, Volume 47, Issue 3, pp 245–256 | Cite as

Food for Education in Honduras: Psychosocial correlates of childhood literacy

  • Thomas M. CreaEmail author
  • Antonia Eliana Diaz-Valdes
  • Elizabeth Gruenfeld
  • José Acevedo
  • Blain Cerney
  • Marlon Medina
  • Glenda Hernandez
  • Olga Canelas


School feeding programs in low- and middle-income countries tend to focus on school attendance and literacy. Some evidence suggests that bolstering schools as a nexus of community plays an important psychosocial function for children and families. This study examines the extent to which childhood literacy rates are associated with parents’ and teachers’ perceptions of community violence and cohesion, following participation in a large-scale school feeding program in the Department of Intibucá, Honduras. Primary school children (n = 3,147) from 176 schools completed standardized literacy tests. Scores were linked to parents’ (n = 328) and teachers’ (n = 537) responses about community cohesion and violence. Social bonding among parents was positively associated with children’s literacy. Community violence reported by teachers exerted a negative influence. The authors discuss these results in light of how vertically focused interventions such as school feeding can be integrated to account for the specific contextual factors that affect, and are affected by, the program itself.


School feeding Central America Honduras Psychosocial Food for Education Primary schools Program design 

The fields of humanitarian aid and development are increasingly adopting a systems approach to intervention, versus focusing on single-issue, or vertical, programs (Kamath and Jense 2010). A clearer understanding of the benefits and drawbacks of vertical programming compared with integrated programs (Atun, de Jongh, Secci, Ohiri, and Adehi 2010)—in what is sometimes termed a “wraparound approach” to service delivery (Bruns, Hyde, Sather, Hook, and Lyon 2016)—is largely driving this shift. School feeding programs, in particular, tend to narrowly focus on school enrolment, attendance, and literacy (Alderman and Bundy 2012), in spite of evidence that these programs can also improve student behavior (Kristjansson et al. 2009) and serve as a source of psychosocial support for children and families (Houinato and Maclure 2002; Retamal and Low 2010). Yet, very few researchers have examined the unintended benefits of school feeding programs or the contextual factors that contribute to or hinder their success (Kristjansson et al. 2009). Likewise, few have explored the unintended benefits of vertical programs in domains that were not the focus of intervention (Kuziemsky, Borycki, Nøhr, and Cummings 2012) or the extent to which unanticipated benefits or contextual challenges may, in turn, influence program goals. Our purpose in this study is twofold: (1) to examine childhood literacy rates associated with implementation of a large-scale school feeding program in the Department of Intibucá, Honduras; and (2) to explore the extent to which children’s literacy is associated with parents’ and teachers’ perceptions of the program’s impacts for children, parents, school, and the community.

School feeding programs and Food for Education (FFE)

In the context of low- and middle-income countries (LMIC), malnutrition is a significant barrier to the accomplishment of the United Nations’ Education for All (EFA) goals (UNESCO 2012, 2016). Food insecurity worldwide has increased since the economic crisis of 2008, especially for the world’s most vulnerable populations (Vilar-Compte, Sandoval-Olascoaga, Bernal-Stuart, Shimoga, and Vargas-Bustamante 2015), with significant negative implications for children’s health and education (Jyoti, Frongillo, and Jones 2005). In this context, Food for Education (FFE) programs—school feeding programs that provide agricultural commodities as well as technical assistance and financial support (USDA 2016; WFP 2007)—gain increased importance (Bundy et al. 2009).

FFE programs promote household investment in the “human capital” of their children through engagement in children’s education, which, in turn, should encourage children’s school enrolment and attendance (Alderman and Bundy 2012; Cheung and Perrotta 2010; WFP 2007). Investing in human capital through school feeding is typically considered a long-term economic goal to reduce poverty and alleviate hunger among schoolchildren (Alderman and Bundy 2012) and to foster larger-scale economic growth through elevating nutrition and health (Martorell 1999). Therefore, FFE programs may lead to both economic growth and social equity (Alderman and Bundy 2012; Martorell 1999), and, presumably, to greater social stability.

FFE programs also demonstrate immediate and practical benefits for families and communities. Parents are more likely to send their children to school when the direct costs of sending them, in terms of their contributions to the household, are lower than the benefits received in terms of food provision and prospects for the future (Alderman, Gilligand, and Lehrer 2012). For example, in-school FFE programs typically provide children with a meal or snack served in school, which the literature shows to be effective incentives to enrolment and attendance (Alderman et al. 2012; Bundy et al. 2009; Cheung and Perrotta 2010).

