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School feeding in Ethiopia: a scoping review
Samson Mideksa1, Tsegaye Getachew2, Firmaye Bogale2
1Knowledge Translation Directorate, Ethiopian Public Health Institute, P O Box 1242, Addis Ababa, Ethiopia. samkmwmtj@gmail.com.
Insights
Ethiopian school feeding programs show mixed results on child nutrition and academic performance. While some studies indicate benefits, poor food quality and funding hinder progress, necessitating further research and policy support.
Area of Science:
- Public Health Nutrition
- Global Health
- Pediatric Health
Background:
- Undernutrition is a critical public health issue in developing nations, particularly in Sub-Saharan Africa, impacting children's growth and weight.
- School feeding programs, utilizing resources like corn-soya blend and vegetable oil, were initiated in Ethiopia in 1994 to combat child undernutrition.
Purpose of the Study:
- To conduct a scoping review mapping the existing evidence on school feeding programs in Ethiopia.
- To assess the potential role of these programs in managing and improving children's nutritional status.
Main Methods:
- The review followed the Arksey & O'Malley methodological framework, supplemented by Levac and colleagues' recommendations.
- Searches were conducted across multiple databases (ERIC, 3ie, Cochrane, MEDLINE, Google Scholar) and grey literature sources up to April 26, 2023.
- Included studies evaluated nutritional and educational impacts of school feeding in Ethiopia, regardless of design; excluded were reports lacking scientific methodology.
Main Results:
- Twenty-seven studies with diverse designs (cross-sectional, cohort, experimental, qualitative) were included.
- Findings on school feeding programs were inconclusive; some reported positive effects on BMI, height, weight, and school attendance, while others showed no impact on stunting, academic achievement, or enrollment.
- Negative factors identified include poor food quality and financial constraints; no data on program coverage was found.
Conclusions:
- School feeding programs present mixed outcomes regarding nutritional status and academic performance.
- Program effectiveness is hampered by poor food quality and financial limitations, highlighting the need for more conclusive research.
- Sustaining these programs requires national policy backing, dedicated budget allocation, and further investigation into program coverage in Ethiopia.
Introduction:
Undernutrition is a major public health problem in developing countries, especially in Sub-Saharan Africa. Undernourished children are smaller and have low weight. To solve this issue, school feeding (corn-soya blend, vegetable oil) started in 1994 in Ethiopia. Thus, this scoping review aims to map the evidence relating to school feeding programs and their potential role in managing children`s nutrition in Ethiopia.
Methods:
This scoping review is informed by the methodological framework of Arksey & O'Malley for scoping reviews and recommendations on the framework by Levac and colleagues. The databases searched included the Education Resources Information Centre, International Initiative for Impact Evaluation, Cochrane Library, MEDLINE, and Google Scholar. To ensure its comprehensive search, grey literature sources were searched. The search was undertaken on 26 April 2023. Studies on school feeding, such as coverage, and studies that evaluate the educational and nutritional impacts of school feeding in Ethiopia, regardless of study designs, were included. Reports (publications) about school feeding without scientific methodology were excluded.
Result:
Twenty-seven studies were included in this review. It includes cross-sectional, prospective cohort, laboratory-based analysis, experimental, case study, and qualitative study designs. The school feeding program results were inconclusive, while some indicate a positive effect on body mass index, height, thinness, anemia, weight, dropout rate, class attendance, and enrollment. The others showed that the school feeding program did not affect stunting, thinness, weight, hemoglobin level, enrollment, attendance, dropout rate, and academic achievement. Factors affecting school feeding programs negatively include poor quality food and financial constraints. However, no literature on school feeding program coverage was found.
Conclusion:
School feeding programs improved nutritional status, and academic performance, although some studies show any effect. Poor-quality food provisions and financial constraints affect school feeding programs. There are mixed findings, and further research is required to determine the effect of school feeding programs conclusively. To ensure the program's sustainability, it should be supported by a national policy, and budget allocation is needed. In addition, more evidence should be generated to show the coverage of school feeding programs in Ethiopia.
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