The health and nutritional status of schoolchildren in Africa: Evidence from school-based health programmes in Ghana and Tanzania

Surveys of the health of schoolchildren in Tanga Region, Tanzania and Volta Region, Ghana are reported. Two age groups of both sexes were studied: 8-9 and 12-13 years old. Children themselves tend to have a poor perception of their health status. This is confirmed by biomedical surveys. Evidence was common of chronic ill-health due to undernutrition, anaemia, parasitic infections and micronutrient deficiencies. The older age groups of both sexes were significantly more stunted (height-for-age z score < 2 below National Center for Health Statistics reference values) than the younger groups, indicating that linear growth continues to falter throughout the school-age years. Anaemia was common: 38% of children in Ghana and 75% of children in Tanzania had a haemoglobin level < 120 g/L. Younger children were more likely to be anaemic than older children, but no significant difference between the sexes was observed. Helminth infections which cause blood loss (Schistosoma haematobium and hookworms) were common and only 37% of children in Ghana and 14% in Tanzania had no evidence of worm infection. In Ghana, 71% of children had a low urinary iodine concentration; in Tanzania 38%. The burden of ill-health suggests that school health programmes in these countries which deliver anthelmintics and micronutrient supplements have the potential to improve the health, growth and educational achievements of schoolchildren.