The effectiveness of these programs for increasing literacy, however, remains in debate, as their implementation tends to differ significantly by context, provision, community support, and other factors. A systematic review of school feeding programs in LMIC found that children fared better in math assessments yet made comparatively smaller increases in cognitive functioning (Kristjansson et al. 2009). Similarly, in a multicountry review, Bundy and colleagues (2009) found strong improvements in math scores but weak improvements in literacy scores. In Cambodia, Cheung and Perrotta (2010) found no significant improvement in school performance. By contrast, researchers in Pakistan found that girls improved, on average, 20% in literacy skills (USDA 2013), and researchers in Guatemala (Crea, Gruenfeld, and Acevedo 2015) and Honduras (Crea et al. 2016) similarly found significant increases in reading comprehension over time, associated with FFE program implementation. Overall, there is mounting evidence suggesting that FFE programs help children enrol in school and remain there, alleviate hunger, avoid short-term cognitive impairment, and improve cognitive performance. The findings concerning impacts of school feeding on literacy, however, remain more mixed.

Psychosocial correlates of school feeding in LMIC

Food insecurity affects children’s well-being in terms of psychosocial, cognitive, and educational outcomes. Studies have associated poor nutrition and hunger with heightened anxiety, aggression, and mental health problems (Jyoti et al. 2005; Kleinman et al. 1998), as well as difficulties with peers (Alaimo, Olson, and Frongillo 2001). Kristjansson and colleagues (2009) found evidence that school feeding may positively impact classroom behavior among school-age children in LMICs, but they also stated that we need further research to disentangle the relationship amongst hunger, school feeding, and psychosocial outcomes.

Regarding humanitarian aid and development, school feeding can act as a safety net for the children and their families. In contexts where children experience frequent disruptions to their daily lives and/or frequent exposure to violence, school can provide a space for safety (Houinato and Maclure 2002; Retamal and Low 2010). Retamal and Low (2010) present the school, in this context, as a safe space that provides children with hygiene, education, and therapeutic activities, and as a place of gathering for community members and aid agencies, all striving to protect and support the children. Houinato and Maclure (2002) discuss the implementation of a FFE program in Sierra Leone during the 1999 conflict, when many children faced violence, the traumatic loss of relatives, and displacement along with their families. Researchers concluded that the return to school served as a healing intervention, where children and their families perceived the reestablishment of a structured educational environment as hope for the future and a meaningful benefit for all community members (Houinato and Maclure 2002).

The existing literature on FFE in LMICs shows that, in the short term, these programs help to alleviate hunger amongst undernourished children and improve school enrolment and attendance. Evidence also suggests that FFE can improve psychosocial outcomes and provide a safety net that helps children and families to strengthen resilience, with mixed findings on the effectiveness of achieving literacy. Our current, dual purpose is to examine literacy rates for primary school children associated with implementation of a large-scale FFE program in Intibucá, Honduras, and to investigate the extent to which children’s literacy is associated with parents’ and teachers’ perceptions of FFE’s impacts for children, parents, school, and the community. Our specific research questions are as follows:
  1. (1)

    What are parents’ perceptions of FFE’s impact on children, parents, and communities?

  2. (2)

    What are teachers’ perceptions of FFE’s impact on children, parents, and communities?

  3. (3)

    What is the relationship between parents’ and teachers’ reports of FFE’s perceived impacts, and the literacy rates of individual children?


The Department of Intibucá, Honduras

Honduras is a country in Central America that faces high rates of poverty and violence, and low rates of literacy. In 2014, the poverty rate in Honduras was 63.0% (INE n.d.). According to the World Bank (2016), one of the main causes of the country’s low economic growth is its crime rate, amongst the highest in the world. Honduras has a rate of 60 homicides per 100,000 inhabitants (UNAH 2016), while the threshold for homicide rates considered high worldwide is 20 per 100,000 inhabitants (World Bank 2016). By comparison, high-income countries on average have a homicide rate of 2.2 per 100,000; middle-income countries, 6.6 per 100,000; and low-income countries, 11.4 homicides per 100,000 (World Bank 2016). Between 2014 and 2015, reports of attacks and maltreatment in Honduras increased by 39.8% (18,450 cases). Most of those attacks were physical harm (56.7%), followed by sexual assaults (16.4%); 15.2% of the attacks were aggressions against women. The country is divided into 18 departments and each department is subdivided into municipalities. The Department of Intibucá—the location of this study—experiences 33.1 homicides per 100,000 inhabitants (UNAH 2016), one of the lower rates in the country (UNAH 2016). In terms of literacy, in 2014 Hondurans had on average 7.8 years of education, the illiteracy rate was 12.8% (for people age 15 or older), and approximately 92% of primary school–aged children were enrolled in school (INE n.d.). These indicators had improved since 2009, when the illiteracy rate was approximately 16.4% for Intibucá (Municipio de Intibucá 2015) and 15.6% for the country overall (INE n.d.).

