Impacts of Global School Feeding Programmes on Children's Health and Wellbeing Outcomes: A Scoping Review.

Objectives: School feeding programmes (SFPs) are widely implemented to address child poverty, food insecurity and malnutrition, yet evidence on their influence on children's health outcomes is limited. With ongoing debate around universal versus targeted provision, this scoping review aims to map global literature on SFPs, identify which health and well-being outcomes are reported, and explore how these outcomes vary by programme type (targeted vs universal).

Design: Scoping review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The protocol was pre-registered on the Open Science Framework.

Data sources: Four electronic databases-Medline, PubMed, Web of Science and Google Scholar-were searched in December 2023 and July 2025. Reference lists of included papers were also screened.

Eligibility criteria: Included studies examined the impact of SFPs on physical, emotional, psychological and social health outcomes in children aged 5-16. Only English-language studies published between 2009 and 2025 were included.

Data extraction and synthesis: Data were extracted using a structured template and reviewed by multiple authors. Due to the heterogeneity in study designs and reported outcomes, a narrative synthesis approach was used to group findings thematically, following established guidance for narrative synthesis in systematic reviews.

Results: A total of 44 papers were included in the final review, spanning 13 countries and published between 2009 and 2025. SFPs were associated with healthier weight status, improved dietary intake, better social engagement and reductions in stigma. Targeted programmes addressed food insecurity but were more often linked to stigma and poorer mental health outcomes.

Conclusions: Universal SFP were effective at improving children's health outcomes such as healthy weight, improved behaviour and social support. Overall, both targeted and universal SFP positively impact children's health outcomes and address health disparities.