School feeding in low-income countries  School feeding programs have been defined by the World Bank as "targeted social safety nets that provide both educational and health benefits to the most vulnerable children, thereby increasing enrollment rates, reducing absenteeism, and improving food security at the household level". Beyond improvements in access to food, school feeding programs also have a positive impact on nutritional status, gender equity, and educational status, each of which contributes to improving overall levels of country and human development. While school meals are provided by the governments of most high and middle-income countries around the globe, the children who may benefit most from school feeding programs are in low-income countries that do not have government-provided school meals. School feeding in low-income countries often starts through funding by international organizations such as the United Nations World Food Programme or the World Bank or national governments through programs such as the McGovern-Dole International Food for Education and Child Nutrition Program. However, some governments have first started school-feeding programs and then requested the help of these organizations and programs. Additionally, many countries have "graduated" from their dependency on foreign assistance by reshaping their school feeding programs to be country-led and self-supported. While there are school feeding programs in a number of countries, each program varies widely from country to country in design, implementation, and evaluation. Thus, literature reviews and studies often focus on a small number of countries, as school feeding is not a uniform unit of intervention and cannot be compared or assessed on an international scale. According to the United Nations World Food Programme, 66 million primary school age children go hungry every day, with 23 million hungry children in Africa alone. Furthermore, 80% of these 66 million children are concentrated within just 20 countries. Additionally, 75 million school-age children (55% of them girls) do not attend school, with 47% of them living in sub-Saharan Africa. Thus, the need to reduce hunger while increasing school enrollment in these children is evident, and school feeding programs have been developed to target this multifaceted problem. Schools have become a natural and convenient setting for the implementation of health and education interventions. School feeding is just one facet of school health initiatives, as other programs may include de-worming, HIV/AIDS prevention and education, and life and health skills education. Overall, school feeding programs have been shown to directly increase the educational and nutritional status of recipient children, and indirectly impact the economic and social lives of themselves and their family. Additionally, school feeding directly addresses the Millennium Development Goals (MDGs) of reducing hunger by one-half, achieving universal primary education, and achieving gender parity in education by 2015.