how you clean them usually? Select all that apply. 1 - Scrape excess food into rubbish bin 2 - Wash with clean or hot water 3 - Wash with detergent 4 - Other, specify After you clean kitchen surfaces, pots, pans, plates and utensils, how do you dry them? Select all that apply. 1 - Clean towel 2 - Air dry 3 - Other, specify Drinking water / water for cooking Where do you get water for cooking? Select all that apply. 1 - Pond, lake 2 - Dam 3 - Stream/river 4 - Unprotected spring 5 - Protected spring 6 - Well 7 - Borehole 8 - Water tank 9 - Roof catchment 10 - Other, specify Where do you get water for children's beverages (e.g., for powdered drinks)? Select all that apply. 1 - Pond, lake 2 - Dam 3 - Stream/river 4 - Unprotected spring 5 - Protected spring 6 - Well 7 - Borehole 8 - Water tank 9 - Roof catchment 10 - Other, specify How important is it to boil or filter water that will be used for drinking? 1 - Not important 2 - A little important 3 - Rather important 4 - Very important Why is it important to boil or filter water that will be used for drinking? Select all that apply. 1 - Kills germs, microorganisms 2 - Makes water safe to drink 3 - Reduces chance of illness (diarrhea) 4 - Gives water better taste 5 - Other, specify 88 - DK How important is it to boil or filter water that will be used for cooking? 1 - Not important 2 - A little important 3 - Rather important 4 - Very important Why is it important to boil or filter water that will be used for cooking? Select all that apply. 1 - Kills germs, microorganisms 2 - Makes water safe to drink 3 - Reduces chance of illness (diarrhea) 4 - Gives water better taste 5 - Other, specify 88 - DK How likely are children to get sick from drinking unboiled or unfiltered water? 1 - Not likely 2 - A little likely 3 - Somewhat likely 4 - Highly likely How long does water need to be boiled to ensure it is safe? 1 - Less than 1 min 2 - Between 2 and 3 mins 3 - 3 minutes 4 - More than 3 minutes 88 - DK For the following statements, state how much you agree or disagree with the statement: 160 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Drinking water / water for cooking Where do you get water for cooking? Select all that apply. 1 - Pond, lake 2 - Dam 3 - Stream/river 4 - Unprotected spring 5 - Protected spring 6 - Well 7 - Borehole 8 - Water tank 9 - Roof catchment 10 - Other, specify Where do you get water for children's beverages (e.g., for powdered drinks)? Select all that apply. 1 - Pond, lake 2 - Dam 3 - Stream/river 4 - Unprotected spring 5 - Protected spring 6 - Well 7 - Borehole 8 - Water tank 9 - Roof catchment 10 - Other, specify How important is it to boil or filter water that will be used for drinking? 1 - Not important 2 - A little important 3 - Rather important 4 - Very important Why is it important to boil or filter water that will be used for drinking? Select all that apply. 1 - Kills germs, microorganisms 2 - Makes water safe to drink 3 - Reduces chance of illness (diarrhea) 4 - Gives water better taste 5 - Other, specify 88 - DK How important is it to boil or filter water that will be used for cooking? 1 - Not important 2 - A little important 3 - Rather important 4 - Very important Why is it important to boil or filter water that will be used for cooking? Select all that apply. 1 - Kills germs, microorganisms 2 - Makes water safe to drink 3 - Reduces chance of illness (diarrhea) 4 - Gives water better taste 5 - Other, specify 88 - DK How likely are children to get sick from drinking unboiled or unfiltered water? 1 - Not likely 2 - A little likely 3 - Somewhat likely 4 - Highly likely How long does water need to be boiled to ensure it is safe? 1 - Less than 1 min 2 - Between 2 and 3 mins 3 - 3 minutes 4 - More than 3 minutes 88 - DK Attitudes / Responsibilities Cooks are responsible for preventing food poisoning or foodborne illness. 1 - Strongly agree 2 - Agree 3 - Disagree 4 - Strongly disagree Servers are responsible for preventing food poisoning or foodborne illness. 1 - Strongly agree 2 - Agree 3 - Disagree 4- Strongly disagree Supervision and Awareness Has anyone ever come to supervise you as you prepare school meals? 1 - Yes 0 - No If yes, who has supervised you? Select all that apply. 1 - Public health inspector 2 - Ministry official 3 - School principal or head teacher 4 - Parents of students 5 - WFP officials 6 - Other, specify How often do they come to supervise you? 1 - Daily 2 - About once a week 3 - About once a month 4 - Every 3 months 5 - Every 6 months 6 - Once a year 7 - Less than once a year Are you aware someone is coming to supervise you in advance? Do they arrange it with you or is it a random drop in? 1 - Arranged supervision 2 - Random drop in What do you do to prepare for these visits? [open-ended] Access to food safety information Have you ever recieved information about food safety techniques? 1 - Yes 0 - No When was last time you received food safety information? 1 - This week 2 - Last week 3 - This month 4 - Within past 6 months 5 - Within the past year 6 - Over a year ago Who did you receive food safety information from? 1 - Public health inspector 2 - Ministry official 3 - School principal or head teacher 4 - Parents of students 5 - WFP officials 6 - Other, specify What was the information you received? [open-ended] Did you ever attend a training on food safety? 