Effectiveness of Teacher-Based Interventions in Addressing Malnutrition Among Sub-Saharan African Primary School Children: a Systematic Review
Author: JONATHAN NSAMBA
Supervisor: Everd Maniple Bikaitwoha
In order to address the high malnutrition rates in Sub Saharan Africa, majority of nutrition programs have continuously been streamlined through the health system yet this has not yielded results as expected. The education sector on the other hand has showed immense capacity in addressing some challenges such as elimination of short term hunger through School Feeding Programs yet little attention has been given to teachers as far as implementing health and nutrition interventions. With an increased school enrolment rate in Sub Saharan Africa, there is need to reach all these children through high impact low cost interventions.
This study therefore set out to consolidate evidence about the effectiveness of teacher- based interventions in addressing Malnutrition in Sub Saharan Africa through a Systematic Review and Meta Analysis of literature since no study has attempted to. This study was underpinned by Barnfenbrenner’s Ecological Systems theory that emphasises the role of the surrounding environment to the growth and development of a child.
A comprehensive search strategy through online databases that included EBISCO, PubMed, BASE, Cochrane, Google Scholar, LILACS, Project MUSE, TRIP Database and Emerald Insight gave rise to 95,734 studies in total. These were identified and taken through a series of screening stages such that the most eligible as per the inclusion and exclusion criteria were included to answer the review question.
Three studies met the inclusion criteria and these included Eboh and Boye (2006) in Nigeria; Mbithe et al (2008) in Kenya; Steyn et al (2015) in South Africa. Risk of bias assessment and quality of the study appraisals were carried out per included study.
Teacher- based interventions have a positive effect on nutrition status of primary school children, school attendances, are sustainable and reach many children. The outcome measure of standardised mean difference gave a positive outcome (0.025 at 95% CI) although this was a small effect outcome.
There are limited numbers of high quality Randomised Controlled Trials with teachers in Primary Schools taking up active roles in the implementation process. Many studies have external personnel to implement an activity which leaves the teachers short of knowledge and skills for sustainability of the interventions.
There is need to actively involve teachers in the primordial and primary prevention stages of malnutrition through strengthening nutrition education, supplementary programs and school gardening. This therefore calls for training, capacity building and empowerment of teachers as drivers of change.
Teachers have a big role to play in the fight against Malnutrition in Sub Saharan Africa since there are more schools than health facilities and more teachers than health workers.