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Gustavo J Bobonis, Edward Miguel, Charu P Sharma

Cited by*: 6 Downloads*: 22

Iron-deficiency anemia is among the world's most widespread health problems, especially for children, but it is rarely studied by economists. This paper evaluates the impact of a health intervention delivering iron supplementation and deworming drugs to 2-6 year old children through an existing pre-school network in the slums of Delhi, India. At baseline 69 percent of sample children were anemic and 30 percent had intestinal worm infections. Sample pre-schools were randomly divided into groups and gradually phased into treatment. Weight increased significantly among assisted children, and pre-school participation rates rose sharply by 5.8 percentage points - a reduction of one-fifth in school absenteeism - in the first five months of the program. Gains are largest in low socio-economic status areas. Year two estimates are similar, but two methodological problems--sample attrition, and the non-random sorting of new child cohorts into treatment groups--complicate interpretation of the later results.

Michael Kremer, Edward Miguel

Cited by*: 7 Downloads*: 13

The history of foreign development assistance is one of movement away from addressing immediate needs and toward focusing on the underlying causes of poverty. A recent manifestation is the move towards sustainability,' which stresses community mobilization, education, and cost-recovery. This stands in contrast to the traditional economic analysis of development projects, with its focus on providing public goods and correcting externalities. We examine evidence from randomized evaluations on strategies for combating intestinal worms, which affect one in four people worldwide. Providing medicine to treat worms was extremely cost effective, although medicine must be provided twice per year indefinitely to keep children worm-free. An effort to promote sustainability by educating Kenyan schoolchildren on worm prevention was ineffective, and a mobilization' intervention from psychology failed to boost deworming drug take-up. Take-up was highly sensitive to drug cost: a small increase in cost led to an 80 percent reduction in take-up (relative to free treatment). The results suggest that, in the context we examine, the pursuit of sustainability may be an illusion, and that in the short-run, at least, external subsidies will remain necessary.

Michael Kremer, Edward Miguel

Cited by*: 1 Downloads*: 6

Intestinal helminths - including hookworm, roundworm, schistosomiasis, and whipworm - infect more than one-quarter of the world's population. A randomized evaluation of a project in Kenya suggests that school-based mass treatment with deworming drugs reduced school absenteeism in treatment schools by one quarter; gains are especially large among the youngest children. Deworming is found to be cheaper than alternative ways of boosting school participation. By reducing disease transmission, deworming creates substantial externality health and school participation benefits among untreated children in the treatment schools and among children in neighboring schools. These externalities are large enough to justify fully subsidizing treatment. We do not find evidence that deworming improves academic test scores. Existing experimental studies, in which treatment is randomized among individuals in the same school, find small and insignificant deworming treatment effects on education; however, these studies underestimate true treatment effects if deworming creates positive externalities for the control group and reduces treatment group attrition.

Michael Kremer, Edward Miguel, Rebecca Thornton

Cited by*: 16 Downloads*: 13

We report results from a randomized evaluation of a merit scholarship program for adolescent girls in Kenya. Girls who scored well on academic exams had their school fees paid and received a cash grant for school supplies. Girls eligible for the scholarship showed significant gains in academic exam scores (average gain 0.12-0.19 standard deviations) and these gains persisted following the competition. There is also evidence of positive program externalities on learning: boys, who were ineligible for the awards, also showed sizeable average test gains, as did girls with low pretest scores, who were unlikely to win. Both student and teacher school attendance increased in the program schools. We discuss implications both for understanding the nature of educational production functions and for the policy debate surrounding merit scholarships.

Michael Kremer, Edward Miguel

Cited by*: 16 Downloads*: 19

We examine social learning using data from a program that promoted use of deworming medicine in Kenyan schools. These drugs kill worms in the body; although people are soon reinfected, treatment interferes with the cycle of transmission, generating positive externalities. Individuals randomly exposed to more information about deworming drugs through their social network were significantly less likely to take the drugs and more likely to believe the drugs are "not effective." This finding is consistent with the hypothesis that those exposed to the program had overly optimistic prior beliefs about net private drug benefits. The combination of strong social effects and extensive social networks among teenagers implies that a "child-to-child" public health approach focused on teenagers will speed social learning. There are large differences between social effect estimates relying on experimental variation (negative estimates) and nonexperimental methods (positive estimates).