Impact of Malaria Control and Enhanced Literacy Instruction on Educational Outcomes Among School Children in Kenya
A Multi-Sectoral, Prospective, Randomized Evaluation
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 on how health interventions interact with other efforts to improve education quality. This impact evaluation by Simon Brooker and Katherine Halliday aimed to evaluate the single and joint impact of school-based malaria prevention and enhanced literacy instruction on health and educational achievement of school children in Kenya. A factorial, cluster randomized trial was implemented in 101 government primary schools on the south coast of Kenya between 2010 and 2012. The interventions were:
- intermittent screening and treatment (IST) of malaria in schools by public health workers using rapid diagnostic tests (RDTs) once a school term; and
- training workshops and support for teachers to promote explicit and systematic literacy instruction.
Schools were randomized to one of four groups:
- receiving either the malaria intervention alone;
- the literacy intervention alone;
- both interventions combined; or
- control group where neither intervention will be implemented.
A total of 5,233 children from Classes 1 and 5 were randomly selected and followed up for 24 months. No impact of the malaria intermittent screening and treatment (IST) intervention was observed for prevalence of anaemia or P. falciparum or on sustained attention in the classroom. In contrast, the literacy intervention had a significant impact on literacy outcomes, specifically knowledge of Swahili sounds, words and English spelling. The positive impact of the literacy intervention appears to be due to two key factors observed in the intervention schools: the increased time children spent reading in class and the increased print displayed in the classrooms. The combined IST and literacy intervention showed no significant synergistic effects.