Skip to main content
Download PDF

School feeding in Ethiopia: a scoping review

BMC Public Health volume 24, Article number: 138 (2024) Cite this article

Abstract

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.

Peer Review reports

Background

Undernutrition causes eight million child deaths worldwide every year [1] It is a major public health problem in developing countries, especially in Sub-Saharan Africa [2] Despite some positive progress in economic growth observed in many developing countries, undernutrition continues to be highly prevalent and is associated with poor health status and poor academic performance [3]. Undernutrition inhibits academic attainment through poor growth and mental development, reduced motivation and poor cognitive development [4]. On the other hand, being overweight and obese is reported to have the potential to impair academic performance via social pathways such as discrimination and stigma [5]. According to the Global School-Based Student Health Survey, the mean body mass index (BMI) estimates among adolescents in South Asia, Southeast Asia, East Africa, West Africa and Central Africa are < 20. The lowest age-standardized mean BMIs were seen in Ethiopia, Niger, Senegal, India, Bangladesh, Myanmar, and Cambodia [6]. The World Bank report also indicated that, academic performance in students of Sub-Saharan African countries is less than half of what is expected for their age based on the Africa Student Learning Index (ASLI) [7]. Ethiopia is among the countries where adolescent students’ academic achievement is low according to the ASLI score measured [7, 8]

School age provides an opportunity to remedy nutritional and developmental deficits that were not addressed during early childhood [9]. Nutritional interventions in school-aged children have been reported to result in improved cognitive function [10,11,12]. The School Feeding Program (SFP) has been recognized as a platform for nutritional, health and educational intervention programs [13]. The contribution of SFP with regard to outcomes of energy intake, micronutrient status, enrollment and school attendance and academic achievement displayed relatively consistent positive effects [14, 15]. Its positive effect on physical growth, cognitive and academic performance was less conclusive in some countries while substantial effect was seen elsewhere [16, 17]. The SFP is also believed to pave the way to achieve sustainable development goals and to reduce inequalities in education. In sub-Saharan African countries, SFP showed an encouraging effect on learning outcomes and a small average effect on attendance [18]. In Ethiopia, evidence on the nutritional and educational effects of SFP is minimal with some pocket studies conducted at the sub-national level [19] The Ethiopian school feeding programme, which has been in operation for 30 years, is expanding its reach and putting more strategic emphasis on developing a pilot project that connects school feeding with regional agricultural production. The Ethiopian government is actively working to change the nation's agricultural sector, including its approaches to school feeding, through effective policies and projects [20].

This scoping review aims to map the evidence relating to school feeding programs and their potential role in managing children under nutrition. Thus, its main focuses are to explore coverage of school feeding, quality of school feeding, nutritional impacts, funding issues, and effects on educational achievements among students in Ethiopia. The study results will inform the public, donors, academia, policy makers and other stakeholders. To make judicious use of evidence regarding school feeding, scientific evidence regarding school feeding in the country should be summarized, analyzed and presented in an accessible format.

Methods

The scoping review used the methodological framework of Arksey & O’Malley for scoping reviews [21]. and recommendations on the framework by Levac and colleagues [22]. This framework has six stages: 1) identifying the research question; 2) identifying relevant studies; 3) study selection; 4) charting the data; 5) collecting, summarizing and reporting the results; and 6) consultation with relevant stakeholders. A protocol was developed and registered on Open Science Framework (OSF) on March 30, 2023 https://osf.io/5m6dh/ as OSF preregistration.

Identifying relevant studies

The following databases were searched to find relevant studies: Education Resources Information Centre (ERIC), International Initiative for Impact Evaluation (3ie), Cochrane Library, and MEDLINE. In addition, Google Scholar was used. Furthermore, to make the search as comprehensive as possible, grey literature sources were searched. These sources include databases of relevant organizations such as the World Health Organization (WHO), the World Food Programme (WFP), the Food and Agriculture Organization (FAO), China Foundation for Poverty Alleviation, United Nations International Children's Emergency Fund (UNICEF), United Nations Educational, Scientific and Cultural Organization (UNESCO), Addis Ababa University electronic library, and website of the Ministry of Education. Only studies published or written in English without date limits were considered. The search strategy included all identified keywords and index terms from MESH terms for the included database and/or information source. The reference lists of all included sources of evidence were screened for additional studies. The first search was undertaken on 30 April 2022 and updated on 26 April 2023.

