Socioeconomic disparities in anthropometric status among primary school children: A potential association with school meals

Objective: To assess the growth and nutritional status of children in primary schools across different socioeconomic groups in Wad-Madani City, Central Sudan, and map it to World Health Organization (WHO) standards; and to investigate a potential association between school meal intake and nutritional status. Methods: This cross-sectional anthropometric study involved a randomly selected sample of 506 children from 10 primary schools in the city. Height and weight were measured following WHO standards and converted into Z-scores for weight-for-age (WAZ), height-for-age (HAZ), and BMI-for-age (BAZ). We compared the mean Z-scores between children in the private and public school sectors, adjusting for ethnicity and other potential predictors. Statistical analyses included multivariate linear regression to assess predictors of growth and nutritional status, alongside group comparisons using appropriate statistical tests. Results: Children in public schools had significantly lower BAZ and HAZ levels compared to both WHO standards and private school children. The mean BAZ was -1.0 (SD = 1.23) for public school children and -0.13 (SD = 1.40) for private school children (p = 0.001), with 17.8% (n = 57) of public school children classified as thin (wasted) or severely wasted. The median HAZ was -0.20 (95% CI: -0.34, -0.02) for public school children and 0.19 (95% CI: 0.03, 0.40) for private school children (p