Food for Education (FFE) Honduras

The United States Department of Agriculture (USDA) funds the Food for Education program in Honduras, under the McGovern-Dole International Food for Education and Child Nutrition Program. This program concentrates on school literacy, enrolment, and attendance through providing school feeding, teacher training, hygiene, and school infrastructure support to 19 countries (USDA 2014). In Honduras, since 2012, Catholic Relief Services (CRS) Honduras—coordinating with their implementing partners, the Social Pastoral of the Diocese of Santa Rosa de Copán (Caritas SRC) and the Central Committee for Water and Integrated Development in Intibucá (COCEPRADII, for its acronym in Spanish)—has implemented FFE in the 17 municipalities of the Department of Intibucá, each year reaching over 50,000 students and 2,000 teachers in 1,047 schools. As in other FFE programs funded by USDA, CRS Honduras oversaw teacher training, infrastructure support, and school feeding, recruiting and training parent volunteers in food preparation and hygiene to serve food to students on a daily basis.

The USDA, through CRS Honduras and their implementing partners (Caritas SRC and COCEPRADII), provides commodities for basic food rations. Basic rations consist of corn soy blend (CSB), vegetable oil, red beans, yellow corn, and rice. Occasionally, the Honduran government also gives funds for local purchases of vegetables, fruits, and other local foods. Some ingredients, such as sugar and spices, the parents provide. The number of parent volunteers (mostly mothers) who work in schools depends on the size of the schools. For small schools, 1 parent cooks for 15–30 children. Some schools with more than 50 students will have, during the week, several volunteer groups of 3–6 mothers each. Parent volunteers work at least 1 day a week, for about 4 hours per day. Parents do not receive remuneration for this work, but the program provides take-home rations for some volunteers (such as those who serve on school feeding committees). To date, CRS has given take-home rations to 15,000 volunteers.

Results from evaluations of FFE in Honduras from 2012 to 2015 (Crea et al. 2016) show significant gains in literacy over time, associated with FFE implementation. Children’s literacy rates at endline increased to 42.5%, from 21.8% at baseline and 41.3% at midterm; girls consistently scored higher than boys at each time point (p < .001). Over 90.0% of the children attended school at each time point. The current study uses data collected through the final evaluation of FFE.



From a population of 1,047 schools in the 17 municipalities of Intibucá, we randomly selected 176 schools for inclusion in the study. For larger schools, we randomly chose 22 students for inclusion, using preexisting school rosters. For smaller schools, we invited all second-, third-, and fourth-grade students to participate. All children assented to participation, and all parent volunteers present during data collection provided consent. The final sample of students totaled n = 3,147. At each school, we invited teachers (grades 2, 3, and 4) to participate (n = 328). Principals also invited parent volunteers to participate at each school, for a convenience sample (n = 537).


Trained assessors gave each child the Early Grade Reading Assessment (EGRA) test customized for Honduras by the US Agency for International Development (USAID). Assessors employed EGRA to assess literacy skills, using a series of subtasks (Dubeck and Gove 2015). For this study, the EGRA reading comprehension score constitutes the dependent variable, measured by a child’s ability to read a short passage and answer questions correctly about the content. If a child scores 5 out of 5 on the reading comprehension score, s/he is considered literate (1 = literate, 0 = not literate).

Using questionnaires, assessors asked parents and teachers questions related primarily to program implementation but also to community cohesion and perceived violence in the community. Anecdotal reports to CRS Honduras prior to the final evaluation indicated a concern about community violence, such that CRS implemented community patrols to ensure greater security for community members on the way to and from school. We scored each question in this study on a 5-point Likert scale. Question examples include: “Having a complementary meal at school helps my child pay more attention in the classroom” (for parent respondents); “FFE project activities have helped to reduce violence among students while at school” (for parent and teacher respondents); and “FFE project activities have strengthened the wider community” (for parent and teacher respondents).


