Under Nutritional Status of Pre-Primary School Children with and Without School Meals Program in Addis Ababa, Ethiopia

Abstract

Background: Ethiopia has decided to incorporate the school feeding program in the second phase of the Growth and
Transformation Plan. The country is committed to ending child undernutrition by 2030 as indicated in the 2015
SEQOTA declaration. The effect of school meals program on the prevention of under-nutrition is not well understood,
and no studies have addressed the effect of school meals program on nutritional status among pre-primary school
children in Addis Ababa. Thus, this study aimed to explore the association between a school meals program and a
child’s under-nutrition in the Kolfe Keranio sub-city of Addis Ababa, Ethiopia.
Methods: A comparative cross-sectional study was conducted among 518 pre-primary school children; 257 students
were from schools with meal programs and 261 from those without. A simple random sampling technique was used
to select the schools and study participants. Anthropometric measurements, socio-demographic information, and
maternal, and child health characteristics were collected between February and March 2016. Data were double entered
using EpiData and using STATA 13TM and Emergency Nutrition Assessment for SMART software and Emergency
Nutrition Assessment for SMART software. Multivariate logistic regression models were employed to control for
confounding factors in exploring the association between school meals and undernutrition. statistical significance was
declared at a cut-off p-value of 0.05.
Results: Among the study participants, 7% (95% CI: 5, 11) and 5% (95% CI: 3, 8) prevalence of underweight was
observed in children without the school meals program and with the school meals program, respectively. The prevalence of wasting was 4% (95% CI: 2, 7) and 5% (95% CI: 3, 8) with and without a school meals program. The
children’s gender, parents’ marital status, maternal education, exclusive breastfeeding, child illness two weeks before
the survey, household head gender, and dietary diversity were found to have a statistically significant association with
child under-nutrition.
Conclusion: The magnitude of wasting among children in the school meals program was lower than those
of children without the program; while the magnitude of underweight was found to be higher, respectively. No
statistically significant difference was observed in children's undernourishment between the two groups.
Strengthening the existing school meals program is needed with emphasis on diversifying the types of meals
provided for school children.