Nutritional Status and Educational Performance of School-Aged Children in Lalibela Town Primary Schools, Northern Ethiopia

Prevalence and factors associated with stunting and thinness among school age children in rural primary schools, East Dembia District, Northwest Ethiopia

Purpose

To assess the prevalence and factors associated with stunting and thinness among school-age children in rural primary schools in the East Dembia District, Northwest Ethiopia.

Methods

An institution-based cross-sectional study was conducted using a systematic random sampling procedure to select 840 school-aged children. A structured interviewer-administered questionnaire was used to collect the data. Height and weight measurements were taken, and a combined wet mount and concentration technique was used. Epi Data 3.1 was used to enter data, which was then exported to SPSS version 20 for analysis. Bi-variable and multivariable logistic regression analyses were done. Variables with a p-value of less than 0.05 were considered significantly associated with stunting and thinness.

Results

The prevalence of stunting and thinness was 25.5 and 13.0%, respectively. Being infected with an intestinal parasite (AOR =4.34; 95% CI: 2.52, 12.27), being in the age group 11–14 years (AOR =3.73; 95% CI: 2.19, 6.34), having the lowest dietary diversity practice (AOR =4.61; 95% CI: 1.73, 12.27), unimproved water sources (AOR =1.76; 95% CI: 1.07, 2.91), not practicing good hygiene practice (AOR =1.71; 95% CI: 1.04, 2.804) and having an unimproved latrine type (AOR =1.72; 95% CI: 1.03, 2.89) were significantly associated with stunting. On the other hand, unsecured food (AOR =1.74; 95% CI: 1.08, 2.81), eating less than 3 meals per day (AOR = 2.67; 95% CI: 1.11, 6.46), and untreated water (AOR =1.72; 95% CI: 1.08, 2.75) were factors associated significantly with thinness.

Conclusion

Stunting and thinness are predominant public health problems in the study area, provided that the prevalence of stunting is slightly higher than that of a national survey on health and nutrition in schoolchildren, whereas the prevalence of thinness is lower when compared to the same national survey. In this study, the primary factor that was significantly associated with stunting was dietary diversity; the primary factor that was associated with thinness was eating fewer than 3 meals per day. So, an integrated strategy is important to alleviate undernutrition among school-aged children in the current study area.

Impact of malnutrition on the academic performance of school children in Ethiopia: A systematic review and meta-analysis

Objective

This study aimed to identify the impact of malnutrition on the academic performance of children in Ethiopia.

Method

The protocol of this study is registered in PROSPERO with a registration number CRD42021242269. A comprehensive search of studies from HINARY, MEDLINE (via PubMed), EMBASE, Cochrane Library, SCOPUS, Google Scholar, and Google was conducted. All published and unpublished studies conducted about the effect of any forms of malnutrition on academic performance of elementary school children in Ethiopia using the English language were included. Quality of the articles was assessed using the Joanna Briggs Institute critical appraisal tool. The pooled log odds ratio with 95% confidence interval was determined to identify the effect of malnutrition on academic performance. I-square statistics was applied to check the degree of heterogeneity between studies. The presence of publication or small study bias had been assessed by Funnel plots, Egger's weighted regression test, and Begg's rank correlation test.

Result

A total of 10 studies were included in this study. The pooled prevalence of good academic performance among elementary school students in Ethiopia was 58% (95% confidence interval: 48%, 69%). Stunting (odds ratio = 0.48; 95% confidence interval: 0.30, 0.79), underweight (odds ratio = 0.38; 95% confidence interval: 0.27, 0.53), and iodine deficiency (odds ratio = 0.49; 95% confidence interval: 0.31, 0.78) had a significant association with the academic performance. Rural residence (odds ratio = 0.61; 95% confidence interval: 0.44, 0.83), being female (odds ratio = 0.53; 95% confidence interval: 0.37, 0.77), and uneducated parent (odds ratio = 0.51; 95% confidence interval: 0.44, 0.58) were also factors associated with good academic performance of primary school children in Ethiopia.

Conclusion

This study concluded that malnutrition in the form of stunting, underweight, and iodine deficiency affected the academic performance of elementary school children in Ethiopia. So, the Ministry of Health worked better to strengthen the nutrition intervention at the critical periods of brain development.

Stunting, age at school entry and academic performance in developing countries: A systematic review and meta-analysis

AIM

To review evidence of the effects of stunting, or height-for-age, on schooling level and schooling trajectories, defined as the combination of school entry age, grade repetition, and dropouts.

METHODS

We conducted a systematic review of studies (last update March 20, 2021) that assessed the association between stunting, or height-for-age, and at least one component of school trajectory using five databases (PubMed, Embase, Education Resources Information Center (ERIC), Web of Science and PsycINFO). Two independent reviewers performed study selection and data extraction. Pooled effects were calculated using the generic inverse variance weighting random effect model. The risk of bias was assessed using the ROBINS-I tool.

PROSPERO ID

CRD42020198346.

RESULTS

We screened 3944 articles and 16 were eligible for the qualitative and quantitative synthesis. Meta-analysis showed that an increase in height-for-age leads to an increase in early enrollment [OR=1.34 (95% CI, 1.07-1.67)], a reduction in late enrollment [OR=0.63 (95% CI, 0.51-0.78)], an increase in schooling level [MD=0.24 (95% CI, 0.14-0.34)], and a reduction of school overage [OR=0.79 (95% CI, 0.70-0.90)]. Stunted children were more likely to repeat a grade than non-stunted [OR=1.59 (95% CI, 1.18-2.14).

CONCLUSION

This review suggests that stunting in childhood might negatively affect school trajectories. Future research should evaluate the effect of stunting on school trajectories and the modification effect of socioeconomic status.