Quality of Home Packed School Lunch Among Children Attending Kindergarten School in Jimma Zone, South West Ethiopia, 2026

Mean School-Lunch Dietary Diversity Score (mDDS)

The nutritional quality of home-packed school meals (including snacks and lunches) will be assessed using a structured parent reported lunchbox inventory over two non-consecutive school days. The score is calculated based on the presence of 9 distinct food groups adapted from the FAO(Food and Agriculture Organization)/WHO(World Health Organization) dietary diversity indicators: Starchy staples (grains, roots, tubers) Legumes and nuts Dairy products Flesh foods (meat, poultry, fish) Eggs Vitamin A-rich fruits and vegetables Dark green leafy vegetables Other vegetables Other fruits. For each observation day, a score is calculated (Range: 0-9). The final primary outcome is the mean score across the two data collection days. A higher score represents a more diverse and higher-quality school meal.

Child's Healthy Dietary Preference Score

Children's preferences for healthy versus unhealthy foods will be assessed using a pictorial tool adapted for the local Ethiopian context. Children are presented with 10 pairs of standardized images (one nutrient-dense item and one energy-dense/processed item). For each pair, the child selects their preferred item. A score of 1 is given for each healthy choice. The total score ranges from 0 (lowest preference) to 10 (highest preference). The outcome is the change in the mean score from baseline to endline. A higher score indicates a stronger preference for healthy dietary options.