Impact of school closure on children’s nutritional status

The movement control order (MCO) is back and along with it, schools are closed and home-based teaching and learning classes (PdPR) will soon be implemented again. 

School closures have disrupted the regular access to food assistance for school children who need it.

Even before the Covid-19 pandemic started, some children in Malaysia were suffering from the double burden of malnutrition: under- and over-nutrition. 

These children do not meet their recommended intake of important nutrients. On the other hand, high consumption of fast food and sugar-sweetened beverages have also contributed to childhood obesity.

To address these problems, the Education Ministry has initiated two school feeding programmes which are the Supplementary Food Programme and Nutritious Meal Program in Schools to promote children’s health, education and social development. 

However, school closure due to Covid-19 pandemic disrupts the continuation and expansion of these programmes. This puts millions of low-income households to be disproportionately burdened and at an increased risk of food insecurity, which children are the most affected ones.

To cope with the challenges of pandemic and school closures, inadequate nutritional intake including iron should not be overlooked. Iron deficiency can result from inadequate intake or poor absorption of dietary iron, increased needs in periods of growth, and infection by intestinal helminths, such as hookworm.

Why is it important to have adequate iron intake? Iron is an essential nutrient for the development and cell growth in the immune and neural systems. It is also important in the regulation of energy metabolism to ensure consistent and high-performance activities. 

Iron regulation is critical for normal brain functions, especially in learning and memory. Lack of iron may also contribute to developmental delay, cognitive impairments, poor mental and motor functions and reduced school academic performance. Besides, lack of iron is also associated with iron deficiency anaemia.

Addressing nutritional needs in the midst of the Covid-19 pandemic is challenging. Some families are struggling to make ends meet and may have difficulty in buying nutritious food. 

What can parents and caretakers do to avoid the negative implications of iron deficiency among children during these tough times? Here are some recommendations to follow: 

  1. Provide adequate iron-rich foods including legumes; such as chickpeas and soybeans, vegetables such as fern shoots (pucuk paku), spinach (bayam pasir), kale (kangkung), fruits such as kedondong, jackfruit and rambutan, lean meat, fish and cereal products. If they cannot afford to buy meat, eggs are alternative for a good source of iron.
  2. Have a periodic assessment of children’s iron status at a community clinic.
  3. Comply to the prescribed iron supplements by healthcare professionals regarding the dosage and intake frequency.
  4. Improve hygiene and sanitation practices to avoid soil-transmitted helminths exposures.
  5. Increase understanding and awareness of the importance of iron in the growth and development of children.

Parents should try their best to practice healthy eating, good hygiene and seek medical advice within their own capacity. 

These steps are important to ensure that our children can improve their nutritional status and immune system to reduce the susceptibility to Covid-19 infection and at the same time achieve their full potential by being focused, alert, and productive during PdPR and other learning experience during this challenging period. 

The article was written by Dr Khadijah Yusof Azuddin (Doctor of Public Health candidate), Professor Dr Moy Foong Ming and Professor Dr Noran Naqiah Hairi. It was first published on 10 May 2021 on Malaysiakini website.

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