School Feeding and Nutritional Status of Students in Dubti District, Afar, Northeast Ethiopia: Comparative Cross-Sectional Study

Figures & data

Table 1 Socio-Demographic Characteristics of the Respondents

Variables	Response	Frequency (%)		p-value
		SFP (n=468)	NSFP (n=468)
Age of the students	<=10 years	171 (36.5%)	211 (45.1%)	0.008
	>10 years	297 (63.5%)	257 (54.9%)
Sex of the students	Male	259 (55.3%)	282 (60.3%)	0.128
	Female	209 (44.7%)	186 (39.7%)
Grade level	1st	86 (18.4%)	87 (18.6%)	0.005
	2nd	46 (9.8%)	52 (11.1%)
	3rd	53 (11.3%)	72 (15.4%)
	4th	50 (10.7%)	61 (13%)
	5th	61 (13.0%)	76 (16.2%)
	6th	59 (12.6%)	57 (12.2%)
	7th	55 (11.8%)	31 (6.6%)
	8th	58 (12.4%)	32 (6.8%)
Parent marital status	Married	404 (86.3%)	394 (84.2%)	0.589
	Divorced	57 (12.2%)	64 (13.7%)
	Died either of one	7 (1.5%)	10 (2.1%)
Residence	Urban	308 (65.8%)	461 (98.5%)	<0.001
	Rural	160 (34.2%)	7 (1.5%)
Religion	Muslim	424 (90.6%)	383 (81.8%)	<0.001
	Protestant	34 (7.3%)	33 (7.1%)
	Orthodox	10 (2.1%)	52 (11.1%)
Ethnicity	Afar	359 (76.7%)	288 (61.5%)	<0.001
	Amhara	80 (17.1%)	168 (35.9%)
	Others	29 (6.2%)	12 (2.6%)
House hold member	≤5	293 (62.6%)	295 (63.0%)	0.892
	>5	175 (37.4%)	173 (37.0%)
Maternal age	<35	3 (0.6%)	2 (0.4%)	0.024
	35–45	353 (75.4%)	387 (82.7%)
	>45	112 (23.9%)	79 (16.9%)

Abbreviations: SFP, school feeding program; NSFP, non-school feeding program; n, number of samples.

Table 2 Socioeconomic Characteristics and Source of Information of the Respondents

Variables	Response	Frequency (%)		Chi Square	p-value
		SFP (n=468)	NSFP (n=468)
Mothers’ educational status	Cannot read and write	156 (33.3%)	184 (39.3%)	133.064	<0.001
	Read and write	138 (29.5%)	105 (22.4%)
	Primary school	26 (5.6%)	124 (26.5%)
	High school	34 (7.3%)	33 (7.1%)
	College and above	114 (24.4%)	22 (4.7%)
Fathers’ educational status	Cannot read and write	101 (21.6%)	50 (10.7%)	131.983	<0.001
	Read and write	148 (31.6%)	186 (39.7%)
	Primary	143 (30.6%)	39 (8.3%)
	High school	39 (8.3%)	104 (22.2%)
	College and above	37 (7.9%)	89 (19.0%)
Mothers’ occupation	House wife	380 (81.2%)	290 (62.0%)	42.725	<0.001
	Merchant	56 (12.0%)	116 (24.8%)
	Civil servant	21 (4.5%)	43 (9.2%)
	Daily laborer	11 (2.4%)	19 (4.1%)
Fathers’ occupation	Pastoral	126 (26.9%)	52 (11.1%)	85.999	<0.001
	Agro-pastoralist	175 (37.4%)	136 (29.1%)
	Civil servant	146 (31.2%)	188 (40.2%)
	Daily laborer	21 (4.5%)	92 (19.7%)
Pocket money	Given	94 (20.1%)	132 (28.2%)	8.423	0.004
	Not given	374 (79.9%)	336 (71.8%)
Media source	Yes	436 (93.2%)	460 (98.3%)	15.043	<0.001
	No	32 (6.8%)	8 (1.7%)
Type of media source (n=896)	Television	175 (40.1%)	384 (83.5%)	181.953	<0.001
	Radio	249 (57.1%)	70 (15.2%)
	Mobile phone	12 (2.8%)	6 (1.3%)

Abbreviations: SFP, school feeding program; NSFP, non-school feeding program; n, number of samples.

