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American Journal of  Medical 
Science and Innovation (AJMSI) 

Breakfast Intake and Associated Factors among Primary School Students in Selected
Private and Public Schools, Kakata City, Margibi County- Liberia

Washington Kezelee1*, Dawolo G. Milton2, Doris S. Wakia2, Theophilus T. Fayiah2, Moses C. D. Shilue2

Volume 2 Issue 2, Year 2023
ISSN: 2836-8509 (Online)

DOI: https://doi.org/10.54536/ajmsi.v2i2.1546
https://journals.e-palli.com/home/index.php/ajmsi

Article Information ABSTRACT

Received: September 06, 2023
Accepted: October 03, 2023
Published: October 12, 2023

Breakfast consumption has been shown to positively affect children’s cognitive performance. 
The objective of  this study was to compare the breakfast intake of  primary school students 
attending private and public schools. This was a cross-sectional study conducted in Kakata 
City, Margibi County among 129 private and public school students in the 4th, 5th, and 6th 
grades. Private and public-school students were compared based on their religious practices, 
age range, educational and employment status of  parents, and gender using the Chi-square 
test. The study found that 42% of  private-school children and 35 percent of  public school 
children ate breakfast prepared at home by parents. Private school children ate their breakfast 
most often at home, regardless of  whether it was prepared at home or elsewhere (92% vs. 
89%). On average, private school children added fruits (36% vs. 18%) and vegetables (35% 
vs. 14%) to their breakfast more than their public-school counterparts. Sugar was regularly 
added to 58% of  private school children and 44% of  public school children’s breakfasts. 
Private school children consumed milk during breakfast more than public school children 
(50% vs. 40%). Furthermore, private school children ate less oil during breakfast compared 
with public school children (64% vs. 83%). Finally, private school children consumed 
breakfast more regularly than public school children (49% vs. 38%). In conclusion, Private 
school children appeared to consume more diverse food during breakfast than their public-
school counterparts. Nutrition promotion intervention should be aimed at extending free 
school feeding programs to all public and private primary schools. 

Keywords
Breakfast, Private School, Public 
School

1 Cuttington University Schools of  Graduate & Professional Studies, Department of  Public Health Nutrition, Liberia
2 Cuttington University Schools of  Graduate & Professional Studies, School of  Health Sciences, Liberia
* Corresponding author’s e-mail: wkezelee@up.edu.ph

INTRODUCTION
 As outlined in sustainable development goal 4, all children 
should have access to quality education ((Bernstein, 
2017). To achieve this goal, children all over the world 
must receive a quality education in a conducive learning 
environment. The provision of  a conducive learning 
environment includes the provision of  a nutritious diet 
before, during, and after the classroom learning period. 
Ending hunger and malnutrition (SDG 2) in any country 
will be the most cost-effective and appreciated step 
toward reaching the fourth sustainable development goal 
(Gil et al, 2019).  Although universal education will reduce 
global poverty, hunger among schoolchildren remains a 
global challenge.
In Malawi, hunger in both primary and secondary 
school children were found to be a major social 
problem (Mwambene, Muula, & Leo, 2013). Hunger was 
associated with high rates of  truancy among Tanzanian 
schoolchildren (Seidu, Dadzie, & Ahinkorah, 2021).  The 
objective of  this study was to compare the breakfast 
intake of  primary school students attending private and 
public   schools in Kakata City, Margibi County, Republic 
of  Liberia.

Importance of  Breakfast for School Children      
Kids need breakfast to obtain their daily nutrient and 
energy intake, as it is the most important meal of  the 
day. The nutrient and energy intake of  school children 
who regularly consume breakfast is significantly higher 

than that of  children who skip breakfast (Intiful & 
Lartey, 2014). Breakfast-eating children perform better 
academically than breakfast-skipping children (Littlecott et 
al, 2016). Children’s cognitive performance was reported 
to be positively impacted by breakfast consumption 
(Widenhorn-Muller et al, 2008). In childhood and 
adolescence, breakfast consumption helps prevent 
excess adiposity (Blondin et al, 2016). Ramsay et al. (2018) 
also found that skipping breakfast was associated with 
significantly lower fiber consumption, folate intake, iron 
intake, and calcium intake.

Inadequate Breakfast Intake among School Children 
and Associated Factors
A study found that School children with highly educated 
mothers consumed more breakfast compared with children 
with mothers not highly educated (ALBashtawy,2015). 
Breakfast consumption was found to be low among boy 
children in public schools compared with boy children 
in private schools (Al-Hazzaa et.al, 2020). Income status 
of  parents had been identified to be one of  the factors 
related to breakfast skipping among primary school 
children ( Tee et al., 2018). A study among Saudi School 
children found that children in private schools consumed 
breakfast more frequently than those attending public 
school. The study also found that mothers prepared 
breakfast at home most of  the time for their school 
children (84.5%). Additionally, Parents appeared mostly 
satisfied with the breakfast consumed by their child at 



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Am. J. Med. Sci. Innov. 2(2) 136-140, 2023

home and placed high importance on breakfast compared 
to lunch or dinner (Al-Hazzaa et al., 2020).

