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Worms: Education and Health Externalities in Kenya

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  • Edward Miguel
  • Michael Kremer

Abstract

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.

Suggested Citation

  • Edward Miguel & Michael Kremer, 2001. "Worms: Education and Health Externalities in Kenya," NBER Working Papers 8481, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:8481
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    2. Politi, Dimitra, 2010. "The Impact of Iodine Deficiency Eradication on Schooling: Evidence from the Introduction of Iodized Salt in Switzerland," SIRE Discussion Papers 2010-02, Scottish Institute for Research in Economics (SIRE).
    3. Anoshua Chaudhuri, 2005. "Direct and Indirect Effects of a Maternal and Child Health Program in Rural Bangladesh," Journal of Developing Societies, , vol. 21(1-2), pages 143-173, June.
    4. Wechtler, Annika & Michaelowa, Katharina & Fehrler, Sebastian, 2007. "The cost-effectiveness of inputs in primary education: Insights from recent student surveys for sub-Saharan Africa," Proceedings of the German Development Economics Conference, Göttingen 2007 5, Verein für Socialpolitik, Research Committee Development Economics.
    5. Burgess, Robin & Venables, Anthony J., 2004. "Toward a microeconomics of growth," Policy Research Working Paper Series 3257, The World Bank.
    6. Stéphane J. Baele, 2013. "The ethics of New Development Economics: is the Experimental Approach to Development Economics morally wrong?," The Journal of Philosophical Economics, Bucharest Academy of Economic Studies, The Journal of Philosophical Economics, vol. 7(1), November.
    7. Bloom, David E. & Canning, David & Sevilla, Jaypee, 2004. "The Effect of Health on Economic Growth: A Production Function Approach," World Development, Elsevier, vol. 32(1), pages 1-13, January.
    8. Omar Azfar & Clifford Zinnes, 2006. "Which incentives work? An experimental analysis of incentives for trainers," Natural Field Experiments 00209, The Field Experiments Website.
    9. Masayuki Kudamatsu, 2012. "Has Democratization Reduced Infant Mortality In Sub-Saharan Africa? Evidence From Micro Data," Journal of the European Economic Association, European Economic Association, vol. 10(6), pages 1294-1317, December.
    10. Paul Glewwe, 2002. "Schools and Skills in Developing Countries: Education Policies and Socioeconomic Outcomes," Journal of Economic Literature, American Economic Association, vol. 40(2), pages 436-482, June.
    11. José García-Montalvo & Marta Reynal-Querol, 2002. "Fighting Against Malaria: Prevent Wars While Waiting For The "Miraculous" Vaccine," Working Papers. Serie EC 2002-31, Instituto Valenciano de Investigaciones Económicas, S.A. (Ivie).
    12. Ranis, Gustav, 2004. "The Evolution of Development Thinking: Theory and Policy," Center Discussion Papers 28528, Yale University, Economic Growth Center.
    13. Michael Kremer & Sylvie Moulin & Robert Namunyu, 2003. "Decentralization: A cautionary tale," Natural Field Experiments 00290, The Field Experiments Website.
    14. Timothy Besley & Robin Burgess, 2003. "Halving Global Poverty," Journal of Economic Perspectives, American Economic Association, vol. 17(3), pages 3-22, Summer.
    15. Clemens, Michael A. & Kenny, Charles J. & Moss, Todd J., 2007. "The Trouble with the MDGs: Confronting Expectations of Aid and Development Success," World Development, Elsevier, vol. 35(5), pages 735-751, May.
    16. Vermeersch, Christel & Kremer, Michael, 2005. "Schools meals, educational achievement and school competition: evidence from a randomized evaluation," Policy Research Working Paper Series 3523, The World Bank.
    17. Chishio Furukawa, 2014. "Do Solar Lamps Help Children Study? Contrary Evidence from a Pilot Study in Uganda," Journal of Development Studies, Taylor & Francis Journals, vol. 50(2), pages 319-341, February.
    18. World Bank, 2009. "Kenya - Poverty and Inequality Assessment : Executive Summary and Synthesis Report," World Bank Publications - Reports 3081, The World Bank Group.

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    More about this item

    JEL classification:

    • I00 - Health, Education, and Welfare - - General - - - General
    • I10 - Health, Education, and Welfare - - Health - - - General

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