BackgroundUnderachievement in schools is a global problem and is especially prevalent in developing countries. Indicators of educational performance show that Uganda has done remarkably well on education access-related targets since the introduction of universal primary education in 1997. However, educational outcomes remain disappointing. The absence of school feeding schemes, one of the leading causes of scholastic underachievement, has not been given attention by the Ugandan authorities. Instead, as a national policy, parents are expected to provide meals even though many, especially in the rural areas, cannot afford to provide even the minimal daily bowl of maize porridge.ObjectiveTo assess and demonstrate the effect of breakfast and midday meal consumption on academic achievement of schoolchildren.Design, Materials and MethodsWe assessed household characteristics, feeding patterns and academic achievement of 645 schoolchildren (aged 9–15 years) in Kumi district, eastern Uganda, in 2006–2007, using a modified cluster sampling design which involved only grade 1 schools (34 in total) and pupils of grade four. Household questionnaires and school records were used to collect information on socio-demographic factors, feeding patterns and school attendance. Academic achievement was assessed using unstandardized techniques, specifically designed for this study.ResultsUnderachievement (the proportion below a score of 120.0 points) was high (68.4%); in addition, significantly higher achievement and better feeding patterns were observed among children from the less poor households (p<0.05). Achievement was significantly associated with consumption of breakfast and a midday meal, particularly for boys (p<0.05), and a greater likelihood of scoring well was observed for better nourished children (all OR values>1.0).ConclusionWe observed that underachievement was relatively high; inadequate patterns of meal consumption, particularly for the most poor, significantly higher scores among children from ‘less poor’ households and a significant association between academic achievement and breakfast and midday meal consumption.

BackgroundIron and zinc are essential micronutrients for humans and deficiency of the two elements is widespread in the world with the highest prevalence in less developed countries. There are few data on dietary intake of iron and zinc in Uganda, and no food composition table is available. There is hardly any widely published literature that clearly documents the quality of Ugandan children's diet. Thus information of both food intake and the concentration of these trace elements in local food ingredients are needed in order to assess daily intake.MethodsThe present study focused on the iron and zinc content in selected foods and intake of the micronutrients iron and zinc among schoolchildren in Kumi District, Uganda. Over a period of 4 weeks single 24-hour dietary recall interviews were carried out on a convenience sample of 178 schoolchildren (9-15 years old). Data from the dietary recalls was used when selecting foods for chemical analysis.ResultsResults from this study showed that the iron concentrations varied, and were high in some cereals and vegetables. The zinc concentrations in foods generally corresponded with results from other African countries (Mali and Kenya). Data from the 24-hour dietary recall showed that the daily Recommended Nutrient Intake (RNI) was met for iron but not for zinc.ConclusionsThe schoolchildren of Kumi district had a predominantly vegetable based diet. Foods of animal origin were consumed occasionally. The iron content in the selected foods was high and variable, and higher than in similar ingredients from Kenya and Mali, while the zinc concentrations were generally in accordance with reported values. The total daily zinc (mg) intake does not meet the daily RNI. The iron intake is adequate according to RNI, but due to iron contamination and reduced bioavailability, RNI may not be met in a vegetable based diet. More studies are needed to investigate possible sources of contamination.

Children in resource poor settings are at a high risk of inadequate iron and vitamin A intake when diets lack diversity and are dominated by staple foods. Yet comparative information on diet quality among school children is scarce. The objective of the study was to assess the potential of simple food group diversity to serve as a proxy indicator of iron and vitamin A status among rural school children in Uganda. A cross sectional correlation model of associations between Food Group Diversity (FGD) and iron and vitamin A status was used. We analyzed 8 schools in Kumi District, Uganda, randomly selected from the 34 schools that participated in the main part of the study. Our sample included primary school children, aged between 9-15 years (n = 172). Food group diversity and food variety (FV) were calculated from both a food frequency questionnaire (FFQ) and a 24-hour dietary recall. The FGD and FVS were tested against iron (as serum ferritin) and vitamin A (as serum retinol) status. The FGD (based on FFQ data) was 9.6 (±1.9). There was a positive correlation between 24-hour recall and FFQ for consumption of cereals (Corr. Coef = 0.28; p < 0.05), which was also the most highly consumed group (98.9% & 86.9% by FFQ and 24-hour recall; respectively). Consistent with other studies, increase in the number of food groups significantly increased serum ferritin and serum retinol measures (p < 0.001). Presence of at least one food item in the "roots & tubers"; "cereals"; and "pulses/nuts", significantly increased serum ferritin and serum retinol concentrations (p < 0.01). We speculate that simple food group diversity may reflect intake and serve as a simple indicator of iron and vitamin A status among school children. Strategies aimed at increasing dietary diversity in the community may benefit the families of these children and improve their micronutrient status.

Poor nutrition and health can affect children’s education. The nutritional status of school children (9-15 years) was assessed in Kumi district, Eastern Uganda in 2006-2007. Selection of schools was done using modified cluster sampling involving 34 schools (n=645). Assessments for nutritional status were done anthropometrically (height and weight), biochemically (iron, n=145; iodine, n=87; and vitamin A, n=145) and assessment for health status was done following the formal ether concentration technique for examination for intestinal helminths (n=189) and a quick malaria (n=119) test for malaria parasites. Prevalence rates for stunting, underweight and thinness were 8.7% (95CI 6.7-11.1); 13.0% (95CI 10.6-15.8); and 10.1% (95CI 7.9-12.6), respectively of which males and the older age group of children were more affected. Prevalence rates for iodine deficiency, anaemia, iron deficiency and vitamin A deficiency (VAD) were 3.4% (95CI 0.9-9.1); 24.1% (95CI 17.7-31.6); 82.1% (95CI 75.2-87.7); and 30.3% (95CI 23.3- 38.2), respectively. Anaemia (measured as haemoglobin status), iron deficiency (measured as serum Ferritin) and VAD (measured as serum retinol) were higher among females (26.3%, 95CI 17.5-36.7; 83.8%, 95CI 74.4-90.7; 33.8%, 95CI 24.0-44.6) compared to males (21.5%, 95CI 12.8-32.8; 80%, 95CI 69.0-88.4; 26.2%, 95CI 16.6-37.8). Geohelminth (S.mansoni & N.americanus) and malaria parasitemia were 4.8% and 46.2%, respectively. Prevalence rates for stunting, iodine deficiency and geohelminth infections were low. The high prevalence rates of wasting/thinness, underweight, iron and vitamin A deficiencies show these as significant public health problems among school children in Kumi district. There is a need to focus attention on nutritional and health conditions of school children to improve their conditions. Much can be done to prevent malaria infection by promoting the use of Insecticide Treated Nets and chemoprophylaxis. The biennial dosage with albendazole for deworming, and universal use of iodized salt in Uganda are success stories that should continue; iron deficiency anaemia can be controlled through nutrition education, provision of nutritious school meals coupled with control of malaria and deworming. Since many children attend school, such services if delivered through school systems would assist those school children who most need them.