Table 3 Health-Related Characteristics of the Respondents

Variables	Response Category	Frequencies (%)		Chi Square	p-value
		SFP (n=468)	NSFP (n=468)
Have latrine	Yes	209 (44.7%)	367 (78.4%)	112.685	<0.001
	No	259 (55.3%)	101 (21.6%)
Immunization status	Not immunized	23 (4.9%)	12 (2.6%)	20.486	<0.001
	Partially immunized	48 (10.3%)	17 (3.6%)
	Fully immunized	356 (76.1%)	397 (84.8%)
	Unknown status	41 (8.8%)	42 (9.0%)
Have diarrhea	Yes	171 (36.5%)	206 (44.0%)	5.441	0.02
	No	297 (63.5%)	262 (56.0%)
Have cold flu	Yes	104 (22.2%)	217 (46.4%)	60.541	<0.001
	No	364 (77.8%)	251 (53.6%)
Smoking in the family	Yes	252 (53.8%)	157 (33.5%)	39.191	<0.001
	No	216 (46.2%)	311 (66.5%)
Chat chewing in the family	Yes	220 (47.0%)	245 (52.4%)	2.671	0.102
	No	248 (52.7%)	223 (47.3%)
Drinking water source	River water	13 (2.8%)	6 (1.3%)	126.674	<0.001
	Dug water	9 (1.9%)	1 (0.2%)
	Pipe water	345 (73.7%)	461 (98.5%)
	Protected spring	101 (21.6%)	0 (0%)
Hand washing before eating	Yes	427 (91.2%)	434 (92.7%)	0.71	0.399
	No	41 (8.8%)	34 (7.3%)
Method of hand washing	Water only	382 (89.5%)	316 (72.8%)	38.88	0
	Water and soap	45 (10.5%)	118 (27.2%)
Time for hand washing	Before meal	343 (73.3%)	267 (57.1%)	34.542	0
	After meal	99 (21.2%)	130 (27.8%)
	After toilet	26 (5.6%)	71 (15.2%)
Hand washing after toilet	Yes	365 (78.0%)	368 (78.6%)	0.057	0.812
	No	103 (22.0%)	100 (21.4%)
Method of hand washing	Water Only	325 (89.0%)	240 (65.2%)	58.872	<0.001
	Water and Soap	40 (11.0%)	128 (34.8%)

Abbreviations: SFP, school feeding program; NSFP, non-school feeding program; n, number of samples.

Table 4 Nutrition-Related Characteristics of the Respondents

Variables	Response Category	Frequencies (%)		Chi Square	p-value
		SFP (n=468)	NSFP (n=468)
Eating Frequency (per 24 hour)	Once	14 (3.0%)	3 (0.6%)	38.745	<0.001
	Twice	35 (7.5%)	2 (0.4%)
	>Twice	419 (89.5%)	463 (98.9%)
Eat breakfast	Yes	432 (92.3%)	463 (98.9%)	24.513	<0.001
	No	36 (7.7%)	5 (1.1%)
Eat lunch	Yes	443 (94.7%)	464 (99.1%)	15.693	<0.001
	No	25 (5.3%)	4 (0.9%)
Eat dinner	Yes	467 (99.8%)	464 (99.1%)	1.801	0.179
	No	1 (0.2%)	4 (0.9%)
Nutrition education	Yes	182 (38.9%)	4 (0.9%)	212.589	<0.001
	No	286 (61.1%)	464 (99.1%)
Nutrition Education Frequency (n=186)	Once	25 (13.7%)	2 (50.0%)	11.183	0.004
	Twice	152 (83.5%)	1 (25.0%)
	Three time	5 (2.7%)	1 (25.0%)
Diet source information	School Mini-media	295 (63.0%)	187 (40.0%)	149.293	<0.001
	Radio	108 (23.1%)	45 (9.4%)
	Television	65 (13.9%)	236 (50.4%)

Abbreviations: SFP, school feeding program; NSFP, non-school feeding program; n, number of samples.

Table 5 Prevalence on Malnutrition Among the Respondents

Variables	Response Category	Frequencies (%)		Chi Square	p-value
		SFP (n=468)	NSFP (n=468)
HAZ	Not Stunted	404 (86.3%)	367 (78.4%)	11.033	0.004
	Moderately Stunted	43 (9.2%)	60 (12.8%)
	Severely Stunted	21 (4.5%)	41 (8.8%)
BAZ	Normal	420 (89.7%)	403 (86.1%)	45.480	<0.001
	Moderate thinness	14 (3.0%)	37 (7.9%)
	Severe thinness	9 (1.9%)	28 (6.0%)
	Overweight	19 (4.1%)	-
	Obesity	6 (1.3%)	-

Abbreviations: HAZ, height for age Z scores; BAZ, BMI for age Z scores; SFP, school feeding program; NSFP, non-school feeding program; n, number of samples.

