Measuring teachers’ impact on child nutrition in Uganda

Malnutrition in school-age children undermines national education efforts in Uganda.

July 18, 2017

Malnutrition in school-age children undermines national education efforts in Uganda. Recent surveys have shown that 20% of children age 6-12 are underweight, while 80% are iron-deficient and 38% have anemia, according to research compiled by Richard Bukenya, a Ugandan scholar in the Borlaug Higher Education for Agricultural Research and Development (BHEARD) program.

With the aid of BHEARD, Bukenya, pictured at right with two data collectors, recently earned his Ph.D. in Nutritional Sciences from the University of Illinois Urbana-Champaign (UIUC). Bukenya studied under the supervision of Dr. Juan Andrade, whose lab’s goal is to improve nutrition in low-income populations by developing and implementing new technologies.

The goal of BHEARD, supported by the U.S. Agency for International Development, is to develop agricultural scientists and increase agricultural research capacity in partner countries. The program is named after Dr. Norman Borlaug, an American biologist, humanitarian and Nobel laureate who has been called “the father of the Green Revolution.”

Bukenya conceptualized the causes of malnutrition in Uganda using the UNICEF framework. The immediate causes include poor feeding practices and bouts of disease. The underlying causes include limited household food security, restricted access to clean water and sanitation, and inadequate maternal and child care practices. The basic causes include sub-standard living environments, poor education, inappropriate cultural practices, limited appreciation of nutrition data, and little awareness of the role of nutrition in national development agendas.

Although there is not a national school lunch program, the Ugandan government has issued policies and guidelines to support schools that want to provide meals and address poor nutrition among children. Few primary schools, however, have adopted them. Ninety-two percent of Ugandan children do not eat breakfast at home before reporting to school, while 70% of children do not eat at least one meal at school. Of the 60% of schools, mainly from urban areas, that do provide meals, many do not provide fruits, vegetables, fortified and animal food sources.

 Since nearly eight million 6- to 12-year-old Ugandans, a quarter of the country’s population, are enrolled in primary education, schools are an ideal place for nutrition interventions. A greater effort is needed, therefore, to identify barriers to the adoption of those interventions.

Some studies have focused on the effectiveness of nutrition interventions at Ugandan schools, but few have focused on the characteristics of teachers, especially head teachers, who interact with students daily and are more likely to deliver food and nutrition education. Head teachers have executive authority in Ugandan schools, and often facilitate the implementation of policies and programs. They work with parents, fellow teachers, children, and the general community. They are well positioned to address malnutrition. Head teachers, however, might be limited by their basic knowledge of nutrition, which can become a barrier to successfully implementing nutrition interventions at their schools.

The fact that reliable nutrition data is in short supply in Uganda is partly due to the lack of validated survey instruments. To remedy this, Bukenya focused his doctoral dissertation work on developing a General Nutrition Knowledge Questionnaire (GNKQ) for Ugandan adults.

Bukenya’s research had two objectives. First, to develop a tool to obtain valid and reliable basic nutrition data among adults, including head teachers and community extension agents. Second, to examine the potential role that nutrition knowledge of head teachers plays in the adoption of recommended school feeding practices.

His work resulted in the first validated GNKQ for Uganda. This is a psychometric tool that evaluates basic nutrition knowledge in terms of five dimensions: expert recommendations, food groups, selecting food, relation of nutrition and diseases, and food fortification.

Bukenya found that head teachers’ knowledge of basic nutrition is related to a higher awareness of the Ugandan school nutrition guidelines. He also found that variables associated with a school’s environment, such as the type of school (public or private), the involvement of parents, the number of qualified teachers and amount of school materials, were helpful in predicting the level of implementation of school nutrition guidelines.

Now that he has earned his Ph.D., Bukenya expects to return to Uganda and apply what he has learned through research and training. He wants to strengthen the collaboration between UIUC and Ugandan universities by linking students and faculty.

 – Matt Milkovich

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