School-based health programs for improving education and health outcomes

• In Event: Roundtable Session 3
  In Refereed Roundtable Session: Teaching and Teachers

Proposal

Abstract: Poor student health is a significant obstacle to participation and learning in school, particularly in low- and middle-income countries. Concurrently, lack of school participation may also keep students from receiving inputs linked to positive health outcomes (Duflo, Dupas, and Kreme, 2017). Despite efforts by education and healthcare professionals to address these problems, inadequacies across both education and healthcare continue to undermine positive results and increase opportunity gaps. However, a growing body of evidence supports the benefits of utilizing schools to provide health care and suggests that increasing coordination between the two domains may reduce the barriers for children to healthcare and their ability to learn.
There are several reasons to believe schools may be a good location for health care dissemination. First, when it comes to contagious conditions, the standard crowded design of schools makes students especially vulnerable. Second, treating some children in a school may positively affect other students who are not treated. Third, schools are often convenient and cost-effective venues to administer treatment to many people at once, rather than locating and reaching them individually. Further, improving the predictability of health worker availability may also improve take-up of health programs since high rates of health worker absenteeism and closure of facilities may reduce the extent to which parents use these services (Banerjee, Glennerster, and Duflo 2008).
This presentation will focus on the results from eight randomized evaluations by researchers affiliated with The Abdul Latif Jameel Poverty Action Lab (J-PAL) in Burkina Faso, China, Kenya, and the United States. These studies demonstrate that health interventions delivered at schools can be cost-effective and convenient venues to improve student health and learning outcomes. In particular, I will draw on each study's key results, discussing the impact of school-based programs such as those involving deworming (Baird et al. 2016), iron supplements (Wong, 2014), eyeglasses (Nie, 2020), free food (Kazianga, 2012), and health information (Glewwe, West, and Lee. 2018). Ultimately, with insight from these studies, I plan to discuss transferable lessons as to when or not school-based health inputs can be effective.
From this, I hope to also discuss how cross-disciplinary relationships can improve education and health, as well as other domains. In particular, I'd like to draw attention to programs that aim to increase learning outcomes through a broader health and anti-poverty approach, such as free school meal programs. This will be especially necessary as we consider CIES 2023 goals and equity as a broader goal for education and schools. Moreover, this will touch on ways to adapt our programs and research approaches to address the relationship between health and education and how that relationship contributes to social (dis)advantage. Lastly, this presentation will also touch on how J-PAL is systematically generating and summarizing new evidence to help fill gaps that remain barriers to understanding how to improve student health.

Citations:
Duflo, Esther, Pascaline Dupas, and Michael Kremer. “The Impact of Free Secondary Education: Experimental Evidence from Ghana,” Working paper, 2017.
Baird, Sarah, Joan Hamory Hicks, Michael Kremer, and Edward Miguel. 2016. "Worms at Work: Long-Run Impacts of a Child Health Investment." Quarterly Journal of Economics 131(4): 1637-1680.
Banerjee, Abhijit, Rachel Glennerster, and Esther Duflo. 2008. "Putting a Band-Aid on a Corpse: Incentives for Nurses in the Indian Public Health Care System." Journal of the European Economic Association 6(2-3): 487-500.
Glewwe, Paul, Kristine L West, and Jongwook Lee. 2018. "The Impact of Providing Vision Screening and Free Eyeglasses on Academic Outcomes: Evidence from a Randomized Trial in Title I Elementary Schools in Florida." Journal of Policy Analysis and Management 37(2): 265-300.
Kazianga, Harounan, Damien de Walque, and Harold Alderman. 2012. "Educational and Child Labour Impacts of Two Food-for-Education Schemes: Evidence from a Randomised Trial in Rural Burkina Faso." Journal of African Economies 21(5): 723-760.
Nie, Jingchun, Xiaopeng Pang, Lei Wang, Scott Rozelle, and Sean Sylvia. 2020. "Seeing is Believing: Experimental Evidence on the Impact of Eyeglasses on Academic Performance, Aspirations, and Dropout among Junior High School Students in Rural China." Economic Development and Cultural Change 68(2): 335-355.
Wong, Ho Lun, Yaojiang Shi, Renfu Luo, Linxiu Zhang, and Scott Rozelle. 2014. "Improving the Health and Education of Elementary Schoolchildren in Rural China: Iron Supplementation Versus Nutritional Training for Parents." Journal of Development Studies 50(4): 502-519.

Author

• Demitria Wack, Abdul Latif Jameel Poverty Action Lab (J-PAL at MIT)