Table 6 Determinants of Stunting Among Students in SFP Schools

Variables	Response Category	Stunting		COR (95% CI)	AOR (95% CI)
		Yes	No
Age of the Student	<=10 years	37	134	2.8 (1.6–4.7)	0.5 (0.1–1.7)
	>11 years	27	270	1	1
Grade level	1st	24	62	1	1
	2nd	8	38	0.5 (0.2–1.3)	0.96 (0.3–2.8)
	3rd	10	43	0.6 (0.3–1.4)	0.4 (0.1–1.1)
	4th	3	47	0.2 (0.1–0.6)	0.13 (0.02–0.8)*
	5th	7	54	0.3 (1.3–0.8)	0.12 (0.1–0.06)*
	6th	5	54	0.2 (0.1–0.7)	0.15 (0.02–0.8)*
	7th	5	50	0.3 (0.1–0.7)	0.13 (0.1–0.7)*
	8th	2	56	0.1 (0.1–0.4)	0.04 (0.1–0.3)*
Ethnicity	Afar	48	311	1	1
	Amhara	15	65	1.5 (0.8–2.8)	1.6 (0.8–3.4)
	Others	1	28	0.2 (0.1–1.7)	0.84 (0.1–8.4)
House hold member	<5	52	241	1	1
	>5	12	163	0.3 (0.1–0.7)	0.6 (0.2–1.4)
Hand washing before eating	Yes	61	366	1	1
	No	3	38	0.5 (0.1–1.6)	0.6 (0.1–2.6)
Have diarrhea	Yes	18	153	0.6 (0.3–1.1)	0.7 (0.3–1.4)
	No	46	251	1	1
Have cold flu	Yes	11	93	0.7 (0.3–1.4)	1.3 (0.5–2.9)
	No	53	311	1	1
Hand washing after toilet	Yes	55	310	1	1
	No	9	94	0.5 (0.2–1.1)	0.7 (0.2–2.1)
Smoking in the family	Yes	47	205	2.7 (1.4–4.8)	1.7 (0.6–4.4)
	No	17	199	1	1
Khat chewing in the family	Yes	35	185	1.4 (0.8–2.4)	1.6 (0.9–2.9)
	No	29	219	1	1
Nutrition education	Yes	18	164	1	1
	No	46	240	1.7 (0.9–3.1)	1.2 (0.4–3.2)
Diet information source	School mini-media	49	246	1	1
	Radio	13	95	0.7 (0.4–1.83)	0.8 (0.4–1.7)
	Television	2	63	0.2 (0.1–0.7)	0.15 (0.1–0.7) *

Note: *Significant at p-value of 0.05.

Abbreviations: COR, Crude odds ratio; AOR, adjusted odds ratio.

