Stunting, age at school entry and academic performance in developing countries: A systematic review and meta‐analysis

Aim To review evidence of the effects of stunting, or height‐for‐age, on schooling level and schooling trajectories, defined as the combination of school entry age, grade repetition and dropouts. Methods We conducted a systematic review of studies (last update 20 March 2021) that assessed the associ...

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Bibliographic Details
Published in:Acta Paediatrica 2022-10, Vol.111 (10), p.1853-1861
Main Authors: Gansaonré, Rabi Joël, Moore, Lynne, Bleau, Louis‐Philippe, Kobiané, Jean‐François, Haddad, Slim
Format: Article
Language:English
Subjects:
Academic Performance
Age
Body Height
Child
Children
Developing Countries
dropout
Grade repetition
Growth Disorders - epidemiology
Growth Disorders - etiology
height‐for‐age
Humans
LDCs
Meta-analysis
Reviews
school entry
Schools
stunting
Systematic review
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Summary:Aim To review evidence of the effects of stunting, or height‐for‐age, on schooling level and schooling trajectories, defined as the combination of school entry age, grade repetition and dropouts. Methods We conducted a systematic review of studies (last update 20 March 2021) that assessed the association between stunting, or height‐for‐age, and at least one component of school trajectory using five databases (PubMed, Embase, Education Resources Information Center [ERIC], Web of Science and PsycINFO). Two independent reviewers performed study selection and data extraction. Pooled effects were calculated using the generic inverse variance weighting random‐effect model. The risk of bias was assessed using the ROBINS‐I tool (PROSPERO ID: CRD42020198346). Results We screened 3944 articles, and 16 were eligible for the qualitative and quantitative syntheses. Meta‐analysis showed that an increase in height‐for‐age leads to an increase in early enrolment [OR = 1.34 (95% CI, 1.07–1.67)], a reduction in late enrolment [OR = 0.63 (95% CI, 0.51–0.78)], an increase in schooling level [MD = 0.24 (95% CI, 0.14–0.34)] and a reduction in school overage [OR = 0.79 (95% CI, 0.70–0.90)]. Stunted children were more likely to repeat a grade than non‐stunted [OR = 1.59 (95% CI, 1.18–2.14)]. Conclusion This review suggests that stunting in childhood might negatively affect school trajectories. Future research should evaluate the effect of stunting on school trajectories and the modification effect of socioeconomic status.
ISSN:0803-5253
1651-2227
DOI:10.1111/apa.16449