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Objective: This study evaluated the impact of the Addis Ababa SFP on educational outcomes. Design: Single-group repeated measurement/longitudinal study design and multistage stratified sampling design was followed. Effect sizes estimates, repeated measures ANOVA, Chi-square, Generalized Additive Mixed Model, and mixed effects negative binomial regression were used. Academic scores, attendance and dropout, and height and weight of schoolchildren were collected. Setting: School Feeding Programs in Addis Ababa, Ethiopia. Participants: Schoolchildren in primary schools, and school directors and teachers in 15 randomly selected schools for KII. Results: Anthropometric measurements of 4500 schoolchildren were taken from 50 schools. Academic scores of 3924 schoolchildren from 46 schools, class attendance records of 1584 schoolchildren from 18 schools, and annual enrollment records of 50 schools were gathered. School meals achieved a minimum to large scale effects on educational outcomes with effect sizes (η2) of academic scores (boys=0.023, girls=0.04), enrollment (girls=0.001, boys=0.05), and attendance (Cramer’s V=0.2). The average scores of girls were significantly higher than that of boys (p<0.0001). Height-for-age in all schoolchildren (p<0.01) and BMI-for-age Z-scores in adolescent girls of 15–19 years (p<0.0001) ever had significant positive relationship with average scores. Significant relation was observed between nutritional status and attendance (p=0.021). KIIs showed that SFP created convenient teaching-learning environment, reduced hunger in schools, while boosting enrollment, attendance, and academic performance among the schoolchildren. Conclusion: The Addis Ababa SFP has positively contributed to educational outcomes. Strengthening the program would enhance nutritional outcomes and diminish educational inequalities.

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Pediatric surgery is a crucial pillar of health equity but is often not prioritized in the global health agenda, especially in low-and middle-income countries. Gastroschisis (GS) is a type of structural congenital anomaly that can be treated through surgical interventions. In Rwanda, neonatal surgical care is only available in one hospital. The experience of parents of children born with gastroschisis has not been previously studied in Rwanda. The objective of this study was to explore the lived experiences of parents of children diagnosed with GS in Rwanda. A qualitative study using a semi-structured interview guide was conducted. Parents who had children with gastroschisis and were discharged alive from the hospital in Rwanda were interviewed by trained data collectors, from May to July 2021. Data were transcribed, translated, and then coded using a structured code-book. Thematic analysis was conducted with the use of Dedoose software. Sixteen parents participated in the study. Five themes emerged from the data. They were: “GS diagnosis had a significant emotional impact on the parents”, “Parents were content with the life-saving medical care provided for their children despite some dissatisfaction due to the delayed initiation of care and shortage of medications”, “GS care was accompanied by financial challenges”, “support systems were important coping mechanisms” and “the impact of GS care extended into the post-discharge period”. Having a newborn with GS was an emotional journey. The lack of pre-knowledge about the condition created a shock to the parents. Parents found support from their faith and other parents with similar experiences. The experiences with the care received were mostly positive. The overall financial burden incurred from the medical treatment and indirect costs was high and extended beyond the hospital stay. Strengthening prenatal and hospital services, providing peer, spiritual and financial support could enhance the parents’ experience.