1 - Yes 0 - No >> Next section When was the last time you attended one? 1 - In past week 2 - In past month 3 - In past 6 months 4 - In past year 5 - More than one year ago Was the training provided by Public Health Inspectors? 1 - Yes 0 - No If not, who provided the training? [insert response] Where did you receive information about food safety? Select all that apply. 1 - SMP training 2 - Public Health Inspectors 3 - Other SMPs 4 - MoH materials 5 - MoE materials 6 - Other, specify Did you have any difficulty understanding the content or training materials? 1 - No difficulty 2 - Little difficulty 3 - Some difficulty 4 - A lot of difficulty 161 | AIR.ORG Evaluation of the PALAM/A Project: Baseline Report Access to food safety information Have you ever recieved information about food safety techniques? 1 - Yes 0 - No When was last time you received food safety information? 1 - This week 2 - Last week 3 - This month 4 - Within past 6 months 5 - Within the past year 6 - Over a year ago Who did you receive food safety information from? 1 - Public health inspector 2 - Ministry official 3 - School principal or head teacher 4 - Parents of students 5 - WFP officials 6 - Other, specify What was the information you received? [open-ended] Did you ever attend a training on food safety? 1 - Yes 0 - No >> Next section When was the last time you attended one? 1 - In past week 2 - In past month 3 - In past 6 months 4 - In past year 5 - More than one year ago Was the training provided by Public Health Inspectors? 1 - Yes 0 - No If not, who provided the training? [insert response] Where did you receive information about food safety? Select all that apply. 1 - SMP training 2 - Public Health Inspectors 3 - Other SMPs 4 - MoH materials 5 - MoE materials 6 - Other, specify Did you have any difficulty understanding the content or training materials? 1 - No difficulty 2 - Little difficulty 3 - Some difficulty 4 - A lot of difficulty Sri Lanka PALAM/A Program Observation Tool School Observation Checklist Instructions: Ask a member of the school staff to show you the entire school grounds and all its buildings. It is important to observe things directly. You may ask your guide questions to clarify your ratings, but you should see things yourself (not just rate based on what someone tells you). A. General Information Date of Observation Observer Name Observer Designation District Name of School Government Feeding Program  Meal  Milk/Yogurt  Meal and Milk/Yogurt Does this school currently receive any feeding assistance?  No  Yes, government program implemented by WFP  Yes, other (specify) Principal (Head Teacher) Name Principal (Head Teacher) Phone Number School’s Language of Instruction  Tamil  Sinhala  English  Mixed medium Class/Grade Levels in School Number of Primary Grade Teachers at the School Female Total Number of Students Enrolled in the School by Grade Level Female Male G1 G2 Male G3 G4 Sri Lanka PALAM/A Program Observation Tool G5 Does the school have a Health Club?  Yes  No Does the school have a child safety/protection committee?  Yes  No Congeniality Index If any circumstances affected your ability to complete this observation, please describe Time at Start Time at End GPS Coordinates Sri Lanka PALAM/A Program Observation Tool B. Main Physical School Infrastructure 1. The school grounds are clean. Cleans refers to free of litter/garbage that is not in a closed garbage container, free of insects, vermin, unwanted animals, feces, molds, and other disease vectors which lead to diarrheal diseases, acute respiratory infections, etc. If any of the above are present on the school grounds then select “No”. Yes No 2. The school grounds are safe. Safe refers to the grounds being free of large holes or pits students could fall into, the play-area is clear of hazards and hazardous materials, there is a safe boundary wall/fence around the grounds, etc. If any of the above are present on the school grounds then select “No”. Yes No 3. Dangerous materials are inaccessible to students. Dangerous materials include (but are not limited to) cleaning chemicals, bleach, highly flammable liquids like kerosene and petrol, paint thinner, etc. If any of the above are present on the school grounds then select “No”. Yes No 4. The school grounds and school buildings are free of standing water. Large areas of standing water attract vermin and transmit diseases. Standing water sources can include (but are not limited to) large puddles on the ground or roof, bowls, broken equipment and tires that collect water, etc. Select “No” if any of the above are present OR if there is so much standing water, puddles, bogs, marshland, etc. that the school grounds are fully wet (for example if a school is located on a flood plain and is accessed by boat). Yes No Sri Lanka PALAM/A Program Observation Tool C. WASH Facilities 1. School has access to any source of drinking water. Sources for drinking water may include pipes, public standpipe, borehole, protected well, bottled water, filtered water, or water treated chemically (chlorine) or boiled, as well as water taken directly from rivers, lakes, ponds, or streams (without treatment). Yes No 2. Drinking water that is available is treated to make it safe for drinking. Water that is safe for drinking is either piped, comes from a public standpipe, borehole, or protected well, or is bottled water, filtered water, water