Raveenthiranathan Lakshana, Ramanarayanan Venkitachalam, Thankappan K R
Department of Public Health, Amrita Vishwa Vidyapeetham Amrita School of Medicine, Kochi, Kerala, India.
Department of Public Health Dentistry, Amrita Vishwa Vidyapeetham Amrita School of Dentistry, Kochi, Kerala, India
BMJ Open. 2024 Jul 17;14(7):e080100. doi: 10.1136/bmjopen-2023-080100.
Mid-day meal programmes (MDM) were introduced in India to improve school attendance, nutritional status and educational outcomes of school children. Numerous primary studies have examined the impact of the MDM programmes on both nutritional and educational outcomes in various settings across the country. However, synthesising the findings from these studies has been challenging. To address this gap, we conducted a systematic review to assess the effects of MDM programmes on the nutritional and academic outcomes of school children in India.
A comprehensive literature search was conducted, and relevant studies published between 1997 and 2022 were included. Two reviewers independently conducted study selection, data extraction and risk of bias assessment. The results were synthesised descriptively.
The systematic review included 31 studies. Among them, 16 studies focused on academic outcomes, while 18 studies reported children's nutritional status. Studies on MDM Scheme (MDMS) in children show mixed results on nutritional outcomes. While some studies show marginal improvements in height and weight measurements, others show no significant improvement. Regular MDMS access improves enrollment, attendance and retention rates for children, with lower dropout rates and higher academic achievement. However, its impact on academic performance remains unclear.
The MDM programme in India was effective in improving the academic achievement and a few nutritional outcomes of school children, underscoring the importance of sustaining MDM programmes in India.
The review was prospectively registered in PROSPERO (CRD42023391776). Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023391776.
印度引入了午餐计划（MDM），以提高学童的入学率、营养状况和教育成果。众多的初步研究考察了MDM计划在该国不同地区对营养和教育成果的影响。然而，综合这些研究的结果具有挑战性。为了填补这一空白，我们进行了一项系统综述，以评估MDM计划对印度学童营养和学业成果的影响。
进行了全面的文献检索，纳入了1997年至2022年间发表的相关研究。两名评审员独立进行研究筛选、数据提取和偏倚风险评估。结果进行了描述性综合。
该系统综述纳入了31项研究。其中，16项研究关注学业成果，18项研究报告了儿童的营养状况。关于儿童MDM计划（MDMS）的研究在营养成果方面显示出不同的结果。一些研究表明身高和体重测量有小幅改善，而另一些研究则表明没有显著改善。定期参与MDMS可提高儿童的入学率、出勤率和留校率，辍学率降低，学业成绩提高。然而，其对学业表现的影响仍不明确。
印度的MDM计划在提高学童的学业成绩和一些营养成果方面是有效的，这凸显了在印度维持MDM计划的重要性。
该综述已在PROSPERO（CRD42023391776）上进行了前瞻性注册。可从以下网址获取：https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023391776 。
