The target groups for many nutrition interventions are mothers and children under the age of two, as evidence has shown significant and substantial benefit for these age groups. Less is known about the potential for school-age children to benefit nutritionally from interventions through a complementary, life-cycle approach. The central hypothesis tested here is that nutrition-sensitive interventions can improve growth at school-age and that schools are an effective platform for children to be able to access these interventions. I address this hypothesis by examining three key research questions: 1) whether and to what extent catch-up growth can occur at school age; 2) how household characteristics (agriculture and dietary quantity and quality in particular) are related to nutrition at school age and what entry points may exist for holistic intervention; and 3) how school feeding programs are related to education participation (and thus access to nutritional inputs through programming) and how programs may be strengthened to improve links with local agriculture.
Examining the first question, in a review of the potential for catch-up growth at school age, a range of intervention studies counter claims of the irreversibility of pre-school growth faltering with evidence that early deficits can, at least to some extent, be made up in childhood and adolescence. For the second question, in analysis of relationships between school-age nutritional status and household agriculture in Mali, associations were observed between household agricultural production variety and measures of dietary diversity and food variety, but no associations between these measures and school-age child nutrition outcomes were found. In making the link to programming through the third question, no significant associations were found between school feeding and the education participation outcomes measured at the school level in Kenya.
I conclude that opportunities for improving the nutrition of school-age children do exist and that understanding the potential for agriculture-nutrition disconnects and the dynamic nature of school feeding programs could help improve the design of multi-sectoral, nutrition-sensitive interventions at school age, including Home Grown School Feeding (HGSF).