tailieunhanh - WORMS: IDENTIFYING IMPACTS ON EDUCATION AND HEALTH IN THE PRESENCE OF TREATMENT EXTERNALITIES

In the figure shown here (Figure 1), teaching contributes to the development of pupils’ action competence, which in turn should enable the pupils to act with regard to their own lives and living conditions. Teaching and educational processes have been put in the center of this model in order to stress that a health promoting school is not only about the food in the canteen, a smoke-free environment etc. This also means that pupils and teachers are considered to be the key-players at a health promoting school. The school’s teaching has to reflect the overall aim of a health promoting school. This means that the teaching. | Econometrica Vol. 72 No. 1 January 2004 159-217 WORMS IDENTIFYING IMPACTS ON EDUCATION AND HEALTH IN THE PRESENCE OF TREATMENT EXTERNALITIES By Edward Miguel and Michael Kremer1 Intestinal helminths including hookworm roundworm whipworm and schistosomiasis infect more than one-quarter of the world s population. Studies in which medical treatment is randomized at the individual level potentially doubly underestimate the benefits of treatment missing externality benefits to the comparison group from reduced disease transmission and therefore also underestimating benefits for the treatment group. We evaluate a Kenyan project in which school-based mass treatment with deworming drugs was randomly phased into schools rather than to individuals allowing estimation of overall program effects. The program reduced school absenteeism in treatment schools by one-quarter and was far cheaper than alternative ways of boosting school participation. Deworming substantially improved health and school participation among untreated children in both treatment schools and neighboring schools and these externalities are large enough to justify fully subsidizing treatment. Yet we do not find evidence that deworming improved academic test scores. KEYWORDS Health education Africa externalities randomized evaluation worms. 1. INTRODUCTION Hookworm roundworm whipworm and schistosomiasis infect one in four people worldwide. They are particularly prevalent among school-age children in developing countries. We examine the impact of a program in which seventy-five rural Kenyan primary schools were phased into deworming treatment in a randomized order. We find that the program reduced school absenteeism by at least one-quarter with particularly large participation gains among the youngest children making deworming a highly effective way to boost school participation among young children. we then identify crossschool externalities the impact of deworming for pupils in schools located near treatment