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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.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 8481.

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Date of creation: Sep 2001
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Publication status: published as Miguel, Edward and Michael Kremer. "Worms: Identifying Impacts On Education And Health In The Presence Of Treatment Externalities," Econometrica, 2004, v72(1,Jan), 159-217.
Handle: RePEc:nbr:nberwo:8481

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  1. James Heckman & Hidehiko Ichimura & Jeffrey Smith & Petra Todd, 1998. "Characterizing Selection Bias Using Experimental Data," Econometrica, Econometric Society, vol. 66(5), pages 1017-1098, September.
  2. Fogel, Robert W, 1994. "Economic Growth, Population Theory, and Physiology: The Bearing of Long-Term Processes on the Making of Economic Policy," American Economic Review, American Economic Association, vol. 84(3), pages 369-95, June.
  3. Joshua D. Angrist & Victor Lavy, 1999. "Using Maimonides' Rule To Estimate The Effect Of Class Size On Scholastic Achievement," The Quarterly Journal of Economics, MIT Press, vol. 114(2), pages 533-575, May.
  4. Geissler, P. W. & Nokes, K. & Prince, R. J. & Achieng' Odhiambo, R. & Aagaard-Hansen, J. & Ouma, J. H., 2000. "Children and medicines: self-treatment of common illnesses among Luo schoolchildren in western Kenya," Social Science & Medicine, Elsevier, vol. 50(12), pages 1771-1783, June.
  5. J.D. Angrist & Guido W. Imbens & D.B. Rubin, 1993. "Identification of Causal Effects Using Instrumental Variables," NBER Technical Working Papers 0136, National Bureau of Economic Research, Inc.
  6. James J. Heckman & Jeffrey A. Smith, 1995. "Assessing the Case for Social Experiments," Journal of Economic Perspectives, American Economic Association, vol. 9(2), pages 85-110, Spring.
  7. Behrman, Jere R, 1996. "The Impact of Health and Nutrition on Education," World Bank Research Observer, World Bank Group, vol. 11(1), pages 23-37, February.
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Cited by:
  1. 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.
  2. Dimitra Politi, 2011. "The Impact of Iodine Deficiency Eradication on Schooling: Evidence from the Introduction of Iodized Salt in Switzerland," ESE Discussion Papers 200, Edinburgh School of Economics, University of Edinburgh.
  3. 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.
  4. Omar Azfar & Clifford Zinnes, 2006. "Which incentives work? An experimental analysis of incentives for trainers," Natural Field Experiments 00209, The Field Experiments Website.
  5. Esther Duflo & Emmanuel Saez, 2003. "The Role Of Information And Social Interactions In Retirement Plan Decisions: Evidence From A Randomized Experiment," The Quarterly Journal of Economics, MIT Press, vol. 118(3), pages 815-842, August.
  6. Michael Kremer & Sylvie Moulin & Robert Namunyu, 2003. "Decentralization: A cautionary tale," Natural Field Experiments 00290, The Field Experiments Website.
  7. 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).
  8. World Bank, 2009. "Kenya - Poverty and Inequality Assessment : Executive Summary and Synthesis Report," World Bank Other Operational Studies 3081, The World Bank.

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