New study demonstrates positive impact of school-based nutrition education on adolescent girls' diets in Ethiopia
- Impact Area
SEPTEMBER 5, 2023
September 5, 2023, Washington, DC: A comprehensive package of nutrition education interventions delivered through public primary schools can significantly improve dietary practices among adolescents, according to a new study published in The Lancet Child and Adolescent Health.
The research, funded by the Bill & Melinda Gates Foundation through the FHI 360 Alive & Thrive initiative, is among the very few to evaluate a school-based adolescent nutrition intervention in Ethiopia. The study, led by the International Food Policy Research Institute (IFPRI) in collaboration with Addis Continental Institute of Public Health, FHI Solutions, and University of South Carolina (USA), has important implications for addressing nutrition challenges among young people, especially girls, in low- and middle-income countries (LMICs).
“Adolescence is a critical phase of physical and psychological development and adequate nutrition plays a vital role in ensuring lifelong health and well-being,” said Abdulaziz Ali Oumer, FHI360, Country Director of Alive & Thrive initiative, Ethiopia, and co-author of the study. “Previous research on the topic in LMICs has largely been limited to micronutrient supplementation and fortification, while to date there have been few studies assessing the impact of nutrition education on health and nutrition outcomes among adolescents. This study is an important step toward filling this gap and providing solid evidence for future interventions and policies.”
The research employed a two-arm cluster-randomized trial, comparing 27 primary schools in the intervention group to 27 schools in the control group. The intervention schools received a series of nutrition education activities, including information dissemination during flag ceremonies, classroom lessons, school club meetings, peer group mentoring, body mass index (BMI) measurement and counseling, and parent-teacher meetings.
The primary outcome of the study was the dietary diversity score, which measures the number of different food groups (out of ten) consumed over a 24-hour period. The intervention group showed a remarkable improvement in dietary diversity compared to the control group. Additionally, the intervention led to increased meal frequency while no significant reduction in the consumption of unhealthy foods, except for certain sweets.
The findings highlight the importance of school-based interventions for improving adolescent nutrition. Many adolescents spend a significant amount of time at school, making it an ideal platform for imparting nutrition education and fostering healthier eating habits. The study demonstrated that by delivering targeted interventions within the school setting, it is possible to positively influence dietary practices and improve nutritional knowledge among both students and parents. However, these interventions may need to be coupled with others to improve the food environments to change eating practices related to junk foods.
“Our study underscores the effectiveness of holistic school-based nutrition programs in promoting healthier dietary choices among adolescent girls,” said Sunny Kim, Research Fellow in Nutrition, Diets, and Health Unit at IFPRI, the lead author of the study. “By incorporating diverse intervention components and engaging students, teachers, and parents, we can create an environment that encourages the consumption of nutritious foods and ultimately contributes to better lifelong health.”
“The intervention’s success in Ethiopia may serve as a model for similar initiatives in other low- and middle-income countries with high rates of adolescent undernutrition. The results emphasize the need for multi-pronged strategies that address not only individual behavior change but also broader environmental factors affecting food choices,” said Purnima Menon, Senior Director, Food and Nutrition Policy, CGIAR and IFPRI, the study co-author.
For more information, please refer to the original research article:
Kim, Sunny; Sununtnasuk, Celeste; Berhane, Hanna; Walissa, Tamirat Tafesse; Oumer, Abdulaziz Ali; Asrat, Yonas Taffesse; Sanghvi, Tina; Frongillo, Edward; Menon, Purnima. Feasibility and impact of school-based nutrition education interventions on the diets of adolescent girls in Ethiopia: a non-masked, cluster-randomised, controlled trial. The Lancet Child & Adolescent Health. Published online: September 01, 2023. https://doi.org/10.1016/S2352-4642(23)00168-2
The International Food Policy Research Institute (IFPRI) provides research-based policy solutions to sustainably reduce poverty and end hunger and malnutrition. IFPRI’s strategic research aims to identify and analyze alternative international and country-led strategies and policies for meeting food and nutrition needs in low- and middle-income countries, with particular emphasis on poor and vulnerable groups in those countries, gender equity, and sustainability. It is a research center of CGIAR, a worldwide partnership engaged in agricultural research for development. www.ifpri.org
Alive & Thrive is a global nutrition initiative to save lives, prevent illness, and ensure healthy growth of mothers and children. From 2009–2014, A&T demonstrated that rapid improvements in infant and young child feeding (IYCF) are possible in settings as diverse as Ethiopia, Bangladesh, and Viet Nam. In 2014, A&T began working in Burkina Faso, India, Nigeria, and throughout the Southeast Asia region, expanding its scope to include maternal and adolescent nutrition, and using agriculture and social protection programs as delivery mechanisms for maternal, infant, and young child nutrition (MIYCN). Currently, A&T is leveraging its robust network and knowledge base to strengthen systems and build capacity in these and other countries across Africa and Asia, while also disseminating innovations, tools, and lessons worldwide.
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