Design and piloting of the SAHARAN toolbox: A comprehensive assessment of school-age children’s growth, cognitive and physical function Joe D Piper1,2, Clever Mazhanga2, Idah Mapurisa2, Tsitsi Mashedze2, Eunice Munyama2, Gloria Mapako2, Dzie Chidhangaro2, Naume Tavengwa2, Lisa Langhaug2, Robert Ntozini2, Melissa Gladstone3, Jonathan Wells4, Jean Humphrey5, Andrew J Prendergast1,2. 1 Queen Mary University of London, London, UK 2 Zvitambo Institute of Maternal and Child Health Research, Harare, Zimbabwe 3 University of Liverpool, Liverpool, UK 4 UCL Great Ormond Street Institute of Child Health, London, UK 5 Johns Hopkins Bloomberg School of Public Health, Baltimore, USA Introduction: There is an urgent need for tools that holistically measure child growth, physical and cognitive function, particularly at school-age, to better characterize the effect of early-life interventions. Methods: We developed the School-Age Health, Activity, Resilience, Anthropometry and Neurocognitive (SAHARAN) Toolbox as a unique combination of tests designed to evaluate child health and function in mid-childhood. Cognitive function is evaluated using the Kaufmann Assessment Battery for Children, with additional tests measuring literacy, numeracy and fine motor skills. Growth is assessed by anthropometry, body composition (using bioimpedance analysis) and skinfold thicknesses to measure the distribution of subcutaneous fat. Knee-heel length provides a sensitive measure of poor growth. Physical function is assessed by handgrip strength, and the broad jump to provide a measure of lower leg strength. Aerobic capacity is measured using the shuttle-run test, with additional sensitivity provided by heart rate monitoring using fitbits, and blood pressure measurement pre- and post-test. Socioemotional function is assessed using a direct questionnaire to the child and the Strengths and Difficulties Questionnaire to the caregiver. A detailed caregiver questionnaire also measures demographics, socioeconomic status, nurturing, child discipline and food and water insecurity Results: A pilot of 20 children aged 7-8 years in rural Zimbabwe has been undertaken to date. Initial results demonstrate good feasibility and acceptability within the community. The results from this pilot study will provide a useful reference set for this neglected age-group and population. Conclusion: The SAHARAN toolbox provides a detailed and portable test battery to holistically measure child growth and function within rural communities.