Trial reportThe Journal of nutrition2019
A School Meals Program Implemented at Scale in Ghana Increases Height-for-Age during Midchildhood in Girls and in Children from Poor Households: A Cluster Randomized Trial.
Trial report in The Journal of nutrition, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 6 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- The role of nutrition-sensitive interventions in improving nutritional outcomes: findings from a systematic review and meta-analysis.International journal for equity in health · 2025Pooled it
- How do publicly procured school meals programmes in sub-Saharan Africa improve nutritional outcomes for children and adolescents: a mixed-methods systematic review.Public health nutrition · 2024Pooled it
- Impact of free school lunch program on nutritional status and academic outcomes among school children in India: A systematic review.BMJ open · 2024Pooled it
- Systems approaches to scaling up: a systematic review and narrative synthesis of evidence for physical activity and other behavioural non-communicable disease risk factors.The international journal of behavioral nutrition and physical activity · 2024Pooled it
- Effects of policies or interventions that influence the school food environment on children's health and nonhealth outcomes: a systematic review.Nutrition reviews · 2024Pooled it
- Impacts of school feeding on educational and health outcomes of school-age children and adolescents in low- and middle-income countries: A systematic review and meta-analysis.Journal of global health · 2021Pooled it
- Nutrition education improves knowledge and BMI-for-age in Ghanaian school-aged children.African health sciences · 2021Trial
- Assessment of Nutritional Trends and Program Implementation Under the Nutrition Improvement Program.Nutrients · 2026Article
- Optimising school meals in Ghana: integrating new food and nutrient standards with aspects of affordability, cultural acceptability and environmental sustainability.Public health nutrition · 2026Article
- Parental knowledge, attitudes, and practices related to school children nutrition in urban settings: cross-sectional study from Central Kazakhstan.Frontiers in nutrition · 2026Article
- Article
- Ready-to-Use School Meals in Northern Ghana Are a Viable Alternative to Traditional School Meals.Annals of the New York Academy of Sciences · 2025Article
- Nutrient gaps and dietary adequacy among adolescent girls in rural North-Eastern Ghana: the role of local food-based approaches, school lunch and multiple-micronutrient fortified biscuits.The British journal of nutrition · 2025Article
- The School Food Environment in Ghana is Associated With Dietary Diversity and Anemia: Findings From the 2022 National Nutrition and Health Survey of In-School Adolescents.Food and nutrition bulletin · 2025Article
- Review of Current Strategies to Address Micronutrient Deficiencies (MNDs) in Ghana: A Scoping Review.Journal of nutrition and metabolism · 2025Review
- Associated factors of dietary diversity among schoolchildren in Plateau Central region of Burkina Faso: a cross-sectional study.BMC nutrition · 2024Article
- The effect of school-entry age on health is understudied in low- and middle-income countries: A scoping review and future directions for research.SSM - population health · 2023Article
- COVID-19-Induced Disruptions of School Feeding Services Exacerbate Food Insecurity in Nigeria.The Journal of nutrition · 2021Article
- Household food insecurity and educational outcomes in school-going adolescents in Ghana.Public health nutrition · 2021Article
- Free Senior High School Lunch Contributes to Dietary Quality of Nonresidential Students in Ghana.Food and nutrition bulletin · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAttention to nutrition during all phases of child and adolescent development is necessary to ensure healthy physical growth and to protect investments made earlier in life. Leveraging school meals programs as platforms to scale-up nutrition interventions is relevant as programs function in nearly every country in the world.
objectiveThe aim of this study was to evaluate the impact of a large-scale school meals program in Ghana on school-age children's anthropometry indicators.
methodsA longitudinal cluster randomized control trial was implemented across the 10 regions of Ghana, covering 2869 school-age children (aged 5-15 y). Communities were randomly assigned to 1) control group without intervention or 2) treatment group providing the reformed national school feeding program, providing 1 hot meal/d in public primary schools. Primary outcomes included height-for-age (HAZ) and BMI-for-age (BAZ) z scores. The analysis followed an intention-to-treat approach as per the published protocol for the study population and subgroup analysis by age (i.e., midchildhood for children 5-8 y and early adolescence for children 9-15 y), gender, poverty, and region of residence. We used single-difference ANCOVA with mixed-effect regression models to assess program impacts.
resultsSchool meals had no effect on HAZ and BAZ in children aged 5-15 y. However, in per-protocol subgroup analysis, the school feeding intervention improved HAZ in 5- to 8-y-old children (effect size: 0.12 SDs), in girls (effect size: 0.12 SDs)-particularly girls aged 5-8 y living in the northern regions, and in children aged 5-8 y in households living below the poverty line (effect size: 0.22 SDs). There was also evidence that the intervention influenced food allocation and sharing at the household level.
conclusionSchool meals can provide a platform to scale-up nutrition interventions in the early primary school years, with important benefits accruing for more disadvantaged children. This trial was registered at www.isrctn.com as ISRCTN66918874.
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Registered trials
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 OpenQuestion graph.