We averaged parent and teacher responses at the school level and then linked these school-level values to individual children’s EGRA scores within schools. We used generalized linear mixed statistical models to account for autocorrelation of children (level 1) within schools (level 2) within municipalities (level 3). Independent variables included child’s age (in years); gender (female = 1); child’s grade (grade 4 and grade 3, each compared with grade 2); rural school (vs. urban); number of teachers in the school; and 5-point Likert scale variables measuring parents’ and teachers’ perceptions of how the FFE program influences the community, and their perceptions of community violence.


Of the 3,147 children in the sample, 1,330 (42.3%) scored 100.0% on reading-comprehension literacy (see Table 1). Bivariate analyses showed that girls accounted for less than half of the study sample (48.6%) but were more likely to be literate (52.2%; p < .001; see Table 1). Children in grade 4 were more likely to be literate than those in grades 2 or 3 (p < .001). Rural schools accounted for 93.7% of schools overall but were underrepresented among children achieving literacy (91.4%; p < .001). Nearly half of schools (49.5%) had 3 or more teachers, with 39.3% having 2 teachers and 11.2% having 1 teacher. Schools having 3 or more teachers were more likely to have children achieving literacy (54.4%) compared with those with fewer teachers (p < .001). Higher parent opinions of their child’s paying more attention and learning more were each associated with lower literacy rates (p < .01). Higher teacher opinions that teachers face security issues on the way to school were associated with lower literacy rates (p < .001), as were parents’ opinions that the program helps reduce violence among students (p < .001). Higher parents’ and teachers’ opinions that the program helps improve parents’ relationships with one another were each associated with lower literacy (p < .05). Higher parents’ opinions that FFE helps the wider community were also associated with lower literacy (p < .001).
Table 1

Bivariate relationships with literacy (n = 3,147 children)



(n = 3,147)

Mean (SD) or %


(n = 1,330)

Mean (SD) or %

Not literate

(n = 1,817)

Mean (SD) or %

Child Level

Gender (female)***





2nd Grade




3rd Grade




4th Grade




School Level (average scores on Likert scales)

Rural School (vs. urban)***




Teachers per school***










Three or more




Child pays more attention (parents)***

4.51 (0.47)

4.48 (0.45)

4.54 (0.47)

Child has learned more (parents)**

4.54 (0.46)

4.52 (0.47)

4.56 (0.45)

Food preparation is well organized (parents)

4.41 (0.56)

4.40 (0.51)

4.42 (0.60)

Food preparation is done by community (parents)**

4.49 (0.47)

4.46 (0.45)

4.51 (0.47)

Children face security issues (parents)

1.68 (0.62)

1.69 (0.63)

1.67 (0.62)

Children face security issues (teachers)

2.07 (0.72)

2.07 (0.70)

2.06 (0.73)

Teachers face security issues (parents)

1.60 (0.59)

1.60 (0.58)

1.60 (0.59)

Teachers face security issues (teachers)***

1.74 (0.74)

1.68 (0.67)

1.78 (0.78)

FFE helps reduce violence (parents)***

4.28 (0.53)

4.23 (0.51)

4.33 (0.53)

FFE helps reduce violence (teachers)

4.34 (0.60)

4.33 (0.56)

4.36 (0.62)

FFE helps parents’ relationships (parents)*

4.61 (0.43)

4.59 (0.41)

4.62 (0.44)

FFE helps parents’ relationships (teachers)*

4.60 (0.45)

4.58 (0.42)

4.62 (0.48)

FFE helps strengthen community (parents)***

4.55 (0.50)

4.51 (0.49)

4.58 (0.50)

FFE helps strengthen community (teachers)

4.53 (0.52)

4.51 (0.48)

4.54 (0.55)