Study selection

Studies on school feeding program or its impacts among Ethiopian students regardless of study design were included. Studies on both sexes and any form of school feeding intervention in the school compound were included. Surveys related to school feeding were also included. Reports that lacked scientific/systematic information and outcomes in terms of nutritional and educational outcomes were excluded.

The review process had two levels of screening: title and abstract review and full-text review. Articles retrieved were screened independently by two groups of reviewers (SM & EW) and (TG & DA) to assess eligibility, as determined by the inclusion criteria. Full copies of all potentially eligible papers were retrieved. Disagreements at any of the eligibility assessment processes were resolved through discussions and consultation with the team (MH & FB) where necessary.

Data extraction

Relevant information from selected studies was extracted using a form developed by the team. The data collection form included information on: author(s), year of publication, study design, and key findings as they relate to the scoping review question. Data extraction was independently conducted by two groups of reviewers. Differences among reviewers were resolved by involving the other reviewers from the team.

Results

Literature search

The literature search in this review yielded 430 records from all the databases (Fig. 1). After removing duplicates and screening the titles and abstracts, 405 studies were excluded. Before going into full text screening, nine articles were additionally included from the reference of selected studies. Hence, the full texts of 34 potentially eligible studies were retrieved, and, seven studies were excluded.

Fig. 1
figure 1

PRISMA flow diagram for the scoping review process

Full size image

Excluded studies and reasons for exclusion

The studies excluded and their reasons for exclusion are summarized in Table 1 [23,24,25,26,27,28,29]. Seven studies were excluded among the selected full text articles. Studies were excluded for not looking at outcome of interest (2), not looking at intervention of interest (4) and a study that was only at a protocol stage (1).

Table 1 Excluded studies and reasons for exclusion
Full size table

Characteristics of included studies

All included studies were carried out between 2011 and 2022. The majority of the studies (19) were cross-sectional, while the remaining four were cohort studies, one was an experimental study, one was a case study, and another was a laboratory- based study. This scoping review examined the range and nature of literature on school feeding. The studies on school feeding in the Ethiopian context have covered different aspects including coverage of school feeding, quality of school feeding, nutritional outcome, funding issues, and effect on educational achievements among students in Ethiopia. The majority of the identified studies were focused on the educational impact of SFP.

Studies on nutritional impact

Ten of the studies included in the review had the nutritional status of SFP. These studies included cross sectional, cohort and lab-based analysis studies. The studies showed mixed results. Two cross sectional studies showed that SFP increased BMI, [30, 31] another two studies found that SFP decreased thinness, [32, 33]. two studies found that children who consumed school meals had reduced anemia, [34, 35] one study found that SFP reduced underweight, [33] and another study found that height was increased among children in SFP [30]. In contrast, a study reported that the prevalence of stunting was greater among students who ate lunch at school, even though this difference was not statistically significant once the relevant confounders were taken into account [32]. Similarly, a study reported that caloric and nutritional contributions were less than two-thirds of the daily reference nutrient intakes (RNIs) needed from school meals, except those of fiber, thiamine, calcium (for early adolescents), and iron [36]. Other studies found no effect on stunting, [35, 37] thinness, [37] anemia, [38] weight, [33] and height [35]. Generally, seven of the studies reported favorable results on the importance of SFP for nutritional status [30,31,32,33,34,35,36] Table 2 summarizes the main aspects of the studies.