treated chemically (chlorine) or boiled. Water obtained directly from rivers, lakes, ponds, streams without treatment is NOT safe to drink. It is important to confer with school staff that the water system is functioning properly and stored properly (i.e., covered) if not piped. Yes No 3. Students have access to a sufficient amount of clean drinking water. It is recommended that everyone have access to roughly 2 litres per person per day. Drinking water should be provided at clearly marked points. If drinking water comes from the same source as water for hand washing, it has to be treated first to make it safe to drink. Again, water that was treated and is safe to drink should be clearly labeled as such. Clean drinking water should be stored properly (i.e., covered) if not piped. Yes No 4. How many drinking water points are available to students? Enter the number of drinking water points available to students. A drinking water point can be a canister or other container from which drinking water is distributed, or a water tap connected to a pipe, standpipe or borehole. A drinking water point does not include bottled water. Number: __________________________ 5. Does the school provide bottled water? Sri Lanka PALAM/A Program Observation Tool Observe whether the school offers bottled water for drinking. This may be in addition to another source of drinking water. Yes No 6. Is the drinking water source accessible to the smallest students? Drinking water source should be accessible to the youngest / shortest students in the school. A high / elevated drinking water source can be made accessible by building steps, providing a step stool or a box for the smallest children to stand on, etc. Yes No 7. Is there one or more functioning latrine on the school grounds? A functioning latrine has 3 basic characteristics: 1) The toilet slab (either the portion that the person would sit on or the ground around squat hole is level, solid and stable (no cracks, or additional holes or damage). 2) The latrine stalls are sufficiently sturdy to provide full privacy to the user. 3) The pit is not full or overflowing. If the latrines are locked and there is no key available, then the latrines are not functioning as the latrine cannot be used. YES  Continue to #8 NO  Go to #17 8. How many functioning latrines are on the school grounds? Number: __________________________ 9. Are the functioning latrines within a five minute walk of the school buildings? The furthest classroom should not be more than a five minute walk to a latrine or approximately 400 meters from classroom. Yes No Sri Lanka PALAM/A Program Observation Tool 10. The latrines can be used by the smallest students. The youngest / shortest students should be able to easily access, unlock and lock the latrine. The latrine slab should be designed to fit the youngest / shortest students in the school. Yes No 11. The latrines are accessible to students with disabilities. The latrines are accessible to students of different levels of physical ability. For examples, latrines are easy to get to, do not involve climbing many steps, steps have railings for students to hold on to for support if needed, etc. Yes No 12. The functioning latrine stalls are clean and sanitary. For latrines, clean and sanitary refers to no piles of feces or urine on the latrine slab or walls, the smell (noxious fumes) are not overwhelming and there are no piles of garbage and there is a container for paper waste or sanitary napkins. Yes No 13. There are separate, private functioning latrines for girls and boys. There are clearly labeled latrines for boys and for girls. Each of the latrines are private meaning no one can see into the latrine from the outside. Yes No 14. How many separate, private functioning latrines are there for girls and for boys? If there are clearly labeled private latrines for boys and for girls, list the number of latrines designated for boys and for girls. Number for Boys: _____________ Number for Girls: __________________ 15. There are separate, private functioning latrines for male and female teachers. Sri Lanka PALAM/A Program Observation Tool There are clearly labeled latrines for teachers only, separate from the student latrines. Each of the latrines are private meaning no one can see into the latrine from the outside. There are dedicated latrines for male and female teachers. Yes No 16. How many separate, private functioning latrines are there for male and female teachers? If there are clearly labeled private latrines for boys and for girls, list the number of latrines designated for boys and for girls. Number for Male Teachers: _____________ Number for Female Teachers: __________________ 17. Clean water for hand washing is located in close proximity to the latrines. Close proximity for water for hand washing refers to hand washing stations being within 10 meters of the latrines to encourage students and staff to them to use water as often as required. Hand washing points include pitcher of water and basin; small tank/jerry can fitted with a tap; a tippy tap (gourd or plastic bottle with a rope that pours a small stream) or a traditional sink and faucet system. If the school does not have latrines, observe handwashing stations in general (without taking proximity to latrines into account). Yes No 18. Handwashing stations are accessible to the smallest