Effect of School Feeding Program on School Absenteeism of Primary School Adolescents in Addis Ababa, Ethiopia: A Prospective Cohort Study

Abstract

Background: School feeding programs (SFP) in low-income countries are designed to provide food to vulnerable school children to create optimal educational and health conditions for learners. Ethiopia scaled up the implementation of SFP in Addis Ababa. Yet, the utility of this program in terms of school absenteeism has not been monitored thus far. Hence, we aimed at evaluating the effect of the SFP on school performance of primary school adolescents in Addis Ababa, Central Ethiopia. Methods: A prospective cohort study was carried out from 2020 to 2021 on SFP-beneficiary (n = 322) and non-SFP beneficiary (n = 322). Logistic regression models were done using SPSS version 24. Results: In logistic regression, unadjusted model (model 1), the school absenteeism of non-school-fed adolescents was higher by 1.84 (adjusted odds ratio [aOR] 0.36, 95% confidence interval [CI] 1.28-2.64) as compared to school-fed adolescents. The odds ratio remained positive after adjusting for age and sex (model 2: aOR 1.84, 95% CI 1.27-2.65), and sociodemographic (model 3: aOR 1.84, 95% CI 1.27-2.67). In the final model, adjusted model 4, health and lifestyle, there was a significant increase in absenteeism of non-school-fed adolescents (model 4: aOR 2.37, 95% CI 1.54-3.64). The likelihood of absenteeism in female increase by 2.03 (aOR 2.03, 95% CI 1.35-3.05), whereas being in a low tertile wealth index family decreases absenteeism by (aOR 0.51, 95% CI 0.32-0.82). School feeding was negatively associated with school absenteeism. Conclusions: The findings imply the need for strengthening school feeding programs.