Although the past few decades have seen incomes rise and increased government commitment to helping the poor, there is concern that a large fraction of children in rural China still lack regular access to micronutrient-rich regular diets. Insufficient diets and poor knowledge of nutrition among low income populations can result in nutritional problems, including iron deficiency anemia, which adversely affect attention and learning in school. Surprisingly, there has been little research in China trying to document the prevalence of nutritional problems among certain vulnerable populations, such as school-aged children in rural areas. The absence of programs to combat iron deficiency anemia among students might be interpreted as a sign that the government does not recognize the severity of this problem. The goal of this paper is to increase our understanding of the extent of anemia among school-aged children in poor regions of Qinghai and Ningxia, and to identify structural correlates of anemia in this region. We report on the results of a cross-sectional survey involving over 4000 fourth grade students, from 76 randomly selected elementary schools in 10 poor counties in Qinghai Province and Ningxia Hui Autonomous Region, in China’s poor northwest region. Data were collected through structured questionnaires and standardized tests. Trained professional nurses administered hemoglobin (Hb) tests (using Hemocue finger prick kits) and anthropomorphic measurements using high quality equipment. Our baseline data shows that the overall anemia rate is 34.5% (23.0%) using the World Health Organization’s blood Hb cutoff of 120g/L (115g/L). We find that students who live and eat at school have higher rates of anemia. Children with less-educated parents are more likely to be anemic. Higher anemia rates are associated with students with parents working on farms and away from home. Anemia rates are correlated with adverse physical (lower body mass index (BMI) z-scores and higher incidences of stunting), cognitive and psychological impacts among students. Such findings are consistent with recent findings of other studies in other poor areas in China’s Northwest.

Background. Despite growing wealth and the growing commitment of China’s government to providing quality education, a significant share of children across rural China still have no access to regular sources of iron-rich foods, vitamins and other micronutrients. Such poor diets may not only result in high incidences of nutritional problems, including anemia, good nutrition has been shown to be an effective input into the creation of human capital.

Objective. To increase our understanding of the extent of anemia in poor Shaanxi Province’s primary schools, and identify structural correlates of anemia in this region. Methods. A cross-section survey was conducted. Data were collected from 4000 grade fourth grand students (ages 9 to 11) in 70 primary schools in poor rural areas of Shaanxi province. Structured questionnaires and standard test were used to gather data. Trained nurses carried out the hemoglobin tests (using Hemocue finger prick kits) and anthropomorphic measurements using high quality equipment.

Results. The paper shows that the overall anemia rate is 21.5% (39%) when using a blood hemoglobin cutoff of 115 g/L (120 g/L). We find that those students that are boarding at school and those students that eat lunch away from home are more likely to be anemic. Children with anemia are found to have lower height for age (HAZ) scores and have higher incidences of stunting.

Conclusions. If this part of Shaanxi province is representative of the rest of Shaanxi’s poor rural areas (or all national designed poor counties in China), this means that tens of thousands (or millions) of children in rural Shaanxi (all national designed poor counties in China) may be anemic. Although we were not able to pinpoint the exact determinates and causal effects of anemia, the main implication of this work is that anemia remains a serious health problem for educators and health officials in rural China.

The main goal of this paper is to document the nature of boarding schools and empirically analyze the difference of nutrition intake and malnutrition status between boarding and non-boarding students in western rural China. By using two data sets about boarding schools and boarding students in Shaanxi Province, a representative province in western rural China, this paper finds that dormitory and student canteen facilities in boarding schools are under-equipped and services are poor quality and far below that needed for student development. Poor services in boarding schools and inadequate nutrition intake may be an important cause of low student height-for-age Z-scores (HAZ), as students eating at school have a much lower HAZ on average than that of non-boarding students. Furthermore, girls and students with more siblings have relatively lower HAZ, while the higher the number of parents a student has and the more educated they are exert a positive influence on child nutritional status in terms of HAZ. Finally, our analysis implies that the effective way to decrease the inequality of health, malnutrition and human capital between urban and rural in the long run is to improve the facilities and services of boarding schools in rural China.