Table 7 Determinants of Stunting Among Students in NSFP Schools

Variables	Response Category	Stunting		COR (95% CI)	AOR (95% CI)
		Yes	No
Age of the Students	<=10 years	40	171	0.7 (0.4–1.2)	0.6 (0.2–1.3)
	>10 years	61	196	1	1
Grade level	1st	18	69	1	1
	2nd	13	39	1.8 (0.6–5.6)	1.1 (0.4–2.6)
	3rd	15	57	1.4 (0.4–4.3)	0.7 (0.3–1.6)
	4th	9	52	0.9 (0.2–3)	0.4 (0.1–1.1)
	5th	19	57	1.8 (0.6–5.3)	0.6 (0.2–1.8)
	6th	9	48	1 (0.3–3.31)	0.3 (0.1–1.1)
	7th	13	18	3.9 (1.1–12.8)	1.4 (0.4–4.7)
	8th	5	27	1.4 (0.4–4.2)	0.3 (0.1–1.1)
Residence	Urban	98	363	1	1
	Rural	3	4	2.8 (0.6–12.6)	4.9 (0.8–28.3)
Maternal age	<35	0	2	0.000	0.000
	35–45	91	296	2.1 (1.1–4.3)	1.7 (0.7–4.1)
	>45	10	69	1	1
Maternal educational status	Cannot read and write	32	152	1	1
	Read and write	31	74	1.4 (0.4–4.2)	1.6 (0.8–3.2)
	Primary school	30	94	1.1 (0.3–3.2)	1.3 (0.7–2.7)
	High school	3	30	0.3 (0.07–1.6)	0.3 (0.1–1.4)
	College and above	5	17	0.7 (0.2–2.1)	0.6 (0.1–2.6)
Fathers Occupational Status	Pastoral	15	37	1	1
	Agro-pastoral	20	116	0.4 (0.1–1.9)	0.5 (0.2–1.4)
	Civil servant	45	143	0.8 (0.2–3.3)	0.5 (0.2–1.3)
	Daily laborer	18	63	0.7 (0.1–3.2)	0.5 (0.2–1.5)
	Others	3	8	1.1 (0.2–4.6)	0.6 (0.1–3.2)
Parent Marital Status	Married	80	314	1	1
	Divorced	20	44	4 (0.4–34.5)	1.5 (0.7–3.1)
	Died either of one	1	9	2.3 (0.2–18.4)	0.2 (0.1–1.9)
Media Source	Yes	96	364	1	1
	No	5	3	6.3 (1.4–26.9)	17.6 (2.6–116.7)
Vaccination Status	Not immunized	5	7	1	1
	Partially immunized	2	15	0.2 (0.03–1.2)	0.2 (0.03–1.9)
	Fully immunized	81	316	0.4 (0.1–1.2)	0.5 (0.1–1.9)
	Unknown status	13	29	0.6 (0.1–2.4)	0.7 (0.1–3.4)
Time of Hand Washing	Before meal	52	215	1	1
	After meal	28	102	1.2 (0.7–1.9)	1.3 (0.8–2.4)
	After toilet	21	50	1.7 (0.9–3.1)	1.7 (0.8–3.6)
Have Cold Flu	Yes	40	177	0.7 (0.4–1.1)	0.7 (0.4–1.2)
	No	61	190	1	1
Hand Washing after toilet	Yes	75	293	1	1
	No	26	74	1.4 (0.8–2.3)	0.9 (0.5–1.8)
Smoking in the family	Yes	24	133	0.5 (0.3–0.9)	0.52 (0.2–1)
	No	77	234	1	1
Khat Chewing in the family	Yes	45	200	0.7 (0.4–1)	0.8 (0.4–1.4)
	No	56	167	1	1

Abbreviations: COR, Crude odds ratio; AOR, adjusted odds ratio.

Table 8 Determinants of Stunting in Both SFP and NSFP Students

Variables	Response	Stunting		COR (95% CI)	AOR (95% CI)
		Yes	No
Age of the students	<=10 years	77	305	1.3 (0.9–1.9)	0.6 (0.3–1.2)
	>10 years	88	466	1	1
Grade level	1st	42	131	1	1
	2nd	21	77	3.2 (1.3–8)	0.8 (0.4–1.6)
	3rd	25	100	2.9 (1.2–7.2)	0.7 (0.4–1.3)
	4th	12	99	1.4 (0.5–3.8)	0.3 (0.1–0.6) *
	5th	26	111	2.7 (1.1–6.7)	0.5 (0.2–1)
	6th	14	102	1.6 (0.6–4.2)	0.3 (0.1–8)
	7th	18	68	3.1 (1.2–8)	0.8 (0.3–1.8)
	8th	7	83	3.8 (1.6–8.9)	0.2 (0.1–0.7) *
Residence	Urban	142	627	1	1
	Rural	23	144	0.7 (0.4–1.1)	1.2 (0.7–2.4)
Mothers Age	<35	0	5	0	0
	35–45	144	596	1.9 (1.2–3.2)	2 (1.1–3.4)
	>45	21	170	1	1
Ethnicity	Afar	114	533	1	1
	Amhara	48	200	3 (0.9–10.3)	1 (0.7–1.5)
	Others	3	38	2.7 (0.8–9)	0.3 (0.1–1.2)
House hold member	<5	115	473	1	1
	>5	50	298	0.7 (0.4–0.99)	0.7 (0.4–1)
Vaccination Status	Not immunized	5	30	1	1
	Partially immunized	8	57	0.8 (0.2–2.8)	0.8 (0.2–2.8)
	Fully immunized	130	623	1.2 (0.4–3.3)	0.8 (0.2–2.3)
	Unknown status	22	61	2.2 (0.7–6.3)	1.7 (0.5–5.5)
Drinking water Source	River water	4	15	2.7 (0.7–9.9)	2.2 (0.4–10.4)
	Dug water	0	10	0	0
	Pipe water	152	654	2.4 (1.1–4.8)	1.2 (0.4–3.4)
	Protected spring	9	92	1	1
Hand washing before eating	Yes	157	704	1	1
	No	8	67	0.5 (0.2–1.1)	0.5 (0.2–1.2)
Time of hand washing	Before meal	97	513	1	1
	After meal	45	184	0.8 (0.4–1.4)	1.4 (0.9–2.2)
	After toilet	23	74	0.6 (0.3–1)	1.8 (01.1–3.2)
Have latrine	Yes	108	468	1	1
	No	57	303	0.8 (0.5–1.2)	1.1 (0.7–1.8)
Nutrition Education	Yes	18	168	1	1
	No	147	603	2.3 (1.3–3.8)	2.6 (1.1–5.5)*

