Kilandeka, Vivian Richard2024-11-052024-11-052024-05https://www.suaire.sua.ac.tz/handle/123456789/6426MSc DissertationMalnutrition among school-aged children has significant consequences for their health, cognitive development, and overall educational achievement. Rapid shifts in the availability and affordability of less nutritious foods in food environments have contributed to the dual challenges of malnutrition. There is growing global interest in understanding how food environments contribute to this double burden of malnutrition. This study aimed to assess the impact of the school food environment on the eating habits and nutritional well-being of primary school children aged 6 to 13 years in Dodoma region. Specific objectives were first: to evaluate the nutritional status of school-age children and examine how socio- economic, demographic, and environmental factors influence their nutritional well-being; second, to investigate how the school food environments affect the eating behaviours of primary school children in both public and private schools in Dodoma region. A cross- sectional study involving 248 pupils was conducted in eight primary schools in Dodoma region. Four schools were chosen from Chamwino district (a rural setting), including two public and two private schools. The other four schools were located in Dodoma urban district (an urban setting), comprising of two government schools and two private schools. The study also involved eight head teachers and eight health/food teachers, who were purposefully selected from the eight participating primary schools. Anthropometric measurements were made following the World Health Organization (WHO) guidelines to assess stunting, thinness, underweight, and overweight/obesity. Socio-demographic data were collected from pupils using structured questionnaires. School administrators, including head teachers and health/food teachers, provided information on the physical, political, and socio-cultural aspects of the school food environment. Data on eating behaviours were obtained through structured questionnaires and food frequency questionnaires to assess students' dietary patterns over a period of seven days. Additionally, an observation checklist was used to gather information on the availability and accessibility of foods consumed by the school children. Data analysis was performed by using the WHO AnthroPlus v1.0.4 software and IBM SPSS Statistics 26v. Descriptive statistics, such as frequencies and percentages, were calculated. Regression models were used to explore the determinants of nutritional status, reporting both crude (COR) and adjusted odds ratios (AOR). Multilevel modeling was employed to assess individual-level variance in eating behaviours and examine the association between the school food environment and dietary behaviours of children. Prevalence rates among surveyed pupils were as follows: stunting (10.5%), underweight (3.6%), thinness (2.8%), and overweight/obesity (10.1%). Stunting was more common in boys (13.2%) than in girls (8.2%), and it increased with age. Underweight was higher in public schools (8.2%) than in private schools (3.2%). Thinness was more prevalent in public schools (85.7%) than in private schools (14.3%), particularly in rural areas (57.1%) and among younger children (aged 6-9 years, 57.1%). Overweight/obesity was more common among girls (90.1%) than boys. Urban schools had a higher prevalence of overweight/obesity (90.3%) compared to rural schools (89.5%), and private schools had a higher prevalence (95.2%) than public schools (84.7%). Pupils in urban areas were more likely to be overweight/obese than those in rural settings. After adjusting for student characteristics, the school environment accounted for a small proportion of the variance in eating behaviours, ranging from 11.3% to 11.6% for carbohydrate- rich foods, 12.6% to 11.4% for protein-rich foods, 20.3% to 19.4% for vitamins and mineral-rich foods, and 11.0% to 10.1% for lipids and sugar-rich foods. In model 2, controlling for other factors, protein-rich and lipid and sugar-rich foods intake were significantly related to the death of a parent, while vitamins and mineral-rich foods intake were significantly related to the number of adults in the household. None of the investigated school food environmental factors were associated with the children's reported intake of carbohydrate-rich foods, protein-rich foods, vitamin and mineral-rich foods, or lipids and sugar-rich foods. These findings suggested that,enAnthropometric statusPrimary school childrenNutritional statusSocioeconomic Factors and DodomaTanzaniaThesis