Givology Staff's Blog

Health Based Interventions to Increase School Attendance

[b][color=#222222]"What works in education policy in the developing world? A brief look at the role of health-based interventions [/color]to increase school attendance in areas where absenteeism is greatest"[/b]
[color=#222222]By Brent Harlow [/color]
[/color][color=#222222]There is an ever-growing body of research available to inform governments, non-profit organizations NGOs, and private donors as they [/color]try to identify those programs and policies that are most effective at improving educational outcomes for children in the developing world, and choose which of these programs to give their financial support to.
[color=#222222]In this series, as I mentioned in my last post, I will be reviewing existing research and sharing it with Givology readers interested in [/color]what scientific trials have to teach us about what works, what doesn't, and what we have yet to learn about success in education in the developing world.
[color=#222222]In this post, I begin by looking at an important health-based intervention-- deworming treatment-- that has proven extremely effective at [/color]increasing school attendance, and may be a crucial component in addressing the problem of school absenteeism in sub-Saharan Africa and elsewhere. However, health-based interventions do not even begin to address questions such as how to make school affordable to the poorest of the poor, how to incentivize student learning (as opposed to just enrollment and attendance), how to best teach students at the primary and secondary levels, how to narrow the gender gap that persists in education in the developing world, how to best inform or persuade families and students as to the value of education, how to encourage families and students to continue through a complete course of not only primary, but also secondary education, etc. Beginning with my next post, I will be looking at research that addresses some of these difficult questions.
[color=#222222][b]Progress toward universal primary education: 2000 to 2015[/b][/color]
[color=#222222]In September of 2000, 149 heads of state and government and high-ranking officials from over 40 other countries met at the United Nations [/color]Headquarters in New York at the "Millennium Summit" and unanimously adopted the "Millennium Declaration," which includes what have come to be known as the Millennium Development Goals (MDG). The MDGs set time-bound targets for achieving significant progress in the areas of poverty, education, gender equality, health and environmental sustainability by 2015. (1)
[color=#222222]In 2002, the UN Millennium Project was commissioned to come up with an action plan for how to best implement the MDGs. It then sent teams to [/color]countries throughout the developing world to advise leaders on how they might implement these plans, given their countries' unique opportunities and challenges. Concerning the MDG aimed at improving education, i.e. "children everywhere, boys and girls alike, will be able to complete a full course of primary schooling" by 2015, the commission called for nations to build more schools and train more teachers where necessary, to eliminate all primary school fees, and to eliminate gender biases so that boys and girls would be able to attend school. (2)
[color=#222222]The MDG Project has made significant progress toward the goal of achieving universal primary education. According to the MGD Report of 2015, [/color]primary school net enrollment in developing regions of the world increased from 83% in 2000 to 91% in 2015. In the same period, the number of children out of school has fallen from 100 million to 57 million, and the number of girls attending school has increased substantially.(3) [color=#222222]
[/color][color=#222222][b]Sub-Saharan Africa's relative lag in progress, and the role of health-based interventions in addressing this gap[/b][/color]
[color=#222222]The 2015 report goes on to state, however, that while much progress has been made, there is still a lot of work to be done. The report identifies [/color]sub-Saharan Africa in particular as a region that has made remarkable strides in the last fifteen years, even as it continues to lag behind other areas and presents some of the greatest challenges moving forward.
[color=#222222]One of the most promising impact studies to look at ways to increase school participation in sub-Saharan Africa was conducted by Poverty Action [/color]Lab affiliates Michael Kremer and Edward Miguel, who evaluated the Primary School Deworming Project (PSDP)-- initiated by International Child Support in cooperation with the Busia District Ministry of Health-- in western Kenya between 1998 and 2001. (4)
[color=#222222]The PSDP is a school-based deworming program in which over 30,000 students from 75 primary schools in western Kenya were administered medication [/color]that is effective against infection from hookworm, roundworm, whipworm, and schistosomiasis, which are common in many developing regions where unsanitary conditions bring children into contact with soil and water contaminated with fecal matter containing the parasites. The worms can cause intestinal bleeding, resulting in anemia and leading to a variety of health problems, as well as the "abdominal pains" which are given as the reason for a quarter of all school absences in Kenya.
[color=#222222]Kremer and Miguel wanted to see how the deworming treatment affected rates of moderate to severe intestinal worm infections, as well as school [/color]attendance. They found that the deworming treatment reduced moderate to heavy infection by at least 31 percentage points and resulted in a 9.3 percentage point rise in school attendance among all boys, and girls under thirteen years old. There were positive spillover effects too, with school attendance rates in neighboring schools, where the treatment was not given, also rising by 2.7 percentage points.
[color=#222222]Kremer and Miguel find that, at a cost of US$2.92 per additional year of schooling, deworming is an extremely cost-effective intervention for [/color]increasing school attendance rates.
[color=#222222][b]Scaling up the successful school-based deworming program[/b][/color]
[color=#222222]The success of the PSDP trial has led to subsequent school-based deworming campaigns in Kenya, Ethiopia, and even regions outside of sub-Saharan [/color]Africa where intestinal worm infection is prevalent. According to a recent article posted on the J-PAL website, 179 million children in India and 190 million children overall received deworming treatment in the 2015-2016 year. (5)
[color=#222222]3. The report is available at [/color]
[color=#222222]4. The study, "Primary School Deworming in Kenya," is available at[/color]
[color=#222222]5. The article is entitled "School-based Deworming: Over 190 Million Children Received Deworming Treatment in the 2015-2016 Year."[/color]

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