Breakfast Intake among Liberian School Children
Secondary data on the breakfast intake among primary 
school children in Liberia is limited. However, the 
socioeconomic profile of  the country may give some 
clues as to what is happening with breakfast intake among 
school children. School feeding is an essential component 
of  the Liberian government’s efforts to improve the 
education, health, and nutrition of  school-age children. 
However, the program remains donor funded with no or 
limited budgetary input from the government, creating 
serious challenges when donor funds run dry. Mary’s 
Meals currently serves school meals to 151,968 children 
in 669 schools across Liberia. However, these meals are 
not intended to be consumed as breakfast. As indicated 
in the comprehensive food security assessment report 
(2018), Liberia continues to experience household food 
insecurity, with 41% in 2010, 49% in 2012, 16% in 2015, 
and 18% in 2018. There has been some improvement 
since 2015, but a large number of  Liberians remain 
hungry and undernourished. Schoolchildren are also 
affected by this hunger crisis in terms of  diet quality. 
Among 121 countries, Liberia ranks 113th in the 2022 
Global Hunger Index. Having a score of  32.4, Liberia has 
a serious level of  hunger.

METHODOLOGY
Subject and Study Area
This study was a cross-sectional study conducted in 
Kakata City, Margibi County among 66 private and 63 
public-primary school students. A random selection of  
three private and three government schools was made in 
Kakata City from a list of  20 Schools.  The number of  
schools selected was based on available funding. Schools 
were also selected based on the principals, and teachers’ 
willingness to have their students participate. In each 
school, children in the 4th, 5th, and 6th grades were eligible 
to participate. To conduct this study in Kakata, the 
County Educational Officer (CEO) of  Margibi County 
was officially contacted through written communication. 
The communication was written by administration of  the 
School of  Health Sciences of  the Cuttington University 
Schools of  Graduate & Professional Studies. The CEO 
gave us the go-ahead to meet with the principals and 
teachers of  the selected schools to ask them to allow us 

to use their schools for this study. The principals and 
teachers of  the schools selected, permitted us to conduct 
the study. Kakata’s economic activities are dominated by 
trade, petty business, casual labor, salaried employment, 
and to a lesser extent agriculture. 

Sample Size and Sampling Methods
Multisampling was used in this study in three stages. 
The district education officer’s (DEO) office in Kakata 
City provided a list of  all public and private primary 
schools in stage one. Using the list of  public and private 
primary schools, a simple random sampling was used to 
select three public and three private schools (6 schools in 
totality). A list of  all 4th, 5th, and 6th graders in the selected 
schools was obtained from their registrar’s offices in the 
final stage. Using a systematic sampling method, every 
second student on the list was selected for the sample of  
129 students.

Data Collection
This study’s data was gathered entirely through the use 
of  structured questionnaires. The questionnaires were 
designed to collect the following information: student 
ages, gender, religion, parental educational status, parental 
job status, student understanding of  breakfast, parental 
behaviors toward breakfast, breakfast composition, and 
types of  food eaten by students for breakfast.

Data Analysis
The Chi-square test was used to evaluate if  pupils’ 
capacity to enroll in private and public schools was 
connected to their religious practices, gender, age range, 
and educational and work level of  parents. We utilized 
logistic regression to determine the association between 
pupils in private and public schools in terms of  breakfast 
habits and knowledge.

RESULTS
Age, Gender, and Religion of  Students
More than half  of  the students in private schools were 
female (55%) compared with those in public schools 
(44%). In terms of  religious practices, more than half  
of  the students in both public and private schools were 
Christians. However, private schools had more Christian 
students compared with public schools (94% vs. 70%). 
More than half  of  the students in both private and public 
schools were the age of  10 years and above (Table 1).

Table 1: Social Demography Profiles of  Participants
Variables and Category Private School n = 66 Public School n = 63 Chi-Square   p-value

N % N %
Gender Male 30 46 35 56

Female 36 55 28 44 1.31 (0.251)
Religion Christian 62 94 44 70

Muslim 4 6 19 30 12.77 (0.000)
Age 8-10 years 10 15 3 5

≥10 years 56 85 60 95 3.83 (0.050)



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Parental Education and Employment Status
The prevalence of  non-formal education was high among 
mothers (41% vs. 12%) and fathers (22% vs. 9%) of  
public-school children compared with private school 
children. More than half  of  the households of  the students 
in both public and private schools were headed by males. 

