Anemia and School Participation

Last registered on July 21, 2016

Pre-Trial

Trial Information

General Information

Title
Anemia and School Participation
RCT ID
AEARCTR-0001157
Initial registration date
July 21, 2016

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
July 21, 2016, 3:12 PM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Region

Primary Investigator

Affiliation
University of California, Berkeley

Other Primary Investigator(s)

PI Affiliation
Director, Niramaya Health Foundation
PI Affiliation
Assistant Professor of Economics, University of Toronto

Additional Trial Information

Status
Completed
Start date
2001-09-01
End date
2002-10-31
Secondary IDs
Abstract
Anemia is among the most widespread health problems for children in developing countries. This paper evaluates the impact of a randomized health intervention delivering iron supplementation and deworming drugs to Indian preschool children. At baseline, 69 percent were anemic and 30 percent had intestinal worm infections. Weight increased among assisted children, and preschool-participation rates rose by 5.8 percentage points, reducing absenteeism by one-fifth. Gains were especially pronounced for those most likely to be anemic at baseline. Results contribute to a growing view that school-based health programs are an effective way of promoting school attendance in less developed countries.
External Link(s)

Registration Citation

Citation
, , Edward Miguel and Charu Puri-Sharma. 2016. "Anemia and School Participation." AEA RCT Registry. July 21. https://doi.org/10.1257/rct.1157
Former Citation
, , Edward Miguel and Charu Puri-Sharma. 2016. "Anemia and School Participation." AEA RCT Registry. July 21. https://www.socialscienceregistry.org/trials/1157/history/9531
Sponsors & Partners

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Experimental Details

Interventions

Intervention(s)
The preschool health intervention was carried out in Pratham’s preschools with children aged 2-6 years. Children were given iron supplementation (33.3 mg of elemental iron with folic acid) and deworming drugs (400 mg of albendazole) administered during “health camps” conducted three times a year in the preschools. Following WHO recommendations, teachers in treatment preschools administered daily iron doses for 3 school days following each health camp, to all children attending school that day. Treatment and control preschools both also received 200,000 I.U. of Vitamin A at the first health camp during the study period, and thus treatment effects should be interpreted as the impact of iron and deworming in addition to Vitamin A, relative to Vitamin A alone.
Intervention Start Date
2001-12-01
Intervention End Date
2002-03-31

Primary Outcomes

Primary Outcomes (end points)
1) Pre-school attendance
2) Anthropometrics (weight-for-height z-score, weight-for-age z-score, weight, BMI, height, height-for-age z-score)
3) Hemoglobin levels
Primary Outcomes (explanation)
1) Pre-school attendance: Baseline enrollment rosters were collected before the intervention and subsequent participation data was collected through monthly, unannounced visits to all preschools. At each visit, enumerators determined whether each child from the baseline roster was present, absent, had left school, or had transferred to another school. Those present at school are counted as “participants” and those who had dropped out or were absent as “nonparticipants." Children who transferred to another NGO preschool were tracked at those schools during subsequent attendance checks. Children who moved away from the area or about whom the teacher did not have good information, are lost from the sample (until they return to an NGO preschool, if ever).
2) Anthropometrics: measured at health camps by enumerators.
3) Hemoglobin levels: The Hb test consisted of a finger prick blood draw conducted by professional laboratory staff and analyzed using the Cyanometh technique.

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The study was conducted in a low-income urban resettlement area in Delhi. The NGO Pratham runs preschools for children aged 2-6 years. The pre-schools are divided into “clusters,” with each cluster containing one to three preschools, usually all located on the same city block. The clusters are randomly assigned to three groups, Groups I, II and III. Group I is the treatment, and Groups II and III are the controls, although they all received the treatment after the study was finished.
Experimental Design Details
Randomization Method
Computer random number generator
Randomization Unit
Pre-school “cluster” where cluster means a group of pre-schools containing one to three pre-schools.
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
155 pre-school clusters
Sample size: planned number of observations
2,392 children
Sample size (or number of clusters) by treatment arms
Group 1 = Treatment; clusters = 59; preschools = 80; children = 930
Group 2 = Comparison; clusters = 51; preschools = 70; children = 782
Group 3 = Comparison; clusters = 45; preschools = 50; children = 680
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB

Institutional Review Boards (IRBs)

IRB Name
Study has received IRB approval. Details not available.
IRB Approval Date
Details not available
IRB Approval Number
Details not available

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
Yes
Intervention Completion Date
March 31, 2002, 12:00 +00:00
Data Collection Complete
Yes
Data Collection Completion Date
October 31, 2002, 12:00 +00:00
Final Sample Size: Number of Clusters (Unit of Randomization)
Was attrition correlated with treatment status?
No
Final Sample Size: Total Number of Observations
Approximately 1,794 children (this is based on an approximate attrition rate of 25% for all attendance checks)
Final Sample Size (or Number of Clusters) by Treatment Arms
Group 1 = Treatment; clusters = 59 Group 2 = Comparison; clusters = 51 Group 3 = Comparison; clusters = 45
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
No
Reports, Papers & Other Materials

Relevant Paper(s)

Abstract
ANEMIA AND SCHOOL PARTICIPATION

Anemia is among the most widespread health problems for children in developing countries. This paper evaluates the impact of a randomized health intervention delivering iron supplementation and deworming drugs to Indian preschool children. At baseline 69 percent were anemic and 30 percent had intestinal worm infections. Weight increased among assisted children, and preschool participation rates rose by 5.8 percentage points, reducing absenteeism by one fifth. Gains were especially pronounced for those most likely to be anemic at baseline. Results contribute to a growing view that school-based health programs are an effective way of promoting school attendance in less developed countries.
Citation
Bobonis, Gustavo, Edward Miguel, and Charu Puri-Sharma. 2006. "Anemia and School Participation." The Journal of Human Resources 41(4): 692-721.

Reports & Other Materials