Nutrition

Associations between exposure to nutrition, WASH interventions and children’s academic performance in Ethiopia: A systematic review and meta-analysis

Background Poor nutrition and inadequate WASH (water, sanitation, and hygiene) practices significantly impact children’s health, nutrition, and cognitive development, especially in low-income settings. These factors further aggravate the incidence of undernutrition, weaken the immune system, increase susceptibility to illnesses and reduce cognitive performance. Evidence on the effectiveness of existing WASH interventions is needed. Objective This review evaluated the effectiveness of nutritional and WASH interventions on the academic performance of children in Ethiopia. Methods A systematic search of Cochrane, DOAJ, Google Scholar, and PubMed (2010–2024) was conducted using MeSH terms and keywords related to WASH. Two independent reviewers screened studies and extracted data. Eligible studies included cross-sectional and cohort studies on Ethiopian schoolchildren with quantifiable academic outcomes. The JBI SUMARI was used to assess bias, and the GRADE approach was used to evaluate evidence quality. The meta-analysis used a random-effects model in Stata and reported pooled RRs with 95% CIs. Subgroup and sensitivity analyses examined moderators such as study design, intervention type, and sample size. Results A total of 19 studies, 16 cross-sectional (n= 16) and three prospective (n= 3) cohort studies with a total of 9034 participants, were included. The random effects model revealed a significant improvement in academic performance among students receiving both nutrition and WASH, with a pooled large positive effect size of 2.05 (95% CI: 1.26, 2.28; I2=). In the subgroup meta-analysis, the effect of the intervention was more positive among those who skipped breakfast (3.47, 95% CI: 0.47, 6.47), chronic iodine deficiency (4.49, 95% CI: 4.08, 4.90), food insecurity (2.810, 95% CI: 1.281, 4.339), and underweight (0.61, 95% CI: 0.46, 0.75). Conclusion Despite moderate variability and some risk of bias, the evidence supports the integration of comprehensive nutrition and WASH programs into school health initiatives. Future research should focus on long-term effects and cost-effectiveness.

Scaling biofortified wheat production for agrifood and nutritional security in eastern India: Evidence from five years of multi-location field evaluations in Bihar

Nutrition, diet, and academic performance among school-age children in urban low-income settings: A case-control study in Addis Ababa, Ethiopia

Objective To examine the effects of nutrition, dietary practices, and other related factors on academic performance and IQ among children in Addis Ababa, Ethiopia. Methods A case-control study was conducted among 309 children aged 6–14 years attending public and private schools in low-income districts of Addis Ababa from March to August 2023. Binary and multinomial logistic regression models were used to estimate crude (COR) and adjusted odds ratios (AOR) with 95% confidence intervals. Results Hand washing (AOR = 3.7; 95% CI: 1.4, 9.8), access to toilets (AOR = 3.37; 95% CI: 1.25, 9.09), and effective teaching (AOR = 2.94; 95% CI: 1.04, 8.33) good academic performance. Stunting (AOR = 0.16; 95% CI: 0.04, 0.59), underweight (AOR = 0.25; 95% CI: 0.09, 0.70), and overweight (AOR = 0.04; 95% CI: 0.01, 0.14) were associated with poor academic performance. Low meal frequency (AOR = 2.65; 95% CI: 1.06, 6.67) and teachers with BA/BSc degrees (AOR = 6.97; 95% CI: 1.14, 42.68) predicted lower IQ. Conclusion Many factors, especially nutrition and diet, strongly influence academic and cognitive performance; targeted school interventions improve outcomes.