More than half  of  the mothers (64%) and fathers (57%) 
of  students in public schools were unemployed compared 
with mothers (47%) and fathers (30%) of  children in 
private schools. More than half  of  the households of  
students earned less than 15,000 (equivalent to $81.1 USD) 
Liberian dollars per month (Table 2). 

Table 2: Parental education and employment Status
Variables and Category Private School n = 66 Public School n = 63 Chi-Square   

p-valueN % N %
Educational status 
(mothers)

Non-formal education 8 12 26 41
Formal education 58 88 37 59 14.10 (0.000)

Educational status 
(fathers)

Non-formal education 6 9 14 22
Formal education 60 91 49 78 4.24 (0.039)

Household Head Mother 5 8 11 18
Father 61 92 53 83 2.89 (0.089)

Employment status 
of  mothers

Unemployed 31 47 40 64
 Employed 35 53 23 37 3.55 (0.059)

Employment status 
of  fathers

Unemployed 20 30 35 57
Employed 46 70 27 43 9.45 (0.002)

Monthly Household 
Income (LRD)

<15,000 ($81.1 USD) 45 68 51 81
≥15,000 ($81.1 USD) 21 32 12 19 2.76 (0.097)

Students’ Knowledge About Breakfast
Table 3 showed that 99% of  the private school children 
and 94% of  the public school children knew the 
importance of  breakfast (OR, 4.40; 95% CI, 0.47-40.55). 
Students in both public and private schools knew that 

breakfast can be eaten first thing in the morning (OR, 
1.33; 95%CI, 0.34-5.22).  Nevertheless, more private 
school students (91%) agreed that vegetables and fruits 
should be added to breakfast than public school students 
(71%) (OR, 4.0; 95%CI, 1.46-10.89).

Table 3: Comparing Students’ Knowledge of  Breakfast
Response Private School n = 66 Public School n = 63 Odd Ratio

(95%CI)N % N %
Knowledge about the importance of  breakfast 
for schoolchildren

65 99 59 94 4.40 (0.47-40.55)

Breakfast is eaten first thing in the morning 62 94 58 92 1.33 (0.34-5.22)
Include vegetables and fruits in breakfast 60 91 45 71 4.0 (1.46-10.89)

Comparing Breakfast Composition between Private 
and Public-School Students
Students were asked where their breakfasts are usually 
prepared. Table 4 shows that 35% of  public school 
students and 42% of  private school students ate breakfast 
prepared at home (OR, 1.37; 95% CI, 0.67-2.79). In 

addition, students were asked to locate where they usually 
ate breakfast. It was found that 92% of  private school 
children and 89% of  public school children typically ate 
breakfast at home, regardless of  whether the food was 
prepared at home or purchased elsewhere. (OR, 1.52; 
95% CI, 0.45-5.08). In terms of  dietary diversification, 

Table 4: Comparing Breakfast Composition Between Private and Public-School students
Response Private School n = 66 Public School n = 63 Odd Ratio (95%CI)

N % N %
Eat Breakfast prepared at home 28 42 22 35 1.37 (0.67-2.79)
Eat Breakfast at home 61 92 56 89 1.52  (0.45-5.08)
Add fruits to breakfast 24 36 11 18 2.70 (1.18-6.14)
Breakfast is available regularly 32 49 24 38 1.52 (0.75-3.08)
Add vegetables to breakfast 23 35 9 14 3.20 (1.34-7.65)



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the study revealed that 36% of  private school and 18% 
of  public-school children had fruits usually added to 
their breakfast (OR, 2.70; 95% CI, 1.18-6.14) and 35% 
of  private and 14% of  public-school children usually 
had vegetables added to their breakfast (OR, 3.20; 95% 
CI, 1.34-7.65). Additionally, 58% of  private and 44% of  
public school children usually had sugar added to their 
breakfast (OR, 1.69; 95% CI, 0.84-3.40), 50% the private 
and 40% in the public school children had milk usually 
added to their breakfast (OR, 1.52; 95% CI, 0.75-3.05), 
and 64% in the private and 83% in the public schools 
added oil to their breakfast (OR, 0.37; 95% CI, 0.16-0.84). 

Finally, the study showed that breakfast was frequently 
offered for 49% of  private school kids and 38% of  
public-school students (OR, 1.52; 95% CI, 0.75-3.08).

Breakfast Eaten Day before the Questionnaires were 
Administered
According to Table 5, the majority of  pupils in both private 
and public schools (41% vs. 59%) ate rice with soup for 
breakfast the day before the surveys were administered. 
Additionally,39% of  private school students and 24% of  
public-school students ate bread with butter, mayonnaise, 
or eggs.

