Rabi Joël Gansaonré1, Lynne Moore1,2, Louis-Philippe Bleau3, Jean-François Kobiané4, Slim Haddad1,3. 1. Département de Médecine Sociale et Préventive, Faculté de Médecine, Université Laval, Québec, QC, Canada. 2. Axe Santé des Populations et Pratiques Optimales en Santé, Traumatologie-Urgence-Soins intensifs, Centre de Recherche du CHU de Québec - Université Laval (Hôpital de l'Enfant-Jésus), Université Laval, Québec, QC, Canada. 3. VITAM - Centre de recherche en santé durable de l'Université Laval, Québec, QC, Canada. 4. Institut Supérieur des Sciences de la Population, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso.
Abstract
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.
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.