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Child, School, Home: Determinants of Academic Performance* Cecilia A. Florencio Education Research Program Center for Integrative and Development Studies University of the Philippines Email: email@example.com This study was concerned with the determinants of school-related behavior, in particular the relationship between health and nutritional status and academic performance. Such a concern is in place whenever our educational system sets for itself the objective of reducing disparities in education and raising the overall quality and efficiency of education. Although construction of new classrooms, provision of textbooks and other learning materials and training of teachers are necessary to improve the quality of education, it is illogical to expect that these will make up for the difference in learning that could arise because of biological impediments. The objectives of the study relate to (1) nature, magnitude and distribution of health and nutritional problems of school children; (2) relationship between nutritional status and academic performance; and (3) effects on academic achievement of non-nutritional variables, specifically those recommended in the 1976 Project SOUTELE Report. Some 2,304 pupils who were randomly selected from 64 schools in Region I, IV and National Capital Region in Luzon, Region VII in the Visayas and Region XII in Mindanao participated in the study. The other respondents were the pupils’ parents, teachers and school heads. Nutritional assessment was made using anthropometric, biochemical and clinical methods. The children’s mental ability and academic performance were gauged using local standardized tests recommended by the DECS. Energy-protein undernutrition, as reflected by deficits in body weight and height, continued to affect many of the children. The other health problems of the children were anemia, Vitamin A deficiency, goiter and impairment of vision and hearing. Prevalence rates of these health and nutritional problems differed by region, grade level and gender of pupils. All the schools had a health and nutrition program. Growth monitoring, supplementary feeding and nutrition education were common features of the program. Much less were screening for visual and hearing ability and monitoring of nutritional problems other than energy-protein undernutrition knowledge. The school heads and teachers expressed several problems related to supplementary feeding and nutrition education. The pupils, parents, school heads and teachers had a positive perception of the role of health and nutrition in school-related behavior such as absenteeism, dropping out and failure. In general, the academic performance of the pupils was far from satisfactory, which mean test scores in various subjects not exceeding 50 percent of the total number of test items. Those in the lower grades did better than those in the upper grades. Attendance in school, ability to concentrate in class and/or study habits at home was not independent of participation in supplementary feeding, breakfast skipping, feeling of hunger in school and/or health and nutritional status. Better nourished children did significantly better in the mental ability test; specific tests of basic skills, such as Reading, Arithmetic and Communication Arts; and overall assessment of academic competence. This was true even when the data were disaggregated by income group, quality of school, teacher’s ability and mental ability. The significant positive relationship between nutritional status and academic achievement remained even when relevant pupil factors, such as mental ability, visual ability, study habits and pre-school education were held constant. Moreover, even after taking into account the influence of a whole set of relevant pupil, teacher, school and family-related factors, the observed relationship between the two variables still surfaced. Of all the independent variables studied, mental ability turned out to be the most predominant, followed by visual ability, father’s education, presence of a library and teacher-pupil ratio. On the other hand, of the 4 chosen indicators of nutritional status, height-for-age and weight-for-age were the most sensitive in terms of reflecting variations in academic performance. Among the 4 groups of factors considered, pupil-related variables accounted for the highest proportion of variations in the overall test scores, followed by household-related and school-related factors and lastly, teacher- related factors. The final regression model which included 15 variables from the 4 groups explained a high proportion of the total variability in overall test score, exceeding 80 percent in some grade levels. Although this study provided strong evidence that nutritional status does make a difference in the academic achievement of elementary school pupils, it remains for future studies to clarify underlying mechanisms and the significance of mild undernutrition to school-related behavior. Health and nutritional status is only one of many factors which could influence learning, and improving it will not by itself fully correct the inequalities in academic performance of school children. But neither will any other single improvement. Obviously, a multi-pronged approach is needed. But within such framework it is strongly recommended that nutrition be given a more prominent place. After all, before anything else, a school is a biological organism. Conclusions and Recommendations The concluding remarks focus on the two main concerns of the study while the recommendations are limited to those related to nutrition and within the purview of the DECS. Conclusions Nutritional status 1. Underweight, underheight and wasting, which are generally considered reflective of energy protein undernutrition, continue to affect a fairly large number of school children. 2. In addition to energy-protein undernutrition, school children are also affected by other health and nutritional problems such as anemia, Vitamin A deficiency, goiter, and hearing and visual disabilities. 3. The prevalence of specific health and nutritional problems differ by region, grade level and sex of the pupils. Academic Achievement 1. The academic performance of the pupils who participated in the study is far from satisfactory Nutrition and School-related Behavior 1. The pupils and their parents, school heads and teachers have a positive perception of the role of health and nutrition in school-related behavior 2. Attendance in school, ability to concentrate in class and study habits at home are not independent of participation in supplementary feeding, feeling of hunger in school, breakfast skipping and/or health and nutritional status. 3. The academic performance and mental ability of pupils with good nutritional status is significantly higher than that of pupils with poor nutritional status, as a whole, and even when they are grouped according to family income, school quality, mental ability or teacher’s ability. 4. There is a significant positive relationship between nutritional status, mental ability and academic achievement. 5. The relationship between health and nutritional status and academic achievement varies with the grade level and subject taken by the pupils. 6. Of the four chosen indicators of nutritional status, height-for-age and weight-for-age are the most sensitive in terms of reflecting variations in school-related behavior. 