Experimental Evidence on Child Health and Long-run Outcomes in Kenya
Last registered on November 29, 2018

Pre-Trial

Trial Information
General Information
Title
Experimental Evidence on Child Health and Long-run Outcomes in Kenya
RCT ID
AEARCTR-0001191
Initial registration date
April 20, 2016
Last updated
November 29, 2018 1:31 AM EST
Location(s)

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Primary Investigator
Affiliation
University of California, Berkeley
Other Primary Investigator(s)
PI Affiliation
University of California, Berkeley
PI Affiliation
Harvard University
PI Affiliation
George Washington University
Additional Trial Information
Status
On going
Start date
1998-01-01
End date
2019-12-31
Secondary IDs
Abstract
This project creates a longitudinal (panel) data set of Kenyan youth, and exploits this data to rigorously estimate the long-run impact of a child health intervention on a range of later life outcomes. In particular, this project seeks to locate and survey a representative subset of approximately 7,500 individuals who attended schools that were part of a health program that provided deworming medication to more than 30,000 primary school children starting in 1998. The order of phase-in of schools involved in this health program was randomized, allowing us to estimate how exogenous gains in childhood health affect a wide range of adult life outcomes. In previous research, this intervention was shown to have substantial short-term impacts on beneficiaries (Miguel and Kremer, 2004). Despite strong a priori reasons to anticipate significant long-term labor market and demographic benefits from better childhood health, these effects have rarely been demonstrated empirically, in large part due to the near total absence of extended longitudinal data of the kind we collect. Evidence is urgently needed by public policymakers attempting to design effective health programs in less developed countries.
External Link(s)
Registration Citation
Citation
Baird, Sarah et al. 2018. "Experimental Evidence on Child Health and Long-run Outcomes in Kenya." AEA RCT Registry. November 29. https://www.socialscienceregistry.org/trials/1191/history/38044
Sponsors & Partners

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Experimental Details
Interventions
Intervention(s)
In 1998, a local non-governmental organization (NGO) launched a program known as the Primary School Deworming Program (PSDP) to provide deworming medication to individuals enrolled in 75 primary schools in Busia District, a densely-settled farming region of rural western Kenya adjacent to Lake Victoria. The schools participating in the program consisted of nearly all rural primary schools in Budalangi and Funyula divisions in southern Busia district, and contained more than 30,000 pupils at the start of the study. Baseline parasitological surveys conducted by the Kenyan Ministry of Health indicated that these divisions had high rates of helminth infection at over 90%. Using modified WHO infection thresholds (Brooker et al., 2000b), roughly one-third of children in the sample had “moderate to heavy” infections with at least one helminth at the time of the baseline survey, a rate not atypical by regional standards (Brooker et al., 2000a). The 1998 Kenya DHS indicated that 85% of children in western Kenya, in the relevant age range of 8-18 years, were enrolled in school – suggesting that the sample was broadly representative of western Kenyan children as a whole at the time.

The 75 program schools were randomly divided into three groups (Groups 1, 2, and 3) of 25 schools each: the schools were stratified by geographical area (division, then zone), the zones were listed alphabetically (within each division), and then within each zone the schools were listed in increasing order of student enrolment, and every third school was assigned to a given project group. Due to the NGO’s administrative and financial constraints, the schools were phased into the program over the course of 1998-2001, and the order of phase-in was randomly determined, creating experimental treatment groups. This prospective design is central to the present study’s analytical strategy. Group 1 schools began receiving free deworming in 1998, Group 2 schools in 1999, while Group 3 schools began receiving the drugs in 2001. The project design implies that in 1998, Group 1 schools were treatment schools while Group 2 and 3 schools were the control, and in 1999 and 2000, Group 1 and 2 schools were the treatment schools and Group 3 schools the control, and so on. In 2002 all schools received free treatment. Children in Group 1 and 2 schools thus received two to three more years of deworming than Group 3 children, and these early beneficiaries are what we call the deworming treatment group in the present study. Deworming drugs were offered twice per year in treatment schools. Analysis during the first two years of the intervention show large, positive gains in height, self-reported health and school attendance (Miguel and Kremer 2004).
Intervention Start Date
1998-01-01
Intervention End Date
2003-12-31
Primary Outcomes
Primary Outcomes (end points)
We will consider a wide range of outcomes, including labor market earnings, hours worked, sector of employment (for instance, farm versus off-farm work), self-reported health status, urban migration, fertility, marriage, spouse characteristics, and respondents’ children’s health and education.
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
In 1998, a local non-governmental organization (NGO) launched a program known as the Primary School Deworming Program (PSDP) to provide deworming medication to individuals enrolled in 75 primary schools in Busia District, a densely-settled farming region of rural western Kenya adjacent to Lake Victoria. The schools participating in the program consisted of nearly all rural primary schools in Budalangi and Funyula divisions in southern Busia district, and contained more than 30,000 pupils at the start of the study. The 75 program schools were randomly divided into three groups (Groups 1, 2, and 3) of 25 schools each: the schools were stratified by geographical area (division, then zone), the zones were listed alphabetically (within each division), and then within each zone the schools were listed in increasing order of student enrolment, and every third school was assigned to a given project group. Due to the NGO’s administrative and financial constraints, the schools were phased into the program over the course of 1998-2001, and the order of phase-in was randomly determined, creating experimental treatment groups. This prospective design is central to the present study’s analytical strategy. Group 1 schools began receiving free deworming in 1998, Group 2 schools in 1999, while Group 3 schools began receiving the drugs in 2001. The project design implies that in 1998, Group 1 schools were treatment schools while Group 2 and 3 schools were the control, and in 1999 and 2000, Group 1 and 2 schools were the treatment schools and Group 3 schools the control, and so on. In 2002 all schools received free treatment. Children in Group 1 and 2 schools thus received two to three more years of deworming than Group 3 children, and these early beneficiaries are what we call the deworming treatment group in the present study.
Experimental Design Details
Not available
Randomization Method
List randomization.
Randomization Unit
The school is the unit of randomization into the PSDP.
Was the treatment clustered?
Yes
Experiment Characteristics
Sample size: planned number of clusters
75 schools in the PSDP (73 schools included in the follow-up sample).
Sample size: planned number of observations
7,530 pupils
Sample size (or number of clusters) by treatment arms
Among the 73 schools we follow individuals from, 48 are in the treatment group and 25 are in the control group.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials

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IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
University of California Berkeley Committee for the Protection of Human Subjects
IRB Approval Date
2002-02-17
IRB Approval Number
#2002-3-56
Analysis Plan

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