Table 2 Summary of studies on the nutritional impact of school feeding programs in Ethiopia
Full size table

Studies on educational impact

Nineteen studies reported on educational impact (Table 3). The studies showed mixed results. Some of the findings conclude that the implementation of a school feeding program enhances academic achievement, [35, 40,41,42] raises class attendance, [30, 31, 40, 43,44,45,46,47,48,49,50] reduces dropout rates, [42,43,44, 49] and increases enrollment. [40, 42, 48, 50] On the other hand, a study reported that stopping SFP increases male enrollment, and decreases class repetition [49]. In contrast, there were also studies that reported that, there is no significant effect of SFP on the dropout rate, [34, 48, 51, 52] academic achievement, [46, 53, 54] and attendance [34, 48, 51, 53, 54]. The majority of studies (12 studies) have reported favorable results on the importance of school feeding programs for educational outcomes.

Table 3 Summary of studies on the educational impact of school feeding programs in Ethiopia
Full size table

School feeding on other variables

Few studies have reported on the quality of food [39, 45, 55] in SFP programs and financial or funding constraints [50, 55]. These studies included qualitative studies conducted to explore the advantages and challenges of the program. One of the indicated advantages of the SFP program is the contribution of the program in saving parents money and time as the SFPs were making use of (purchasing) local food and agricultural development. Despite the advantage of SFP, studies highlighted challenges related to food provision, infrastructure, and administration.

Challenges related to food provision included a lack of hygienic, adequate, regular, and quality food. Infrastructure challenges, including a lack of independent SFP structures at various levels making implementation and sustainability challenging; a lack of training for cooks; a lack of physical capital, such as feeding utensils, electricity, and water, exacerbated by administration problems, such as inadequate stakeholder engagement, absence of clear policy and financial constraints were reported. Table 4.

Table 4 Summary of studies on other variables of school feeding programs in Ethiopia
Full size table

Discussion

This scoping review aims to map the evidence relating to school feeding programs and their potential role in managing children under nutrition. The main objectives are to explore school feeding programs coverage, quality, nutritional impacts, funding issues, and its impact on educational achievements among students in Ethiopia. The finding of the study indicates mixed results.

School feeding shows an improvement in BMI among underweight students. Additionally, body fat is increased among thin students. Furthermore, the hemoglobin status increased among anemic students. There are also increased weight and height [30,31,32,33,34,35]. This shows that school feeding programs improve the overall anthropometric status. A study from South Africa also obtainedsimilar results. The school breakfast programme improved anthropometric measurements with a 10% increase in the number of children within the healthy BMI range for their age [56] Similarly, a study in Kenya reported that the school feeding programme clearly had a positive effect on children’s nutritional status. The programme reduced anemia and malnutrition and improved child growth [57] However, some studies have shown that SFP has no effect on stunting, thinness, weight, and hemoglobin level [33, 35, 37, 38]. Similarly, a study reported that caloric and nutritional contributions were less than two-thirds of the daily RNIs needed from school meals [36]. This signifies that there is a need for further study.

School feeding programs improve academic performance, [34, 40, 41, 45] increase class attendance, [30, 31, 40, 43,44,45,46,47, 49, 50] decrease the dropout rate, [42,43,44, 49] and increase enrollment. [40, 42, 48, 50] The majority of studies have reported favorable results on the importance of school feeding programs for educational outcomes [30, 31, 34, 40,41,42,43,44,45, 47, 48, 50]. Different studies in different countries also show consistent results with this study. A study in Uganda revealed that, SFP had large impacts on school attendance, and reduced grade repetition [58]. Nutritional interventions in school-aged children have been reported to result in improved cognitive function [9,10,11]. Furthermore, this study found that meals provided in the morning help students better than those provided at the end of school [41]. A similar study in South Africa revealed that meals served at breakfast are also shown to have a positive impact [56] Children who consume a meal before learning have better short-term memory function, as the brain activated differently based on nutrient supply [59] However, some studies indicate that, SFP has no effect on attendance, dropout rate and academic achievement [34, 46, 48, 51,52,53,54]. If loss of teaching time could be the factor for no significant difference in achievement test scores, it might be simpler to offer a take home ration program to prevent disturbance during the school day [60]. This indicates the need for additional research.

