Evidence mapPaperPMID 41527070Full record

SynthesisBMC public health2026

Associations between exposure to nutrition, WASH interventions and children's academic performance in Ethiopia: a systematic review and meta-analysis.

Yimer Mihretie Adugna, Abebe Ayelign, Tadesse Alemu Zerfu

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Yimer Mihretie Adugna *Center for Food Science and Nutrition, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia. luguy00@gmail.com.
Abebe Ayelign *Center for Food Science and Nutrition, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
Tadesse Alemu Zerfu *International Food Policy Research Institute (IFPRI), P.O. Box 5689, Addis Ababa, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPoor nutrition and inadequate WASH (water, sanitation, and hygiene) practices significantly impact children’s health, nutrition, and cognitive development, especially in low-income settings. These factors further aggravate the incidence of undernutrition, weaken the immune system, increase susceptibility to illnesses and reduce cognitive performance. Evidence on the effectiveness of existing WASH interventions is needed.

objectiveThis review evaluated the effectiveness of nutritional and WASH interventions on the academic performance of children in Ethiopia.

methodsA systematic search of Cochrane, DOAJ, Google Scholar, and PubMed (2010–2024) was conducted using MeSH terms and keywords related to WASH. Two independent reviewers screened studies and extracted data. Eligible studies included cross-sectional and cohort studies on Ethiopian schoolchildren with quantifiable academic outcomes. The JBI SUMARI was used to assess bias, and the GRADE approach was used to evaluate evidence quality. The meta-analysis used a random-effects model in Stata and reported pooled RRs with 95% CIs. Subgroup and sensitivity analyses examined moderators such as study design, intervention type, and sample size.

resultsA total of 19 studies, 16 cross-sectional (n = 16) and three prospective (n = 3) cohort studies with a total of 9034 participants, were included. The random effects model revealed a significant improvement in academic performance among students receiving both nutrition and WASH, with a pooled large positive effect size of 2.05 (95% CI: 1.26, 2.28; I2=). In the subgroup meta-analysis, the effect of the intervention was more positive among those who skipped breakfast (3.47, 95% CI: 0.47, 6.47), chronic iodine deficiency (4.49, 95% CI: 4.08, 4.90), food insecurity (2.810, 95% CI: 1.281, 4.339), and underweight (0.61, 95% CI: 0.46, 0.75).

conclusionDespite moderate variability and some risk of bias, the evidence supports the integration of comprehensive nutrition and WASH programs into school health initiatives. Future research should focus on long-term effects and cost-effectiveness.

trial registrationThis systematic review and meta-analysis were registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the ID CRD42024567265.

Indexed as

Academic PerformanceHygieneNutritional StatusSanitationChildCross-Sectional StudiesEthiopiaHumansAcademic performanceEthiopiaNutrition interventionsSystematic reviewWASHWater, sanitation, and hygiene interventions

Identifiers

PMID41527070
PMCPMC12961871

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.