Intergenerational Impacts of Health Investments in Kenya
Last registered on September 19, 2018


Trial Information
General Information
Intergenerational Impacts of Health Investments in Kenya
Initial registration date
June 05, 2015
Last updated
September 19, 2018 10:14 PM EDT

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Primary Investigator
University of California, Berkeley
Other Primary Investigator(s)
PI Affiliation
University of California, Berkeley CEGA
PI Affiliation
University of California, Berkeley
PI Affiliation
University of California, Berkeley
Additional Trial Information
On going
Start date
End date
Secondary IDs
This project will create a dataset consisting of the children of individuals who themselves previously benefited from a randomized health (deworming) program. The project will exploit experimental variation to estimate the causal impact of this earlier program on the health and cognitive development of the recipients’ children, overcoming the key methodological problem of confounding. The project will survey approximately 1,500 children of the 7,500 respondents in the Kenya Life Panel Survey (KLPS), creating the new KLPS-Kids dataset, to estimate the extent to which a health program can help break the intergenerational transmission of poverty.
External Link(s)
Registration Citation
Fernald, Lia et al. 2018. "Intergenerational Impacts of Health Investments in Kenya." AEA RCT Registry. September 19.
Experimental Details
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 (parents) 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 of the program beneficiaries (Miguel and Kremer 2004).
Intervention Start Date
Intervention End Date
Primary Outcomes
Primary Outcomes (end points)
Our key outcome variables will be separate domains of cognitive development (including sequential processing and short-term memory, visual-construction ability and spatial relationships), language, fine motor skills, socio-emotional development, and height.
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
The project will survey a randomly selected subset of approximately 1,500 children aged 3-5 of 7,500 adult respondents in the Kenya Life Panel Survey (KLPS), creating the new KLPS-Kids dataset. The original KLPS sample contains Kenyans who participated in an earlier health study, known as the Primary School Deworming Program (PSDP). The PSDP provided deworming medication to primary school students in rural western Kenya starting in 1998, where the order of phase-in to primary schools was randomized. Previous research finds that this intervention had substantial positive impacts on the health, schooling and labor market hours and earnings of beneficiaries 10 years after the launch of the program. These impacts on parents are a necessary pre-condition for studying later impacts among recipients’ children, and to estimate the extent to which a health intervention can help break the intergenerational transmission of poverty by improving life outcomes for program beneficiaries’ children. In order to measure the impacts on the recipients’ children, this project will create locally appropriate versions of both standard and innovative survey instruments designed to measure various domains of development among children aged 3-5. Since the selection of beneficiaries for the PSDP was randomized, the data will enable the estimation of causal impacts of this program on recipients’ children’s outcomes, overcoming the key methodological problem of confounding.
Experimental Design Details
Not available
Randomization Method
The randomization performed for the PSDP is described in Miguel et al. (2014), "Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities,Data User's Guide", Center for Effective Global Action Working Paper #40. The current project will seek children aged 3-5 of a randomly selected half of adult PSDP/KLPS participants (where randomization is done by computer). Up to 2 children will be interviewed per eligible adult. In cases where the adult has more than two children aged 3-5, children to be interviewed will be randomly chosen using a die roll by the survey enumerator.
Randomization Unit
The adults were randomized into the PSDP at the school level. Adults and children chosen for followup in the present project are randomized at the individual level.
Was the treatment clustered?
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
1,500 children
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)
IRB Name
Committee for the Protection of Human Subjects, University of California, Berkeley
IRB Approval Date
IRB Approval Number
IRB Name
Maseno University Institutional Review Board
IRB Approval Date
IRB Approval Number