Published in PLOS One on 2026-08-05, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Julieth Sebba, Felistar Mwakasungura, Rebecca Mkumbwa, Bruno Sunguya, Stephen Dubik
Source: PLOS One • DOI 10.1371/journal.pone.0355391
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
The school-age period is crucial nutritional-wise owing to its health and developmental impact. In Tanzania, 11% of school-aged children are thin, while 34% are anemic, representing a significant burden of undernutrition with a potential to have a lasting impact on educational and early onset of non-communicable diseases. This study was designed to evaluate its implementation and effects on dietary adequacy among primary-school children in Kisarawe District, Tanzania. A school-based cross-sectional study was conducted among 300 students aged 10–14 years from 10 primary schools from 22/04/2025 to 25/04/2025. Dietary adequacy was assessed using two measures: Dietary diversity and Meal frequency. Descriptive statistics was used to summarize the status of implementation of the school feeding program, while regression analysis was used to identify the effect of the intervention. All ten schools implemented some components of the school feeding program with a significant limitation. Only 65% students were covered in the intervention. Forty-nine percent of students met the minimum dietary diversity score. Participation in a school feeding program was associated with a 45% higher likelihood of attaining minimum meal diversity (APR = 1.45; 95% CI: 1.00–2.12; p = 0.051), although this did not reach statistical significance threshold. Only 15.3% students reported consuming the minimum of three meals per day. School feeding programs were present in Kisarawe district but faced major infrastructural and logistical challenges, with none of the schools fully adhering to national guidelines. Strengthening infrastructure, ensuring reliable food supply, and expanding universal coverage are essential to maximize program impact.
Introduction
Proper nutrition during school years is crucial, as it significantly enhances children’s ability to grow, learn, and thrive [1]. Adequate nutrition during these critical years can enable catch-up growth for children who have suffered from malnutrition in early childhood, with some effects on detrimental impact of earlier nutritional deficits [2]. Dietatry adequacy can primarily be assessed through dietary diversity and meal frequency. Higher dietary diversity and meal frequency improve micronutrient intake and the prevention of chronic effects of undernutrition such as anemia and stunting [3–6].
Globally, severe undernutrition affects approximately 45 million children annually, while 149 million school-aged children live with thinness, highlighting a substantial nutritional burden worldwide [7,8]. Sub-Saharan Africa faces particularly severe nutritional challenges driven by pervasive poverty, conflict, climate crises, and a high prevalence of infectious diseases, exacerbating the nutritional vulnerabilities of school-aged children in this region [9–11]. Tanzania is similarly challenged, with 11% of school-aged children classified as thin and 34% suffering from anemia [12]. These nutritional deficiencies compromise children’s health, educational outcomes, and future socio-economic potential.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Julieth Sebba, Felistar Mwakasungura, Rebecca Mkumbwa, Bruno Sunguya, Stephen Dubik. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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