7. Mental ability and visual ability are the two most predominant predictors of academic achievement. 8. The significant positive relationship between academic achievement and nutritional status is stable, appearing even when the effects of relevant school, teacher, household and pupil-related variables are controlled. Recommendations Further research 1. Determine the reasons for large regional differences in the prevalence of health and nutritional problems. 2. Investigate the underlying mechanism or mechanisms which could explain the connection between nutrition and learning. 3. Clarify the effects of mild forms of malnutrition on academic achievement. 4. Study the health and nutritional situation of high school students (adolescence being a period of nutritional risk) and how it affects their behavior in school. Assessment of Health and Nutritional Status 1. Re-direct the attention of our schools to the original and primary use of growth monitoring, which is to provide an early warning sign to prevent a deterioration in the children’s nutritional status, leading to improved teacher-parent-child interactions on health and nutrition. Growth monitoring should be a part of a well-conceived educational program for all concerned, rather than simply a means of selecting participants in supplementary feeding or describing the nutritional situation of a particular school at a given time. 2. Monitor health and nutritional problems other than energy-protein undernutrition (as shown by weight and height measurements), such as anemia, Vitamin A deficiency, goiter, and visual and auditory disabilities. Health, Nutrition and Other School Programs The responsibility for the nutritional well-being of school children rests primarily on the children and their families. But the educational system cannot take, and to its credit has not take a passive stance in regard to the health and nutritional status of schoolers, particularly those at the elementary level. The health and nutrition program in grade school is “primarily aimed at improving health and nutritional status of the entire school population, giving priority to school children” (SHNC,1986). Over the years, the SHNC has intensified its efforts toward this direction. 1. In its annual report for CY 1983, SHNC-DECS (1984) reported that 30,311 elementary schools, 3,112 secondary schools and 28 teacher training institutions integrated nutrition in their curriculum and a total of 33,560 copies of nutrition posters to be used for nutrition education were distributed in all regions of the country. What is not clear is how the integration is being carried out and what its effects are on the children, primarily and their parents, secondarily. An evaluation of the nutrition education component of nutrition programs in schools is called for, particularly in view of the findings in this study which show poor nutrition knowledge of teachers and pupils, lack of training in nutrition integration among many teachers and the difficulties in nutrition integration encountered by majority of the teachers. 2. The present teacher-education program (B.E. Ed) includes a course entitled “Human Growth, Learning and Development”. It is suggested that the health and nutrition aspects of this subject be strengthened. Emphasis should not be on retardation of physical growth per se but on evidences that impairment in physical growth is accompanied by varying degrees of functional incompetence, including learning disabilities. 3. Some schools offer compensatory and remedial programs to overcome the learning disadvantages of certain categories and remedial programs to overcome the learning disadvantages of certain categories of pupils. As a result of the observed relationship between nutrition and learning, it seems reasonable to include nutritional status as one of the criteria in selecting pupils for supervised study or tutoring. 4. According to the DECS, supplementary feeding aims to help overcome nutritional deficiencies of school children and to serve as a laboratory for nutritional education. The a priori assumption is that supplementary feeding programs are “good”. They may well be. But the fact is that at present we have little definitive knowledge about their impact on the beneficiaries and their families and on the schools, and their cost- effectiveness. Before the program is expanded beyond its already large coverage and before more and more resources are allocated, it is wise to re-examine the underlying principles, methods, criteria and resources used, and even the present arrangements between the DECS and foreign agencies involved in the program. 5. In 1985, a group of researchers (Nysteun, et al.) conducted an assessment of P.L. 480 Title II Program in the Philippines. P.L. 480 Title II food commodities are used in nutrition-related activities undertaken by CARE and CRS. The group recommended that food assistance under P.L. 480 be extended only to 1990 and that the Philippine government should continue to be urged to take steps to assume full responsibility for food assistance programs for its own people. To the credit of the DECS, it has taken definitive steps to develop alternative supplementary feeding schemes. What is needed is to evaluate these schemes to determine what works, under what conditions and at what cost. 6. In view of the many nutritional problems affecting school children, there is a need to improve the food combinations given to the beneficiaries so that the activity is aimed at filling not only energy deficits but also inadequacies in nutrients, such as iron and Vitamin A. In some cases, it may be necessary to provide nutrient supplements and other services to the affected children so as to improve their health. The idea is to view growth monitoring, supplementary feeding and other nutrition measures as part of a well-integrated system of health care for school children, rather than as separate activities. 7. Consistent with the DECS-SHNC Policy Direction No. 5, it is recommended that more determined efforts be taken to assess the health and nutritional problems of students beyond the elementary grades and to develop appropriate programs. Improving the nutritional and health status of school children will not, by itself, fully correct the inequalities in their academic performance since malnutrition occurs primarily in poor environments where many other deprivations exist which may also limit the child’s development. But neither will any other single improvement accomplish this. Moreover, as pointed out, while provision of learning materials, training of teachers and construction of new classrooms are necessary to improve the quality of education in the country, it does not necessarily follow that these reforms could make up for the differences in learning which could arise because of biological impediments among school children. A multi-pronged approach to the problem is definitely needed but within that comprehensive or holistic effort, it is strongly recommended that nutrition be given a more prominent place and more consistent attention. It bears repeating that, before anything else, a school child is a biological organism. *Excerpted from Edukasyon (Vol. 1 No. 2. April-June 1995), A Quarterly Monograph Series of the UP Education Research Program (ERP)