(P22-05-26) Implementation Lessons From the United States National School Lunch Program for the Ghana School Feeding Programme: A Qualitative Study

Objectives: The Ghana School Feeding Programme (GSFP) faces challenges related to program design, funding, and implementation. In contrast, long-standing programs such as the United States National School Lunch Program (NSLP) are advanced in these policy domains. This study explored the implementation strengths and operational enablers of the NSLP to derive lessons applicable to the GSFP.

Methods: A qualitative study was conducted. Key respondents included school district nutrition directors or managers, kitchen managers and staff, and state child nutrition program officials with at least one year of NSLP experience. Key respondents were purposively recruited and completed semi-structured interviews. Interviews were audio-recorded, transcribed verbatim, and de-identified. Two coders independently analyzed transcripts using reflexive thematic analysis guided by the Consolidated Framework for Implementation Research and appreciative inquiry.

Results: Eight key respondents participated in the interviews. Key respondents represented school-district operations and state child nutrition agencies in Oklahoma and Kansas, with a median professional experience of 13 years (range: 3–27). Five interrelated themes describing enablers of NSLP implementation emerged: (1) policy and regulatory influences, including federal meal standards and oversight; (2) program funding and financial management supported by federal reimbursements, grants, and commodity programs; (3) internal support environment characterized by collaborative leadership and staff capacity development; (4) external support and partnerships with community organizations and advocacy groups; and (5) feedback mechanisms such as stakeholder engagement and continuous program evaluation.

Conclusions: Implementation of the NSLP is described to supported by strong policy frameworks, diversified funding mechanisms, institutional support, active advocacy and stakeholder engagement. These findings provide insights that may inform efforts to strengthen the design and implementation of the GSFP. Future research should assess the readiness of the GSFP community and leadership to develop, adopt, and sustain interventions that address existing implementation challenges and improve the nutritional quality of school meals.

Funding Sources: No external funding