Comparative Study of the Nutritional Status of School Aged Children Enrolled On the Ghana School Feeding Programme: A Case of Kwabre East and the Tolon Districts of Ghana

Abstract

Background: Childhood malnutrition remains a public health challenge in Africa. The original aim of the Ghana School Feeding Programme was to improve school enrolment and attendance with secondary aim to alleviate hunger and malnutrition among school aged children across every region. The aim of this study was to investigate the nutritional status of the SAC enrolled in the GSFP. Methodology: A cross-sectional study was carried out among 300 randomly selected 6-12 year aged school children in the Kwabre East (n=150) and Tolon districts (n=150) of Ghana. A semi-structured questionnaire was employed to take information on participants and their caregivers’ demographic characteristics, sanitation and morbidity. Height, weight and haemoglobin concentrations were measured. Dietary data were obtained using a 3 consecutive day 24-hour recall and food frequency questionnaire. Analyses of covariance were used to compare the differences (HAZ, BAZ, energy and nutrient intake from usual and GSFP meals) between the study children from the two districts and logistic regression used to identify predictors of malnutrition. Results: Compared to the study children in the Kwabre East district, the prevalence of stunting and anaemia was significantly higher in Tolon district 15.3% vs. 6%; p=0.009 and 20.5% vs. 7.3%; p=0.001 respectively. The rate of thinness was significantly higher in Kwabre East than the Tolon district in the study children (21.3% vs. 10%; p=0.026). Having a low dietary diversity score was significantly associated with being undernourished (OR=5.1; 95%CI: 1.45-5.1) in Kwabre East and (OR=4.8; 95% CI: 1.41-16.13) in the Tolon district. It was observed that 3 out of 10 study children were undernourished in Kwabre East. Conclusion: From the study, the prevalence of anaemia, stunting and thinness significantly differed between the study children in the two districts. The dietary diversity scores in both districts were high among study children. The chances of being undernourished was significantly higher with the study children who had a low dietary diversity score. Meals from the GSFP contributed more than one-third of the energy, macro-nutrients and micronutrients (Vitamin A, folate, iron and zinc) that were assessed to the daily nutrient intake of the study children. Meals from GSFP did not contribute Vitamin B12 to the daily nutrient intake to children in Tolon district but contributed more than half to daily Vitamin B12 intake of children in Kwabre East district.