27 ....................................................................................................................................... Location: Bangladesh What we know: School feeding programmes have the potential to improve child nutrition status, school attendance and achievements, and therefore to improve to future wellbeing and productivity. What this article adds: In Bangladesh undernutrition is prevalent among schoolchildren as evidenced by indicators of underweight (42%), stunting (31%) and wasting (28%) in girls aged 5 to 10 years as well as defciencies in iodine, vitamin A, iron, calcium and zinc. In a small cross-sectional survey, data were collected from mothers/caregivers in 71 households with children participating in an existing World Food Programme-supported pilot school midday meals (MDM) programme, versus 40 non-MDM households. Results revealed higher intakes of energy, calcium and vitamin A among MDM schoolchildren (although numbers are small and so should be interpreted with caution). ree focus group discussions with mothers/caregivers and local female vegetable growers (n=22) revealed perceptions of school meals as monotonous, with demand for a wider variety of nutritious foods. New menus were developed at the same/similar cost to provide approximately 30%, 39%, 30%, 56%, 43%, 32% and 14% of recommended daily allowance (RDA) for dietary energy, protein, fat, iron, zinc, vitamin A and calcium, respectively. ese new menus now require feld testing. Background Early-life malnutrition is reported to have long-term consequences. Improve- ments in height-for-age in pre-schoolers are linked with increased height as young adults and increased number of school grades completed (Alderman et al, 2006). A recent review commissioned by the World Bank and World Food Programme (WFP) reported that school feeding programmes increase school attendance, cognition and educational achievement, particularly if supported by complementary actions such as de- worming and micronutrient fortifcation or supplementation (Bundy et al, 2009). In response to such evidence and preva- lent undernutrition, the Government of Bangladesh (GoB) and WFP launched a school feeding programme (SFP) in 2002, through which fortifed biscuits were distributed to primary school- children in poverty prone areas of Bangladesh to improve child nutrition status. To complement this initiative, a partnership was formed in between GoB, Global Alliance for Improved Nu- trition (GAIN) and Dubai Cares in 2011 to implement a pilot School Nutrition Project (SNP) in both rural and urban areas of Bangladesh to provide cooked midday meals (MDM) in primary schools. A ‘cluster kitchen model’ was used whereby one basic kitchen provided a meal (oen ‘khichuri’, made from rice, lentils or other pulses with added veg- etables) to 1,500 to 2,500 students from fve to six schools, using domestically produced and locally available ingre- dients cooked on traditional stoves. is model reduced dependence on electricity and ensured quicker delivery of food (within 40 to 60 minutes) com- pared to a large, centralised kitchen; avoided the need to build kitchen ex- tensions in schools; reduced costs per school of kitchen workers; and avoided disturbing schoolteachers from their primary duty of teaching. Research showed that the nutrition status of chil- dren in participating schools, as well as school enrolment and attendance rates, improved signifcantly (Afroze & Tukun, 2014). e WFP supported programme continues to run in selected areas of Bangladesh and the GoB is now formulating a national school feed- ing policy and a plan for scale-up. To inform this process, GAIN conducted the current study to develop an ac- ceptable and cost-effective MDM menu, taking into consideration the menus from the pre-existing programme. Methods A literature review was conducted to investigate the prevalence of undernu- trition and micronutrient defciencies of Bangladeshi primary school-age chil- dren. A pilot study that included a cross- sectional survey was then carried out among 111 mothers and caregivers in 71 pilot MDM households (of randomly selected students from a primary school in Bamna, sub-district of Borguna dis- trict, with the MDM programme) and 40 non-pilot households (of students from the nearest school from the adjacent sub-district with no MDM programme) to estimate energy, calcium and vitamin A intakes using the 24 hour-recall Weekly menu for midday meal in Bangladeshi schools: Caregivers’ choices By Abu Ahmed Shamim, Jannaty Mayna, Ishrat Jahan, Syed Muntasir Ridwan and Rudaba Khondker Abu Ahmed Shamim is the Nutrition Advisor (Consultant) at the Research and Evaluation Division of BRAC. He has previously managed nutrition programmes and research projects at the Bangladesh National Nutrition Council, CARE, Johns Hopkins University, FHI 360 and Helen Keller International. Jannati Mayna has a Master’s degree in Nutrition and Food Science from the Institute of Nutrition and Food Science, Dhaka University and is currently serving as a lecturer at the Khulna City Corporation (KCC) Women’s College, Khulna, Bangladesh. Syed Muntasir Ridwan works at the Global Alliance for Improved Nutrition (GAIN), conducting research in health economics, econometrics and behavioral economics. Dr Rudaba Khondkar is the Country Director of GAIN, Bangladesh. She is a Medical Doctor with expertise in pediatrics and over 15 years’ experience in humanitarian and development with Concern Worldwide, Save the Children, UNICEF and BRAC in Asia, Africa and the Pacific. Dr. Ishrat Jahan studied dental surgery (BDS) and public health (MPH) form James Pitter Grant School of Public Health, BRAC University and is currently working as a researcher at the ARK Foundation, Dhaka, Bangladesh. The authors wish to acknowledge the financial and technical support of GAIN, Bangladesh. However, the views expressed are the responsibility of the authors and do not necessarily reflect the view of GAIN. The writers also acknowledge the insights provided by Dr. Mahbubur Rashed, Ex Head of Programme, GAIN, Bangladesh, and the support of the District Coordinator (Sherina Akther), Shushilan Barguna and the field-team of the School Meal Programme Bamna Barguna. Jannati Mayna Interview procedure being explained to the a mother, Barguna, Bangladesh, 2017 ............................................................................... Research