National Policies for Improving Micronutrient Intake in School Meals: A Global Cross-Sectional Study

Malnutrition, including overnutrition, undernutrition, and micronutrient deficiency, remains a major global public health challenge, closely linked to food insecurity. Among children, micronutrient deficiencies can impair cognitive development, making effective national policies vital to guide in-school micronutrient supplementation within school meal programs. This study aimed to assess how national policies on school feeding, nutrition, health, food safety, agriculture, and private sector engagement influence the implementation of micronutrient supplementation in school meal programs across countries.

The study employed the Bayesian Mindsponge Framework, which combines the Granular Interaction Thinking Theory with Bayesian inference techniques. A dataset comprising responses from 126 government representatives (n = 126) responsible for large-scale school meal programs across 126 countries was analyzed to estimate the effects of various national policy domains on micronutrient supplementation outcomes.

Findings revealed that school feeding policies have a small but positive effect on the implementation of micronutrient supplementation (β = 0.12, SD = 0.10). In contrast, nutrition policies exhibit a slight negative association (β = -0.12, SD = 0.10). Other policies, including those related to health, food safety, agriculture, and the private sector, demonstrated minimal or negligible influence.

The study underscores the positive contribution of school feeding policies in promoting micronutrient supplementation within school meal programs. However, the negative association of nutrition policies suggests the need for critical policy reassessment to ensure coherence and effectiveness. Strengthening cross-sectoral linkages, particularly among health, food safety, agriculture, and private sector policies, may further enhance micronutrient intake and improve child health outcomes globally.