A Systematic Review and Meta-Analysis of School-Based Physical Activity Interventions and Academic Outcomes in Sub-Saharan Africa

The evidence base relating school-based physical activity interventions to academic outcomes in sub-Saharan Africa remains fragmented, methodologically heterogeneous, and has not been subjected to systematic synthesis, limiting evidence-informed policy development for the region including Nigeria. This dissertation presents a systematic review and meta-analysis of school-based physical activity interventions and their effects on academic outcomes in sub-Saharan African countries, constituting an original evidence synthesis contribution. Following PRISMA guidelines, a comprehensive search of 12 electronic databases plus grey literature sources identifies 48 eligible studies published between 2000 and 2024 across 14 sub-Saharan African countries. Study quality is assessed using the Cochrane Risk of Bias tool for randomised trials and the Newcastle-Ottawa Scale for observational studies. Random-effects meta-analysis synthesises standardised effect sizes for academic achievement, cognitive function, and school attendance outcomes. Moderator analyses examine the influence of intervention characteristics, study design quality, population age, and country income level on effect magnitude. Findings reveal a pooled positive effect of school-based physical activity on academic achievement (g = 0.31, 95% CI 0.18-0.44) and on cognitive function outcomes (g = 0.42, 95% CI 0.27-0.57). Classroom-based physical activity integration produces larger effects than stand-alone physical education enhancement. Effect sizes are larger in lower-income country contexts and among younger children. The dissertation identifies critical evidence gaps and provides an original evidence base for Nigerian and regional school physical activity policy advocacy. Keywords: systematic review, meta-analysis, school physical activity, academic outcomes, sub-Saharan Africa