students. Handwashing stations should be accessible to the youngest / shortest students in the school. A high / elevated handwashing station can be made accessible by building steps, providing a step stool or a box for the smallest children to stand on, etc. Yes No 19. Soap is available for hand washing at the handwashing stations. Yes No 20. There is functioning wastewater drainage system in use at hand washing and drinking water points. All water points should have a functioning drainage system to avoid the collection of standing water which attracts vermin and transmits diseases. Functioning wastewater drainage includes a soak pit (a large collection of rocks at least 4 inches deep under the water point), drains for directing water away from the school, etc. If there are no hand washing or drinking water points on the school grounds then select “No”. Sri Lanka PALAM/A Program Observation Tool Yes No 21. WASH facilities are cleaned regularly. While the cleaning of handwashing stations and latrines may not happen during your observation, note whether a cleaning schedule for latrines and handwashing stations is posted or otherwise available in the school. You may need to ask the teacher / staff to show you the schedule. Additionally, you can observe where cleaning equipment (e.g., mop, aseptic cleaning liquids) is stored. Yes No 22. Solid waste is segregated and stored by type. Solid waste is sorted and stored by type: paper, glass, plastics, wood, scrap metal, biodegradable waste. Yes No 23. How often is the solid waste disposed of? While solid waste disposal may not occur during your observation, you may talk to the teacher / staff about the frequency of solid waste collection by local authorities (if any). Solid waste disposal includes composting of biodegradable waste. Daily Weekly Monthly Other, specify D. School Meal Preparation Most schools in Kilinochchi and Mulaitivu districts have food preparation facilities and SMPs may prepare food on premises. Complete this section if food preparation occurs on school grounds. Otherwise, go to Section E. You should observe the food preparation for a 15-minute period when ingredients are prepared for cooking and once the cooking is underway to verify that foods are being fully cooked. Sri Lanka PALAM/A Program Observation Tool 1. School meal preparation takes place on school grounds. Yes  Continue to #2 No  Go to Section E 2. There is no debris, dirt, or standing water in food preparation areas. Debris refers to items that do not belong in food preparation areas including trash, food scraps, sticks, grass, animal droppings, etc. which have the potential to contaminate the food being prepared. All water points should have a functioning drainage system to avoid the collection of standing water which attracts vermin and transmits diseases. Functioning wastewater drainage includes a soak pit (a large collection of rocks at least 4 inches deep under the water point), drains for directing water away from the school, etc. Standing water does not include water in pots currently being used for cooking/food preparation purposes, but does include water left in cooking pots one hour or more after cooking/food preparation is complete Yes No 3. The food preparation area is free of free-roaming animals. There are no animals in food preparation areas to prevent contamination of the food. “Animals” refers to both domestic and wild animals including chickens/roosters, goats, cows, buffalo, sheep, pigs, dogs, cats, etc. that may wander into/through the food preparation area. If an animal does wander in, the staff should shoo it out immediately and throw away any food items that came in contact with the animal. Yes No 4. The food preparation area is separate from eating, classroom, play and toilet areas. There is a clear distinction between where the food is being prepared and where children and staff are eating meals. Similarly, children play and study at least 15 meters from where food is being prepared to reduce risk of injury and food contamination. Latrines should also be at least 15 meters from food preparation areas. Yes No Sri Lanka PALAM/A Program Observation Tool E. Classroom Infrastructure Instructions: Observe the physical infrastructure of the classroom. 1. Classrooms are in good physical/structural condition. Good physical/structural condition includes floors that are free from cracks, holes, there are no problems with dampness, splinters, sliding floor coverings, sharp stones; no broken windows, no holes in the roof, walls are structurally sound (no holes or crumbling), walls have no peeling paint, supports for roof and/or walls are sturdy, etc. Not at All True A Little Bit True Mostly True Very True The classrooms have significant physical/structural issues that threaten the safety of students. The classrooms have several minor physical/structural issues. The classrooms have one or two minor physical/structural issues. The classrooms have NO problems with physical/structural conditions. 2. Classrooms are protected from the elements (sun, rain) with a good roof. Protection from the elements includes protection from rain and protection from the sun while in the classroom. Not at All True A Little Bit True Mostly True Very True None or very little (10% or less) of the classroom area is protected from the elements. Some (11-50%) of the classroom area is protected from the elements. Most (51-89%) of the classroom area is protected from the elements. All or almost all (90% or more) of the classroom area is protected from the elements. 