There were also advantages and challenges of the school feeding program. Advantages of the SFP programs are the contribution of the program in saving parents money and time, as the SFPs were making use of (purchasing) local food and agricultural development. Nevertheless, the challenges related to food provision included a lack of hygienic, adequate, regular, and quality food. Infrastructure challenges, including a lack of independent SFP structures at various levels making implementation and sustainability challenging; a lack of training for cooks; and a lack of physical capital, such as feeding utensils, electricity, and water exacerbated by administration problems, such as inadequate stakeholder engagement; and the absence of clear policy and financial constraints [50, 55].

There is a shortage of evidence on SFPs in Ethiopia. The majority of the studies identified were cross-sectional studies. Therefore, there is a need to conduct more research using higher quality study designs and quantitative research for decision and policy-making.

The limitations of this study were low quality of study design, primarily, cross sectional. Although the study results are mainly from low study designs, the findings of this review have the first hand information to inform the importance of school feeding programs and their effect on nutritional status and academic performance.

Conclusion

School feeding programs in Ethiopia showed mixed findings on nutritional status and academic performance. Besides, poor-quality food provisions and financial or funding constraints affect school feeding programs. The SFP should take into account the nation's diversity, including its geography, climate, agrarian and pastoral areas. Although there are studies conducted in different areas of the country and schools, it is important to conduct nationwide study to conclusively determine the coverage, nutritional, and educational effect of the SFP in Ethiopia.

Strengths and limitations of this study

This is the first scoping review on school feeding in Ethiopia. The search strategy included four electronic databases, including ancestor searching and grey literature (both government and organization websites). Additional literature was sought from relevant bodies such as the ministry of education and experts on the area. This scoping review provides information on the range and nature of evidence on school feeding in Ethiopia and identifies research gaps. Nevertheless, the study was limited to reviewing findings only from publications and grey literature with scientific methods and might therefore miss important information from other sources.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Abbreviations

ASLI:

Africa Student Learning Index

BMI:

Body Mass Index

ERIC:

Education Resources Information Centre

FAO:

Food and Agriculture Organization

3ie:

International Initiative for Impact evaluation

SFP:

School Feeding Program

UNESCO:

United Nations Educational, Scientific and Cultural Organization

UNICEF:

United Nations International Children's Emergency Fund

WFP:

World Food Programme

WHO:

World Health Organization

References

  1. World Health Organization. Communicable disease and severe food shortage: WHO technical note. Geneva: World Health Organization; 2010. http://apps.who.int/iris/bitstream/10665/70485/1/WHO_HSE_GAR_DCE_/2010_6_eng.pdf.

  2. Mwaniki, EW and Makokha, AN. Nutrition status and associated factors among children in public primary schools in Dagoretti, Nairobi, Kenya. Afr Health Sci 2013; 13(1): 39 46. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3645091/.

  3. Best C, Neufingerl N, Van Geel L, Van Den Briel T, Osendarp S. The nutritional status of school-aged children: why should we care? Food Nutr Bull. 2010;31(3):400–17. https://doi.org/10.1177/156482651003100303.

  4. Bisset S, Fournier M, Pagani L, Janosz M. Predicting academic and cognitive outcomes from weight status trajectories during childhood. Int J Obes. 2013;37(1):154–9. https://doi.org/10.1038/ijo.2012.106.

    Article  CAS  Google Scholar 

  5. Branigan AR. Does obesity harm academic performance? Stratification at the intersection of race, sex, and body size in elementary and high school. HHS Public Access. 2018;90(1):25–46.

    Google Scholar 

  6. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128 9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627–42. 10.1016/S0140-6736(17)32129-3

    Article  Google Scholar 

  7. Majgaard, Mingat K, Alain. Education in sub-Saharan Africa: a comparative analysis (English). In: Study AWB, editor. Washington, DC: World Bank Group; 2012, https://doi.org/10.1596/978-0-8213-8889-1.

  8. The World Bank. Ethiopia general education quality improvement project II (P129828). Washington, DC: The World Bank; 2017.

    Google Scholar 

  9. Prentice AM. The emerging epidemic of obesity in developing countries. Int J Epidemiol. 2005;35(1):93–9. https://doi.org/10.1093/ije/dyi272.

    Article  PubMed  Google Scholar 

  10. WHO. Nutrition in adolescence: issues and challenges for the health sector: issues in adolescent health and development. Geneva: WHO; 2005.

  11. Kumar MV, Rajagopalan S. Multiple micronutrient fortification of salt and its effect on cognition in chennai school children. Asia Pac J Clin Nutr. 2007;16:505–11.

    CAS  PubMed  Google Scholar 

  12. Osendarp SJ, Baghurst KI, Bryan J, Calvaresi E, Hughes D, Hussaini M, Karyadi SJ, van Klinken BJ, van der Knaap HC, Lukito W, et al. Effect of a 12-mo micronutrient intervention on learning and memory in well-nourished and marginally nourished school-aged children: 2 parallel, randomized, placebo-controlled studies in Australia and indonesia. Am J Clin Nutr. 2007;86:1082–93.

    Article  CAS  PubMed  Google Scholar 

  13. Drake L, Lazrak N, Fernandes M, et al. Establishing global school feeding program targets: how many poor children globally should be prioritized, and what would be the cost of implementation? Front Public Health. 2020;8:530176.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Bundy D, Burbano C, Grosh ME, et al. Rethinking School Feeding. Washington, DC: The World Bank; 2009.

    Book  Google Scholar 

  15. Jomaa LH, McDonnell E, Probart C. School feeding programs in developing countries: impacts on children’s health and educational outcomes. Nutr Rev. 2010;69:83–98.

    Article  Google Scholar 

  16. Babu SC, Gajanan SN, Hallam JA. Economics of school nutrition. Nutr Econ. 2017;1:257–77.

    Article  Google Scholar 

  17. Devereux S, Hochfeld T, Karriem A et al. School Feeding in South Africa: What We Know, What We Don’t Know, What We Need to Know, What We Need to Do. Food Security SA. Working Paper Series Number. Pretoria: DSTNRF Centre of Excellence in Food Security, (2018). Retrieved from https://foodsecurity.ac.za/publications/school-feeding-in-south-africa-what-we-know-what-we-dont-know-what-we-need-to-know-what-we-need-to-do/

  18. Mundy K and Proulx K. MakingEvaluationWorkforthe Achievement of SDG 4.5 Equality and Inclusion in Education. UNESCO/IOS Evaluation Office, 2019. https://www.norad.no/en/toolspublications/publications/2019/making-evaluation-work-for-the-achievement-of-sdg-4.5equality-and-inclusion-in-educationy-side/. Aaccessed June 2021.

  19. Destaw, Z., Wencheko, E., Kidane, S., Endale, M., Challa, Y., Tiruneh, M., . . . Ashenafi, M. (2022). Impact of school meals on educational outcomes in Addis Ababa, Ethiopia. Public Health Nutrition, 1–11. https://doi.org/10.1017/S1368980022000799

  20. World Food Program Centre of Excellence. WFP Centre of Excellence. Virtual Exchange. May 04, 2020 https://centrodeexcelencia.org.br/en/publications/. Cited May 30 2023.

  21. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.

    Article  Google Scholar 

  22. Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;20(5):69.

    Article  Google Scholar 

  23. Appleby LJ, Tadesse G, Wuletawu Y, Dejene NG, Grimes JET, French MD, et al. Integrated delivery of school health interventions through the school platform: Investing for the future. PLoS Negl Trop Dis. 2019;13(1):1–8. https://doi.org/10.1371/journal.pntd.0006449.

    Article  Google Scholar 

  24. Keating E, Tadesse G, Dejene N G, Yard, E, Appleby, L J, & Cardwell, J M,. Local Perceptions of an Integrated School Health and Nutrition Programme involving WASH, school feeding and deworming in Southwest Ethiopia. SocArXiv s9ac7, Center for Open Science, 2019. https://doi.org/10.31219/osf.io/s9ac7

  25. Kim SS, Menon P, and Tadesse A. A Feasibility Study of Delivering Adolescent NutritionInterventions through School-Based Platforms in Ethiopia: A Cluster-Randomized Evaluation. Study Protocol, 2021. Clinicaltrials.gov: NCT04121559. https://clinicaltrials.gov/ProvidedDocs/59/NCT04121559/Prot_000.pdf

  26. Okell J J, Just D R, Jogo W, Kwikiriza N, and Tesfaye H. Do Behavioral Interventions Increase the Intake of Biofortified Foods in School Lunch Meals? Evidence from a Field Experiment with Elementary School Children in Ethiopia. Ethiopian Health and Nutrition Research Institute, 2022. https://academic.oup.com/cdn/article/6/2/nzac008/6527570.

  27. Blom SC. The integration of school garden activities, the classroom and the feeding scheme: A case study of two primary schools in Tigray, North Ethiopia. Thesis, Faculty of Economic and Management Sciences at Stellenbosch University, 2014. http://scholar.sun.ac.za

  28. Belayneh D, Yetneberk S, Teklewold A, et al. Quality protein maize (QPM) for school feeding in Ethiopia: stakeholders consultation, sensory evaluation and potential impact. J Nutritional Health Food Engineering. 2018;8(6):377–82. https://doi.org/10.15406/jnhfe.2018.08.00299.

    Article  Google Scholar 

  29. Destaw Z, Wencheko E, Zemenfeskidus S, Challa Y, Tiruneh M, Fite MT, Shaleka D, Ashenafi M. Use of modified composite index of anthropometric failure and MUAC-for-age to assess prevalence of malnutrition among school-age children and adolescents involved in the school feeding program in Addis Ababa. Ethiopia BMC Nutrition. 2021;7:81. https://doi.org/10.1186/s40795-021-00471-x.

    Article  PubMed  Google Scholar 

  30. Zenebe M, Gebremedhin S, Henry CJ, Regassa N. School feeding program has resulted in improved dietary diversity, nutritional status and class attendance of school children. Ital J Pediatr. 2018;44:16. https://doi.org/10.1186/s13052-018-0449-1.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Ayehu SM, Sahile AT. Body Mass Index and Associated Factors of School Absenteeism by School Feeding Program at Selected Primary Schools in Addis Ababa, Ethiopia: A Comparative Study. Hindawi Scientifica. 2021. https://doi.org/10.1155/2021/6671468.

    Article  Google Scholar 

  32. Demilew YM, and Nigussie AA. Nutritional status and associated factors among primary school students, in Meket Wereda, Ethiopia: comparing schools with feeding and non-feeding program. Research Square, 2020. https://doi.org/10.21203/rs.2.12672/v2

  33. Mekuria D.D, Alemu Z.A, Abaerei A.A. Under Nutritional Status of Pre-Primary School Children with and Without School Meals Program in Addis Ababa, Ethiopia. East African. J  Health  Biomed Sci. 2021;5(1):22–34.

    Google Scholar 

  34. Mokonnen G. Nutritional status and school performance of children benefited from school feeding program in selected elementary school, Arada Sub city, Addis Ababa, Ethiopia. Thesis, Addis Ababa University, Center for Food Science and Nutrition, 2017.

  35. Tadesse K. Effect of School Feeding Program on Anemia and Stunting among Primary School Children in Addis Ababa, Ethiopia; A Quasi Experimental Study. Thesis, Addis Ababa University, Public Health in Public Health Nutrition, 2018.

  36. Destaw Z, et al,. School feeding contributed valuable dietary energy and nutrients despite suboptimal supply to school-age children and adolescents at primary schools in Addis Ababa, Ethiopia. Nutrition 102 (2022) 111693. http://creativecommons.org/licenses/by-nc-nd/4.0/

  37. Mohammed H. Assesment of Nutrational Status and Associated Factors in Children: A Comparative Study between School Fedding and Non School Feeding Programme in Amibera District Afar Region, Ethiopia. Thesis, Samara University College of Health Sciences Department of Public Health, 2018.

  38. Desalegn TA, Gebremedhi S, Stoecker BJ. Effect of school feeding program on the anthropometric and haemoglobin status of school children in Sidama region, Southern Ethiopia: a prospective study. J Nutr Sci. 2022;11(e69):1–7. https://doi.org/10.1017/jns.2022.73.

    Article  Google Scholar 

  39. Lakew B. Meal Macronutrient Adequacy and Body Composition Of School Children (7–14 Age) from Selected School Feeding Program in Addis Ababa. Ethiopia: Thesis, Food Science and Nutrtition, Addis Ababa Science and Technology University; 2021.

    Google Scholar 

  40. Destaw Z, et al. Impact of school meals on educational outcomes in Addis Ababa. Ethiopia Public Health Nutrition. 2022;25(9):2614–24. https://doi.org/10.1017/S1368980022000799.

    Article  PubMed  Google Scholar 

  41. Robert P, Markus F, Getinet H. School Meals and Educational Outcomes in Rural Ethiopia. J Dev Stud. 2017. https://doi.org/10.1080/00220388.2017.1311405.

    Article  Google Scholar 

  42. Assefa M. Challenges and impacts of primary school feeding: Implication for selected primary schools in Addis Ababa Ethiopia, Pakistan. J Educ Res Evaluation. 2022;10(1):64–76.

    Google Scholar 

  43. Delbiso TD, Kotecho MG, and Asfaw FM. Effects of COVID-19 imposed school closure on school feeding program in Addis Ababa, Ethiopia. Social Sciences & Humanities Open 4 (2021). https://doi.org/10.1016/j.ssaho.2021.100185.

  44. Desalegn TA, Gebremedhin S, Alemayehu FR, Stoecker BJ. The effect of school feeding programme on class absenteeism and academic performance of schoolchildren in Southern Ethiopia: a prospective cohort study. Public Health Nutr. 2021;24(10):3066–74. https://doi.org/10.1017/S1368980021000501.

    Article  PubMed  Google Scholar 

  45. Desalegn TA, Gebremedhin S, Stoecker BJ. Successes and challenges of the Home-grown School Feeding Program in Sidama Region, Southern Ethiopia: a qualitative study. J Nutr Sci. 2022;11(e87):1–7.

    Google Scholar 

  46. Assefa E. The Impact of School Feeding Programme on Students Academic Performance: The Case of Selected Elementary Schools in Debre Libanos Wereda, Oromia Region. Thesis, Addis Ababa University, College of Education and Behavioral Studies School of Psychology Measurement and Evaluation Unit, 2015.

  47. Gebreamlak B. The Impact of Ye Enat Weg School Feeding Program on School Participation and Dietary Intake of Children in Addis Ababa: The Case of Gulele Subcity. Thesis: St. Mary’s University School of Graduate Studies School of Business; 2018.

    Google Scholar 

  48. Guta A. Assessement of the difference of School Feeding Programme on School Participation among Primary School Children in Bishoftu Town, East Shoa Zone, Oromia Regional State. Thesis, Addis Ababa University, College of Health Sciences School of Public Health, 2014.

  49. Gallenbacher DHR. Impact of School Feeding on Primary School Education in Ethiopia. Thesis: Universty of Wein; 2018.

    Google Scholar 

  50. Haile Y and Ali A. Practices, contributions, challenges and sustainability of school feeding program in Ethiopian Somali Regional State, Ethiopia. Journal of Humanities and Social Science (IOSR-JHSS), 2019, 24(1), pp 26–40. https://www.academia.edu/38265401/

  51. Dheressa, D K. Education in Focus: Impacts of School Feeding Program on School Participation: A case study in Dara of Sidama Zone, Southern Ethiopia. Thesis, Department of International Environment and Development Studies (Noragric), Norwegian University of Life Sciences (UMB). 2011.

  52. Aregawi F. The Impact of School Feeding Program on Students Enrollment and Dropout in Jigjiga Zone, Somali National Regional State, Ethiopia. Thesis, Rural Development and Agricultural Extension, Haramaya University, 2012.

  53. Seyoum IA. The Effect of School Feeding and School Input Supply (Sfsis) Intervention on Enrollment, Absenteeism, and Test Score in Lideta Sub-City, Addis Ababa. Thesis, Addis Ababa University, College of Education and Behavioual Studies Department of Educational Planning and Management, 2021.

