Impact of delivering iron-fortified salt through a school feeding program on child health, education, and cognition: Evidence from a randomized controlled trial in rural India

Last registered on May 07, 2018
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Pre-Trial

Trial Information

General Information

Title
Impact of delivering iron-fortified salt through a school feeding program on child health, education, and cognition: Evidence from a randomized controlled trial in rural India
RCT ID
AEARCTR-0002957
Initial registration date
May 04, 2018

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
May 07, 2018, 7:05 PM EDT

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

Locations

Country
India
Region
Jehanabad, Bihar

Primary Investigator

Name
Santosh Kumar
Affiliation
Sam Houston State University
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Other Primary Investigator(s)

PI Name
Mariona Kramer
PI Affiliation
University of Gottingen
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PI Name
Sebastian Vollmer
PI Affiliation
University of Gottingen
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Additional Trial Information

Status
Completed
Start date
2014-11-01
End date
2016-08-30
Keywords
Education, Health
Additional Keywords
Mid-day meal, Double fortified salt, Anemia, Cognition, Education, India, Bihar, Children
JEL code(s)
C93, I1, O11
Secondary IDs
Abstract
We present experimental evidence on the impact of delivering double-fortified salt (DFS), salt fortified with iron and iodine, through the Indian school-feeding program called “midday meal” on anemia, cognition, and math and reading outcomes of primary school children. We conducted a field experiment that randomly provided a one-year supply of DFS at a subsidized price to public primary schools in one of the poorest regions of India. The DFS treatment had significantly positive impacts on hemoglobin levels and reduced the prevalence of any form of anemia by 9.3 percentage points (or about 20 percent) but these health gains did not translate into statistically significant impacts on cognition and test scores. While exploring the heterogeneity in effects, we find that treatment had statistically significant gains in anemia and test scores among children with higher treatment compliance. We further estimate that the intervention was very cost effective and can potentially be scaled up rather easily.
External Link(s)
Working paper

Registration Citation

Citation
Kramer, Mariona, Santosh Kumar and Sebastian Vollmer. 2018. "Impact of delivering iron-fortified salt through a school feeding program on child health, education, and cognition: Evidence from a randomized controlled trial in rural India." AEA RCT Registry. May 07. https://doi.org/10.1257/rct.2957-1.0
Former Citation
Kramer, Mariona, Santosh Kumar and Sebastian Vollmer. 2018. "Impact of delivering iron-fortified salt through a school feeding program on child health, education, and cognition: Evidence from a randomized controlled trial in rural India." AEA RCT Registry. May 07. https://www.socialscienceregistry.org/trials/2957/history/29186
Sponsors & Partners

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Experimental Details

Interventions

Intervention(s)
The intervention is to supply double fortified salt, fortified with iron and iodine, for school lunch preparation (mid-day meal food preparation) in 54 schools of Jehanabad district in Bihar, India.
Intervention Start Date
2015-08-10
Intervention End Date
2016-08-30

Primary Outcomes

Primary Outcomes (end points)
Hemoglobin, Anemia, Cognition, Test scores, Educational attainment outcome, behavior change with regard to diet.
Primary Outcomes (explanation)
NA

Secondary Outcomes

Secondary Outcomes (end points)
NA
Secondary Outcomes (explanation)
NA

Experimental Design

Experimental Design
We delivered DFS to 54 randomly selected public schools in Bihar, India. The DFS was subsequently used to prepare the MDM at the school level. We received DFS directly from the manufacturer and delivered it to the treatment schools either every month or every second month, depending on consumption. Headmasters were encouraged to contact our team in the event that they ran out of DFS before the next delivery date. The regular school visits also functioned as a monitoring system. To account for the potential of a budgetary effect, DFS was sold to headmasters to a subsidized price of Rs. 12 (0.18 USD), which is close to the price of local salt. At endline, headmasters and cooks stated that they did not have any major difficulties with the delivery and usage of the DFS. Only the headmasters and cooks were aware of the intervention.
Experimental Design Details
Randomization Method
Randomization done in office by a computer
Randomization Unit
Schools
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
108 schools
Sample size: planned number of observations
2000 students (20 students per school)
Sample size (or number of clusters) by treatment arms
54 treatment, 54 control schools
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
NA
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
University of Gottingen
IRB Approval Date
2014-08-01
IRB Approval Number
N/A
Analysis Plan

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials