Table 7: Summary table of included studies: Observational studies.
Study (year), and Location |
Sample Size (n), age of participants |
Duration of intervention |
Measurement of exposure and outcomes of interest |
Summary of key findings |
Direction of results |
Remarks |
Neervoort, et al. [28]
Kenya |
Intervention group = 67
Control group = 81
|
1 year
|
Exposure Measurement: school based lunch provided on each school day with health education Outcome measurement: Haemoglobin concentration was measured and adjusted for age and altitude |
Anaemia was 19% among the intervention group and 42% anaemia prevalence was recorded among the control group (difference is significant at p = 0.01) |
*Positive
Intervention is associated with lower anemia levels
|
The following confounders were adjusted for; family size, age and education of mother, adoption status, amount of food consumed at home. All children were dewormed |
Abizari, et al. [41]
Ghana |
N (total) = 383 SFP participants = Non-SFP participants =
School children aged 5-13 years
children aged 6-15 years |
|
Exposure measurement: School based lunch was provided each school day except on holidays
Outcome measurement: - 24 Hr recalls, weighed food records and biochemical analysis to determine concentrations of Hb, serum ferritin and soluble transferrin receptor |
Mean probability of adequacy of micronutrient intake was significantly higher among SFP participants (0.61 vrs 0.18) p < 0.001 SFP participants had 6 g/l higher Hb concentration (p < 0.001) and about 10% points lower anaemia prevalence (p = 0.06) Concentration of soluble transferrin receptor was lower in intervention group (p = 0.004) There was no significant difference in iron and iron deficiency anaemia.
|
*Positive SFP participants had a higher Haemoglobin concentration and lower prevalence of anaemia. Iron intake was higher SFP participants
*Negative There is no significant difference in Iron deficiency and iron deficiency anaemia among SFP and Non SFP participants |
Adjustment was done for background differences. Study area is hyper endermic for malaria Corn soy blend which is given is multiple micronutrient fortified and orange was given twice a week |
Afridi Farzana [46]
India |
N (total) = 226 School meal participants = 143 Non school meal participants = 93
Children aged children |
|
Exposure measurement: Provision of school lunch each school day
Outcome measurement: 24 Hr recalls for school day and non school day |
Daily iron deficiency was reduced by 10% associated with school feeding during school days
Increased iron intake during school days by 3.85 mg (p < 0.001)
|
*Positive
School feeding during school days is associated with increased dietary iron intake |
|
Walker, et al. [49]
Jamaica |
N (total) = 147 School meal group = 73
Non school meal group = 74 Children aged 7-10 years |
|
Exposure Measurement: Children offered lunch in school prepared by school (paid for) during school days
Outcome Measurement: -Repeated 24 Hr recalls of dietary nutrient intake |
Dietary iron intake was significantly higher in the school meal group (3.4 mg ± 1.8 vrs 0.5 mg ± 0.9)
|
*Positive School feeding was associated with increase dietary iron intake
|
School meals were relative expensive ($6-10) compared to other cooked meals and lunch items available from shops and street vendors |
Harding, et al. [42]
Ghana |
N (Total) = 193 School feeding participants = 104 School feeding Non participants = 89
School children aged 2-5 years |
7 months |
Exposure measurement: SFP participants received one meal at lunch for each school day. Meals vary
Outcome measurement: 24 Hr dietary recalls on two non consecutive days. Blood samples were analyzed for haemoglobin levels |
SFP participants had a higher intake of iron compared to non participants but after controlling for confounders SFP participants had a reduced iron intake compared to non participants.
There was no significant difference in haemoglobin levels between the two groups. |
*Negative School feeding was associated with decreased dietary iron intake and haemoglobin levels were not significantly different between participants and non participants |
Foods used for the feeding programme were contributed by parents, cooked and shared among pupils. Foods were from local sources and not fortified. |