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Improving educational achievement and anaemia of school children: design of a cluster randomised trial of school-based malaria prevention and enhanced literacy instruction in Kenya.

Brooker S, Okello G, Njagi K, Dubeck MM, Halliday KE, Inyega H, Jukes MC - Trials (2010)

Bottom Line: Improving the health of school-aged children can yield substantial benefits for cognitive development and educational achievement.A nested process evaluation, using semi-structured interviews, focus group discussion and a stakeholder analysis will investigate the community acceptability, feasibility and cost-effectiveness of the interventions.National Institutes of Health NCT00878007.

View Article: PubMed Central - HTML - PubMed

Affiliation: Malaria Public Health & Epidemiology Group, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya. simon.brooker@lshtm.ac.uk

ABSTRACT

Background: Improving the health of school-aged children can yield substantial benefits for cognitive development and educational achievement. However, there is limited experimental evidence on the benefits of school-based malaria prevention or how health interventions interact with other efforts to improve education quality. This study aims to evaluate the impact of school-based malaria prevention and enhanced literacy instruction on the health and educational achievement of school children in Kenya.

Design: A factorial, cluster randomised trial is being implemented in 101 government primary schools on the coast of Kenya. The interventions are (i) intermittent screening and treatment of malaria in schools by public health workers and (ii) training workshops and support for teachers to promote explicit and systematic literacy instruction. Schools are randomised to one of four groups: receiving either (i) the malaria intervention alone; (ii) the literacy intervention alone; (iii) both interventions combined; or (iv) control group where neither intervention is implemented. Children from classes 1 and 5 are randomly selected and followed up for 24 months. The primary outcomes are educational achievement and anaemia, the hypothesised mediating variables through which education is affected. Secondary outcomes include malaria parasitaemia, school attendance and school performance. A nested process evaluation, using semi-structured interviews, focus group discussion and a stakeholder analysis will investigate the community acceptability, feasibility and cost-effectiveness of the interventions.

Discussion: Across Africa, governments are committed to improve health and education of school-aged children, but seek clear policy and technical guidance as to the optimal approach to address malaria and improved literacy. This evaluation will be one of the first to simultaneously evaluate the impact of health and education interventions in the improvement of educational achievement. Reflection is made on the practical issues encountered in conducting research in schools in Africa.

Trial registration: National Institutes of Health NCT00878007.

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Related in: MedlinePlus

The hypothesised causal pathways through which the malaria and literacy interventions are assumed to improve educational achievement. Open rectangular boxes indicate secondary and mediating outcomes; the incidence of clinical attacks is not measured. Circle boxes indicate contextual variables measured at household and school levels.
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Figure 1: The hypothesised causal pathways through which the malaria and literacy interventions are assumed to improve educational achievement. Open rectangular boxes indicate secondary and mediating outcomes; the incidence of clinical attacks is not measured. Circle boxes indicate contextual variables measured at household and school levels.

Mentions: In the current study, we aim to evaluate the impact of two interventions, one focused on malaria prevention and another on enhanced literacy instruction, on the educational achievement of school children in Kenya. Based on theories of how health interventions affect children's development and their education [2,23], we will assess the main outcomes along a hypothesised causal chain from malaria prevention to anemia, sustained attention and educational achievement (Figure 1), and thereby identify the channels through which the interventions are expected to operate [24]. Here, we discuss the rationale for the choice of interventions and present a novel factorial design of the study, investigating both health and educational interventions.


Improving educational achievement and anaemia of school children: design of a cluster randomised trial of school-based malaria prevention and enhanced literacy instruction in Kenya.

Brooker S, Okello G, Njagi K, Dubeck MM, Halliday KE, Inyega H, Jukes MC - Trials (2010)

The hypothesised causal pathways through which the malaria and literacy interventions are assumed to improve educational achievement. Open rectangular boxes indicate secondary and mediating outcomes; the incidence of clinical attacks is not measured. Circle boxes indicate contextual variables measured at household and school levels.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2959045&req=5

Figure 1: The hypothesised causal pathways through which the malaria and literacy interventions are assumed to improve educational achievement. Open rectangular boxes indicate secondary and mediating outcomes; the incidence of clinical attacks is not measured. Circle boxes indicate contextual variables measured at household and school levels.
Mentions: In the current study, we aim to evaluate the impact of two interventions, one focused on malaria prevention and another on enhanced literacy instruction, on the educational achievement of school children in Kenya. Based on theories of how health interventions affect children's development and their education [2,23], we will assess the main outcomes along a hypothesised causal chain from malaria prevention to anemia, sustained attention and educational achievement (Figure 1), and thereby identify the channels through which the interventions are expected to operate [24]. Here, we discuss the rationale for the choice of interventions and present a novel factorial design of the study, investigating both health and educational interventions.

Bottom Line: Improving the health of school-aged children can yield substantial benefits for cognitive development and educational achievement.A nested process evaluation, using semi-structured interviews, focus group discussion and a stakeholder analysis will investigate the community acceptability, feasibility and cost-effectiveness of the interventions.National Institutes of Health NCT00878007.

View Article: PubMed Central - HTML - PubMed

Affiliation: Malaria Public Health & Epidemiology Group, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya. simon.brooker@lshtm.ac.uk

ABSTRACT

Background: Improving the health of school-aged children can yield substantial benefits for cognitive development and educational achievement. However, there is limited experimental evidence on the benefits of school-based malaria prevention or how health interventions interact with other efforts to improve education quality. This study aims to evaluate the impact of school-based malaria prevention and enhanced literacy instruction on the health and educational achievement of school children in Kenya.

Design: A factorial, cluster randomised trial is being implemented in 101 government primary schools on the coast of Kenya. The interventions are (i) intermittent screening and treatment of malaria in schools by public health workers and (ii) training workshops and support for teachers to promote explicit and systematic literacy instruction. Schools are randomised to one of four groups: receiving either (i) the malaria intervention alone; (ii) the literacy intervention alone; (iii) both interventions combined; or (iv) control group where neither intervention is implemented. Children from classes 1 and 5 are randomly selected and followed up for 24 months. The primary outcomes are educational achievement and anaemia, the hypothesised mediating variables through which education is affected. Secondary outcomes include malaria parasitaemia, school attendance and school performance. A nested process evaluation, using semi-structured interviews, focus group discussion and a stakeholder analysis will investigate the community acceptability, feasibility and cost-effectiveness of the interventions.

Discussion: Across Africa, governments are committed to improve health and education of school-aged children, but seek clear policy and technical guidance as to the optimal approach to address malaria and improved literacy. This evaluation will be one of the first to simultaneously evaluate the impact of health and education interventions in the improvement of educational achievement. Reflection is made on the practical issues encountered in conducting research in schools in Africa.

Trial registration: National Institutes of Health NCT00878007.

Show MeSH
Related in: MedlinePlus