Abstract:
This study investigated the relationship between nutritional status and presence or absence of a school snack program in 300 public primary school children enrolled in grades 1-3 in Jati Asih Sub District, Indonesia. The study also assessed nurtitional status in relation to other potential determinants such as demography, socioeconomic, environmental, and mother's food practice and knowledge. A cross sectional, analytical study was conducted to ascertain nutritional status among public primary school children with and without school snack program. Children with body mass index (BMI) less than 18.5 kg/m2 were considered to be underweight. The percentage of underweight children was statistically significantly higher among children without the snack program (111/150=74%) than in those with it (87/150=58%) (p=.003 by X2 test). This study also observed statistically significant associations between nutritional status and parental education, father's job, status of having breakfast regularly, and mother's nutrition-related knowledge. In the absence of multivariable analysis, it was not possible to rule out bias in the observed association between nutritional status and the snack program. Even so, this association was strong, and it is very unlikely that bias could completely explain it. Therefore, it is reconmmended that the school snack program for public primary school children should be continued and expanded. Consideration should be given to giving snacks more than 3 times a week for more than 9 months duration, in order to achieve better nutritional status. Also, more community-level participation in the program would make it less dependent on government funding. To obtain beteer quality, training for those who implement the program should be conducted in the field, especially food provision. Finally, further studies should be conducted in order to obtain more complete information about the program, its determinants, and its consequences.
