Nutrition, health and academic achievement of primary school children: a case of Kumi District, Eastern Uganda

Abstract

Due to the success of child survival programs coupled with increased access to primary schooling through Universal Primary Education, more children are entering primary school and the education systems are now faced with challenging health and nutrition related problems. This, combined with the recent growth of research quantifying some of the adverse consequences of ill health and malnutrition, call for prompt attention to the strength of the association between health, nutrition and education. Although studies relating schoolchildren’s health and nutritional status and their learning have been conducted else where, relatively little is known about the nutrition and health conditions of school aged children in Uganda and the extent to which these factors affect their learning. This together with information on educational performance of children, Kumi district generated interest in exploring the linkages between health, nutrition and educational achievement among primary school children in Kumi district. The over-all purpose of this study was to investigate the strength of the association between health, nutritional status and scholastic achievement of primary schoolchildren in Kumi district, because of the very poor education outcomes observed in the district. The study was designed as a cross-sectional study. The study involved school children of primary 4, between the ages of 9-16 years. All children sampled were from day schools. Sampling of schools was done using a modification of WHO 30x30 cluster sampling technique (using only grade one schools). The children were sampled randomly from a list of all children in the target class. Anthropometric measurements were done using standard methods, micronutrient assessments were done using (Elisa principles of assay for iron status, LC-MS assay principal for vitamin A status, UROJOD test kit for iodine deficiency), with some slight modifications on stock and buffers used for standard preparation. Health assessments were done using the formal ether concentration technique and a rapid test for helminth and malaria infection respectively. Achievement was measured using un-standardized techniques. Results indicated that the prevalence rate of thinness was 10.1%, stunting was 8.7%, underweight was 13.0%, anemia was 24.1%, iron deficiency was 82.1%, vitamin A deficiency was 30.3%, iodine deficiency was 3.4%, malaria infection was 47.8%, and helminth infection was 4.8%. Boys were thinner, more stunted, and more underweight than girls while the reverse was true for anemia and vitamin A deficiency. Older children were thinner, more stunted and more underweight, than younger children, while the reverse was true for vitamin A deficiency. Health and nutritional status were highly predicted (p<0.05) by factors including age and sex of the child, type of household head, household size, maternal education, household wealth and quantity of land owned by the household. Although a number of factors play a significant role in determining a child’s educational outcomes, this study demonstrated that there was an association between a child’s health, nutritional status and academic achievement, but was rather weak (non significant; p>0.05 for all variables). Findings demonstrated however that a lower height-for-age (<-2.0 SD) reduced the likelihood of a child scoring a good grade. Other anthropometric indicators negatively predicted achievement which is unusual. Similarly the relationship between micronutrient status and academic achievement among the children in Kumi district was weak (non-significant). However, it was clear that a child, who was anemic, had reduced chances of scoring above the 120.0 cut-off point. Results for vitamin A and iron deficiency had negative association with achievement, which was also unusual, requiring further investigation. Likewise, there was a weak (non-significant) association between malaria infection and academic achievement in this group of children (p>0.05). However, an infected child had a lower chance of scoring 120.0 points and above. Socio-economic and demographic factors played a bigger role in determining achievement. Mothers’ education level, feeding at school and attendance for example were the socio-economic variables that significantly determined achievement (p<0.05). In conclusion therefore, there is a relationship between a child’s health, nutritional status and academic achievement, but this association is weak. It is recommended that further studies be conducted in this area, controlling for all other factors that confound learning so as the observe what the outcomes will be.