Note: *Significant at p-value of 0.05.

Abbreviations: COR, Crude odds ratio; AOR, adjusted odds ratio.

Table 9 Multinomial Logistic Regression of Factors Associated with Thinness and Overweight/Obesity Among Students from Both Groups

Variables	Response	Thinness		Overweight/Obesity
		OR (95% CI)	p-value	OR (95% CI)	p-value
Age	<=10 years	2 (1.3–3.1)	0.003	0.52 (0.21–1)	0.18
	>10 years	1		1
Sex	Male	1.13 (0.71–1.8)	0.6	0.9 (0.41–2.1)	0.86
	Female	1		1
Residence	Urban	1.8 (0.72–4.3)	0.21	0.4 (0.1–1.1)	0.8
	Rural	1		1
Diarrhea	Yes	1.3 (0.8–2)	0.26	1.1 (0.5–2.6)	0.8
	No	1		1
Common cold	Yes	1.3 (0.8–2)	0.2	0.3 (0.1–1.1)	0.053
	No	1		1
Latrine	Yes	1 (0.6–1.8)	0.9	0.6 (0.2–1.6)	0.32
	No	1		1
Hand wash	Yes	0.7 (0.4–1.1)	0.1	4.6 (0.9–22)	0.06
	No	1		1
Nutritional education	Yes	0.6 (0.3–1.3)	0.19	1.3 (0.4–4.3)	0.67
	No	1		1
Smoking	Yes	0.9 (0.5–1.5)	0.7	1.7 (0.7–4.5)	0.26
	No	1		1
Khat chewing	Yes	1.3 (0.8–2.1)	0.2	1.6 (0.7–3.7)	0.24
	No	1		1

Abbreviation: OR, odds ratio.

Table 10 Multinomial Logistic Regression of Factors Associated with Thinness and Overweight/Obesity from SFP Groups

Variables	Response	Thinness		Overweight/Obesity
		OR (95% CI)	p-value	OR (95% CI)	p-value
Age	<=10 years	2 (1.3–3.1)	0.003	0.5 (0.2–1.3)	0.2
	>10 years	1		1
Sex	Male	1.13 (0.71–1.8)	0.6	0.9 (0.41–2.1)	0.9
	Female	1		1
Residence	Urban	1.8 (0.72–4.3)	0.21	0.4 (0.1–1.1)	0.1
	Rural	1		1
Diarrhea	Yes	1.3 (0.8–2)	0.26	1.1 (0.5–2.6)	0.8
	No	1		1
Common cold	Yes	1.3 (0.8–2)	0.2	0.3 (0.1–1.1)	0.1
	No	1		1
Latrine	Yes	1 (0.6–1.8)	0.86	0.6 (0.2–1.6)	0.3
	No	1		1
Hand wash	Yes	0.7 (0.4–1.1)	0.14	4.6 (0.9–22)	0.1
	No	1		1
Nutritional education	Yes	0.6 (0.3–1.3)	0.19	1.7 (0.7–4.5)	0.3
	No	1		1
Smoking	Yes	0.9 (0.5–1.5)	0.67	1.6 (0.7–3.7)	0.2
	No	1		1
Khat chewing	Yes	1.3 (0.8–2.1)	0.2	1.3 (0.4–4.3)	0.7
	No	1		1

Abbreviation: OR, odds ratio.