Effect of school feeding program on academic performance of primary school adolescents: A prospective cohort study

BACKGROUND:School Feeding Programs (SFPs) in low-income countries help vulnerable children learn better and maintain their health through the provision of nutritious food to school children. Ethiopia scaled up the implementation of SFP in Addis Ababa. AIMS:We aimed at evaluating the effect of the SFP on the school performance of primary school adolescents in Addis Ababa, Central Ethiopia. METHOD:A prospective cohort study design was employed on 322 SFP-beneficiary and equal-size non-beneficiary adolescents. SPSS version 24 and multivariable linear regression models were used. RESULT:In linear regression, unadjusted model (Model 1), compared with the non-school-fed adolescent, the mean difference in difference of average academic scores of school-fed adolescents was higher by 2.11 (β 2.11, 95% CI 1.39-2.83). The beta coefficient remained positive after adjusted for age and sex (Model 2: β 2.11, 95% CI 1.39-2.83), sociodemographic variable (Model 3: β 2.16, 95% CI 1.45-2.88), health and lifestyle variable (Model 4: β 2.21, 95% CI 1.38-3.04). In the final model, adjusted for model five, school absenteeism, there was a significant difference in favor of school-fed adolescents on GPA-score (Model 5: β 2.32, 95% CI 1.47-3.17). Furthermore, being adolescents in middle tertile wealth index families decrease GPA by 1.22 (β -1.22, 95% CI -2.19 to -0.26) as compared to high tertile wealth index. CONCLUSION:School feeding was positively associated with academic performance. However, these changes may not be meaningful to generate a firm conclusion on the utility of school feeding in improving the academic performance of adolescents.