p < .05; ** p < .01; *** p < .001

The intraclass correlations (ICC) of the regression model were 0.376 at the school level and 0.168 at the municipality level, suggesting that significant variation in literacy exists at both levels and reinforcing the need for a multilevel statistical model. As in the bivariate relationships, results of the multivariate model showed that girls (p < .001), and children in grades 3 and 4, compared with grade 2 (p < .001), were significantly more likely to be literate (see Table 2). For each additional year in age, however, children were less likely to be literate (OR = 0.88, CI = 0.82–0.95, p < .01). With each additional teacher at the school, children were more likely to be literate (OR = 1.22, CI = 1.07–1.38, p < .01). Parents’ perceptions that food preparation is well organized was associated with a greater likelihood of children’s literacy (OR = 1.45, CI = 1.15–1.84, p < .01). Teachers’ perceptions of their facing security issues on the way to school resulted in a lowered likelihood of children’s literacy (OR = 0.80, 0.70–0.91, p < .01). Parents’ beliefs that FFE helps reduce violence among students at school was associated with a lowered likelihood of literacy (OR = 0.63, CI = 0.51–0.77, p < .001). Parents’ opinions that FFE helps strengthen parents’ relationships with each other resulted in a greater likelihood of children’s literacy (OR = 1.72, CI = 1.25–2.38, p < .01).
Table 2

Predictors of child literacy (generalized linear mixed model for logit distribution; n = 3,147)


Odds ratio

95% CI


Child Level

Gender (female vs. male)***




Age (years)***




3rd Grade (vs. 2nd Grade)***




4th Grade (vs. 2nd Grade)***




School Level

Rural School (vs. urban)




Teachers per school




Child pays more attention (parents)




Child has learned more (parents)




Food preparation is well organized (parents)**




Food preparation is done by community (parents)




Children face security issues (parents)




Children face security issues (teachers)




Teachers face security issues (parents)




Teachers face security issues (teachers)**




FFE helps reduce violence (parents)***




FFE helps reduce violence (teachers)




FFE helps parents’ relationships (parents)**




FFE helps parents’ relationships (teachers)




FFE helps strengthen community (parents)




FFE helps strengthen community (teachers)




Intraclass Correlations (ICC)

School: 0.376

Municipality: 0.168

p < .05; ** p < .01; *** p < .001


The study’s results show the importance of unintended benefits of school feeding programs as they relate to primary intervention outcomes. Parents’ beliefs that food preparation is well organized and that parents’ relationships with each other are strengthened through program activities were each associated with higher rates of literacy. This dynamic suggests that, through the recruitment of parent volunteers for food preparation, FFE has made opportunities available for increased community cohesion and relationship building among parents. In turn, this strengthening of relationships may have helped improve children’s education, as evidenced by higher literacy rates. It is possible that FFE as a vertical intervention has created a ripple effect beyond the scope of the intervention itself, such that unplanned benefits (Kuziemsky et al. 2012) have diffused into the larger community (Dearing 2009) and helped meet parents’ psychosocial needs above and beyond educational goals (Houinato and Maclure 2002). Indeed, a growing body of research demonstrates that, in contexts of deprivation, greater engagement with schools can serve to strengthen social bonds within communities (Mutch 2016). Of particular interest in the current study, greater social bonding among parents is also associated with higher literacy rates. Thus, this initial evidence suggests that the unintended benefits of the FFE program serve to bolster the program’s primary goal of improving children’s literacy: by positively influencing parents’ sense of social cohesion, a possible “ripple-back” effect may be in play. We need further longitudinal research to isolate specific intervention effects on literacy, compared with the unintended benefits of the program.

Yet, the experience of community violence exerted a negative influence: as teachers experienced security issues on the way to school, literacy rates declined. Few studies seem to have directly addressed the issue of community violence and literacy rates, although one demonstrated that, in predicting early childhood literacy, home literacy buffers the effects of community violence (Froiland, Powell, Diamond, and Son 2013). In the case of the current study, teachers’ experience of violence and lower literacy rates are likely both indicative of the high rates of violence experienced in Honduras more generally (UNAH 2016).

To examine this issue in more detail, we conducted post-hoc analyses to examine whether differences emerged in perceptions of violence between rural and urban schools. A different dynamic has emerged for students and teachers: Rural parents were more likely to report children facing security issues on the way to school (p < .001), and rural teachers agreed with this assessment (p < .001). Yet, urban teachers were more likely to report teachers facing security issues on the way to school (p < .001). These results suggest that while rural children may be at increased risk of experiencing security risks on the way to school, these experiences do not appear to be affecting literacy rates. For teachers in urban areas, however, experiencing security risks is associated with lower literacy rates. For these teachers, it is possible that facing violence on the way to school prevented them from reaching school consistently—as a result, student literacy suffered from lost instructional time in the classroom.

