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Worms: Education and Health Externalities in Kenya

  • Edward Miguel
  • Michael Kremer

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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File URL: http://www.nber.org/papers/w8481.pdf
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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
Note: HC PE
Contact details of provider: Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.
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Web page: http://www.nber.org
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  1. 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.
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  3. Fogel, Robert W., 1993. "Economic Growth, Population Theory, and Physiology: The Bearing of Long-Term Processes on the Making of Economic Policy," Nobel Prize in Economics documents 1993-1, Nobel Prize Committee.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
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