Impact of Moringa oleifera-fortified school lunches on haemoglobin concentrations in adolescent girls in Zinder, Niger: a six-month intervention study

{ "background": "Adolescent girls in the Sahel region are at high risk of iron deficiency anaemia, which impairs cognitive development and educational outcomes. School feeding programmes are a key intervention platform, yet often lack micronutrient density.", "purpose and objectives": "This brief report evaluates the efficacy of integrating locally sourced Moringa oleifera leaf powder, a nutrient-dense food source, into standard school lunches to improve haemoglobin concentrations in adolescent girls.", "methodology": "A six-month, school-based, controlled intervention was conducted in the Zinder Region. Participants were adolescent girls (n=320) aged 12–16 years. The intervention group received a daily school lunch fortified with 5g of dried Moringa leaf powder, while the control group received the standard lunch. Haemoglobin (Hb) was measured via HemoCue at baseline and endpoint. The primary analysis used a linear mixed-effects model: $Hb{ij} = \\beta0 + \\beta1 Groupi + \\beta2 Timej + \\beta3 (Groupi \\times Timej) + ui + \\epsilon{ij}$, where $ui$ is the random intercept for participant.", "findings": "The intervention group showed a significant increase in mean Hb concentration compared to controls (adjusted mean difference: 0.82 g/dL, 95% CI: 0.51 to 1.13). The prevalence of moderate anaemia (Hb < 11.5 g/dL) was reduced by 18.7 percentage points in the intervention group versus 4.2 points in controls.", "conclusion": "Fortification of school meals with Moringa oleifera leaf powder is an effective, locally sustainable strategy for significantly improving haemoglobin status and reducing anaemia burden among adolescent girls in a resource-limited setting.", "recommendations": "Integrating Moringa leaf powder into national school feeding programme guidelines should be considered. Further research should assess the long-term impact on cognitive performance and