3. Classrooms are protected from flying insects with screens on windows. Not at All True A Little Bit True Mostly True Very True None or very little (10% or less) of the windows in the classroom are Some (11-50%) of the windows in the classroom are protected from insects with screens. Most (51-89%) of the windows in the classroom are protected from insects with screens. All or almost all (90% or more) of the windows in the classroom are Sri Lanka PALAM/A Program Observation Tool protected from insects with screens. protected from insects with screens. 4. In classrooms, there is enough light to read a written page. Not at All True A Little Bit True Mostly True Very True None or very little (10% or less) of the classroom area has enough light to read a written page. Some (11-50%) of the classroom area has enough light to read a written page. Most (51-89%) of the classroom area has enough light to read a written page. All or almost all (90% or more) of the classroom area has enough light to read a written page. 5. Students have adequate space to do learning activities. Adequate space (at a table or desk or on the floor) means that students would be able to comfortably open a book or work with materials (blocks, puzzle, etc.) without bumping into another student. Rate this item based on the space available in the classroom regardless of whether the teacher does these kinds of activities. Not at All True A Little Bit True Mostly True Very True Students have no table/desk/mat on which to work (could only put materials on their laps). Students have table/desk/mat on which to work, but classroom too crowded for them to do activities without bumping into each other. Students have table/desk/mat on which to work, and there is space for some (but not all) to work without bumping into each other. Students have table/desk/mat on which to work, with adequate space for all students to do activities. 6. Students in the class are protected from outside noise. People in the classroom should hear one another when speaking at a normal volume. Not at All True A Little Bit True Mostly True Very True Students in the class are protected from noise 10% or less of the lesson time. Students in the class are protected from noise some (11- 50%) of the lesson time. Students in the class are protected from noise most (51- 89%) of the lesson time. Students in the class are protected from noise almost all or all (90% or more) of the lesson time. F. Literacy Environment Sri Lanka PALAM/A Program Observation Tool Instructions: Observe the reading materials that are relevant and appropriate for primary school children at the school and whether the children engage with these materials. 7. The school has a library or a reading room. The school has a separate room where children can access and read books, , pamphlets, and other educational material that is relevant and appropriate to primary school children. Materials can be either open access (not locked in cupboard) or restricted access (students have to ask the teacher / librarian for permission to use a book). Yes  Go to #33 No  Continue to #32 8. Classrooms in the school have reading corners. There is a space in the classroom where children can access and read books, pamphlets, and other educational material that is relevant and appropriate to primary school children. Materials can be either open access (not locked in cupboard) or restricted access (students have to ask the teacher / librarian for permission to use a book). Yes No  Go to #37 (Health Clubs) 9. The library or reading room has a book borrowing mechanism that allow children to take books out to read after school or at home. There is a mechanism through which children can borrow materials from the library or reading room, either to take home or to read on school premises after school. Yes No 10. How many reading materials are available in the library, reading room, or reading corner? (other than text books – any other suitable/relevant reading materials for primary grade children) Less than 5 5-10 10-15 15-20 More than 20 11. The reading materials are available to children in Sinhala, Tamil or English. Sri Lanka PALAM/A Program Observation Tool The library, reading room, or reading corner has books, textbooks, pamphlets, and other educational material that is relevant and appropriate to primary school children in Tamil, Sinhala, or English. Select all that apply. Sinhala Tamil English Sri Lanka PALAM/A Program Observation Tool About the American Institutes for Research Established in 1946, with headquarters in Arlington, Virginia, the American Institutesfor Research® (AIR®) is a nonpartisan, not-for-profit organization that conducts behavioral and social science research and delivers technical assistance to solve some of the most urgent challenges in the U.S. and around the world. We advance evidence in the areas of education, health, the workforce, human services, and international development to create a better, more equitable world. The AIR family of organizations now includes IMPAQ, Maher & Maher, and Kimetrica. For more information, visit AIR.ORG. 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