Add sugar to breakfast 38 58 28 44 1.69 (0.84-3.40)
Add milk to breakfast 33 50 25 40 1.52 (0.75-3.05)
Add oil to breakfast 42 64 52 83 0.37 (0.16-0.84)

Table 3: Comparing Students’ Knowledge of  Breakfast
Frequently Consumed foods during 
breakfast

Private School n = 66 Public School n = 63 Chi-square Test 
p-valueN % N %

Rice (boiled) with soup 27 41 37 59
Bread (added butter, mayonnaise, or eggs) 26 39 15 24 4.61 (0.100)
Roots/tuber 13 20 11 18

DISCUSSION
In terms of  social demography, more than half  of  private 
school children (55%) were female, compared to 44% 
of  public-school children. Private school students were 
more likely to identify with Christianity than public school 
students. In terms of  age distribution, more than half  of  
the children in both private and public schools were 10 years 
old or older.  There was a significant gap in educational 
attainment between parents of  children attending 
public and private schools. In terms of  comparing the 
educational attainment of  parents (mothers & fathers) 
of  private and public school children, the findings of  the 
study indicated that mothers and fathers of  children in 
private schools were more likely to have obtained formal 
education than their counterparts in the public schools. 
School children with highly educated mothers consumed 
more breakfast compared with children with mothers not 
highly educated (ALBashtawy,2015).
Most importantly, compared to their private-school 
counterparts, more than half  of  mothers and fathers of  
public-school children were unemployed. A household’s 
ability to purchase food is reduced as a result of  
unemployment. Children raised by unemployed parents 
are more likely to experience hunger or food insecurity 
during the school day. The study also showed the income 
disparity between families with children in private and 
public schools. Thirty-two percent (32%) of  private 
school children’s households earn 15,000 Liberian dollars 
per month, compared to 19% of  public school children’s 
households. Income disparities among parents of  primary 
school children can have serious consequences for the 
quality of  children’s diets.

Children in both private and public schools were more 
likely to agree that breakfast is important for school 
children and that breakfast should be eaten first thing in 
the morning. However, children in private schools were 
more likely than children in public schools to agree that 
fruits and vegetables should be included in breakfast. 
Children from both private and public schools were asked 
to demonstrate where their parents typically prepare their 
breakfast. According to the study, 42% of  private-school 
children and 35% of  public school children eat breakfast 
prepared at home, by parents. The children were also 
asked to indicate where they usually ate breakfast. 
According to the findings, 92% of  private school children 
and 89% of  public school children typically ate breakfast 
at home. Students at both schools prefer to eat their 
breakfast at home rather than on campus or elsewhere. 
Breakfasts were regularly available at home for 49% 
of  private school children and 38% of  public-school 
children.  Private school children were more likely than 
public school children to eat breakfast before going to 
school (Al-Hazzaa et al., 2020). The difference may be 
attributed disparity between parents of  private and public-
school children in term of  employment and educational 
attainment. Private school children were privileged to 
have parents who were formally educated and employed 
compared with parents of  public-school children.
Children in private schools were found to be three 
times more likely than those in public schools to have 
vegetables and two times more likely to have fruits in 
their breakfast. Furthermore, more children in private 
schools (64%) added sugar and milk to their breakfast 
than those in public schools. Children in private schools, 



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on the other hand, consumed less oil in their breakfast 
than those in public schools (83%).  On the day before 
the questionnaires were administered, 41% of  the private 
school children and 59% of  the public-school children ate 
cereal (rice), 39% of  the private and 24% of  the public-
school children ate bread (added butter, mayonnaise, or 
eggs), and 20% of  the private and 18% of  the public-
school children ate tubers or roots (cassava, potatoes, yam).

CONCLUSION 
In this study, it was found that, there is a significant 
disparity between parents of  private school children 
and parents of  public-school children in terms of  their 
educational attainment and employment status. The 
parents of  children who attended private schools were 
more likely to be educated and employed than those of  
their public-school counterparts. Private schools had 
more female students than public schools, which had 
more male students. Compared to public schools, private 
schools had a greater number of  students from Christian 
backgrounds. Both private and public-school students 
were knowledgeable about when breakfast should be 
eaten and the importance of  consuming breakfast while 
attending school. However, students in private schools 
were more likely to agree that fruits and vegetables 
should be included in breakfast than their public-school 
counterparts. Fewer than half  of  the students in both 
public and private schools ate breakfast prepared at 
home by their parents. It should be noted, however, that 
more than half  of  the children who had their breakfast 
prepared at home preferred eating it at home rather than 
outside. Even though private school children’s breakfasts 
contained more vegetables and fruits than public 
school children’s breakfasts, less than half  of  students 
in both public and private schools consumed fruits and 
vegetables. When compared to public school children, 
private school children had less oil in their breakfast. The 
majority of  the children ate rice for breakfast the day 
before the questionnaires were administered. 

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