  54. Yohannes A. The Effect of School Feeding Program on the School Performance of Primary Public School Children in Arada Sub City. Addis Ababa, Ethiopia: Addis Ababa. Addis Ababa University School of Social Work; 2017.

    Google Scholar 

  55. Sertse A A. Assessment of Challenge and Prospect of School Feeding in the Government Primary School of Addis Ababa: The Case of Kirkos Sub-city, Master’s thesis, Addis Ababa University, Addis Ababa. Thesis, Addis Ababa University, College of Development Studies Centre for Regional and Local Development Studies, 2019.

  56. Hochfeld T, Graham L, Patel L, Moodley J, Ross E. Does school breakfast make a difference? An evaluation of an in-school breakfast programme in South Africa. Int J Educ Dev. 2016;51:1–9. https://doi.org/10.1016/j.ijedudev.2016.07.005.

    Article  Google Scholar 

  57. Neervoort F, von Rosenstiel I, Bongers K, Demetriades M, Shacola M, Wolffers I. Effect of a school feeding programme on nutritional status and anaemia in an urban slum: a preliminary evaluation in Kenya. J Trop Pediatr. 2013;59(3):165–74. https://doi.org/10.1093/tropej/fms070. (Epub 2012 Dec 12 PMID: 23243080).

    Article  PubMed  Google Scholar 

  58. Alderman, H.; Gilligan, D.; Lehrer, K. The impact of food for education programs on school participation in northern Uganda. Econ. Dev. Cult. Chang. 2012, 61, 187–218. http://www2.econ.iastate.edu/faculty/orazem/TPS_papers/Alderman_Gilligan_Lehrer_FFE_School_Participation_04_2010.pdf

  59. Acham H, Kikafunda J.K, Malde M.K, Oldewage-Theron W H, Egal A A. Breakfast, midday meals and academic achievement in rural primary schools in Uganda: Implications for education and school health policy. Food & Nutrition Research 2012, 56. https://doi.org/10.3402/fnr.v56i0.11217

  60. Wall C, Tolar-Peterson T, Reeder N, Roberts M, Reynolds A, Rico MG. The Impact of School Meal Programs on, Educational Outcomes in African Schoolchildren: A Systematic Review. Int J Environ Res Public Health. 2022;19:3666. https://doi.org/10.3390/ijerph19063666.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors are grateful to Dr. Zelalem Destaw for sharing his own research and suggesting possible literature collections.

Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Knowledge Translation Directorate, Ethiopian Public Health Institute, P O Box 1242, Addis Ababa, Ethiopia

    Samson Mideksa, Tsegaye Getachew, Firmaye Bogale, Ermias Woldie, Desalegn Ararso & Mamuye Hadis

  2. Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia

    Aregash Samuel, Meron Girma & Masresha Tessema

Authors
  1. Samson Mideksa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tsegaye Getachew
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Firmaye Bogale
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ermias Woldie
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Desalegn Ararso
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Aregash Samuel
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Meron Girma
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Masresha Tessema
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mamuye Hadis
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AS and MG conceived the idea, SM and TG developed the review question, and drafted the protocol. MH, FB, and MT helped in developing the methods, and drafting and editing the protocol. SM, EW, TG, and DA were independently screened by two groups, and MH, and FB resolved the disagreements in any of the eligibility assessment processes. AS, MG, and MT helped in the analysis.

Corresponding author

Correspondence to Samson Mideksa.

Ethics declarations

Ethics approval and consent to participate

Since this review involved collecting, reviewing and summarizing publicly available data, this study did not require ethics approval from an Institutional Review Board (IRB).

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mideksa, S., Getachew, T., Bogale, F. et al. School feeding in Ethiopia: a scoping review. BMC Public Health 24, 138 (2024). https://doi.org/10.1186/s12889-023-17613-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12889-023-17613-4

Keywords

BMC Public Health

ISSN: 1471-2458

Contact us