A curious finding in this study is the relationship between parents’ belief that FFE helps reduce violence among students in school, and lower literacy. It is possible that this question captured both the presence of violence in schools and parents’ opinions that the program helped reduce violence. Indeed, from the FFE evaluation, qualitative responses revealed that some communities experience serious risk of violence, including robbery, kidnapping, and murder. With a backdrop of community violence, it would not be surprising that literacy scores in these communities would be lower, even if the program helped to reduce violence. In this case, our theory is that the question of FFE’s reducing violence is, in fact, an indicator of the presence of violence in schools.

A related dynamic is the set of bivariate relationships showing higher ratings of FFE from parents and teachers with lower student literacy. One explanation is that those schools in which students have lower literacy rates are also the schools that are more disadvantaged in terms of resources. Thus, FFE program activities at these sites may be more meaningful for parents and teachers. Another explanation may be related to social-desirability bias. In a low-resource area like the one under study, parents may be more inclined to rate the effects of a program more highly, out of fear that the program might otherwise be reduced or terminated. In the absence of a counterfactual, however, we cannot fully disentangle the differential impacts of the program and other variables.


One limitation of this study is the cross-sectional nature of the data. FFE program implementation occurred prior to the survey; however, in terms of temporal spacing, the study is limited in its ability to claim that the intervention—or its psychosocial correlates—led to greater or lesser literacy in school children. Similarly, the absence of a counterfactual to the FFE program means that this study cannot make any claims regarding causality. Survey responses may be subject to social-desirability bias of parents and teachers, especially when related to a program from which parents, children, and teachers may be benefitting. Their responses specific to perceptions of FFE efficacy may, therefore, be inflated and may also have contributed to some of the curious findings of the study.

Conclusion and implications

This study’s finding point toward future research in the context of Honduras, and beyond. School feeding appears to be related to strengthened social bonds among parents, which in turn are associated with higher literacy rates among children. The extent to which these social bonds influence child well-being and literacy over time, above and beyond the impacts of school feeding, is an important area of future study. In the next phase of the FFE Honduras project, researchers and CRS Honduras will more closely examine how child and family well-being are associated with both program implementation and achievement of literacy. This more holistic examination will help point the way toward a more systemic and integrated approach to serving vulnerable children and families (Atun et al. 2010; Bruns et al. 2016).

A specific example of such a holistic approach has already emerged in FFE Honduras implementation, related to this study. The finding that children, particularly in rural areas, seem more prone to experiencing violence on the way to school prompted a review by CRS Honduras of how to ensure greater child protection. In the next phase of FFE implementation, CRS and their implementing partners will provide enhanced school security patrols, targeted to those communities at highest risk for violence. These organizations will also provide specialized training to teachers and parents on how to respond to situations of violence or potential violence. Further examinations of community violence in Intibucá need to assess the source of this violence, whether it is gang-related, as in the Honduran capital of Tegucigalpa (Corona 2014), or associated with some other type of crime.

This study also raises further issues to explore, connected more generally to school feeding programs in LMICs. In contexts of deprivation or disaster, which present complex social environments, to what extent can or should we consider vertical interventions in isolation from the surrounding contexts? As this study suggests, school feeding can produce unintended benefits for communities—benefits that may also help bolster primary outcomes in child literacy. Yet, contextual factors such as community violence also influence the effectiveness of the program, and are largely beyond the scope of FFE design and purpose. The response of CRS Honduras—to implement school security patrols, and violence prevention and response training for communities—represents an example of moving beyond the dichotomy of vertical versus horizontal approaches to service delivery (Atun et al. 2010). In the service of meeting the primary goals of child literacy, stakeholders must mitigate violence in the community, necessitating a secondary set of intervention activities. In doing so, FFE Honduras moves toward a diagonal approach to service delivery (Gounder and Chaisson 2012)—an integrated, horizontal approach to intervention—while still vertically focused on child literacy.


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Authors and Affiliations

  • Thomas M. Crea
    • 1
    Email author
  • Antonia Eliana Diaz-Valdes
    • 1
  • Elizabeth Gruenfeld
    • 1
  • José Acevedo
    • 2
  • Blain Cerney
    • 3
  • Marlon Medina
    • 4
  • Glenda Hernandez
    • 4
  • Olga Canelas
    • 4
  1. 1.School of Social WorkBoston CollegeChestnut HillUSA
  2. 2.School of SociologyNational Autonomous University of HondurasTegucigalpa, M.D.C.Honduras
  3. 3.Catholic Relief Services (CRS) El SalvadorSan SalvadorEl Salvador
  4. 4.Catholic Relief Services (CRS) HondurasTegucigalpa, M.D.C.Honduras

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