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Does mass deworming affect child nutrition ? meta-analysis, cost-effectiveness, and statistical power

Author

Listed:
  • Croke,Kevin
  • Hicks,Joan Hamory
  • Hsu,Eric
  • Kremer,Michael Robert
  • Miguel,Edward A.

Abstract

The WHO has recently debated whether to reaffirm its long-standing recommendation of mass drug administration (MDA) in areas with more than 20 percent prevalence of soil-transmitted helminths (hookworm, whipworm, and roundworm). There is consensus that the relevant deworming drugs are safe and effective, so the key question facing policymakers is whether the expected benefits of MDA exceed the roughly $0.30 per treatment cost. The literature on long run educational and economic impacts of deworming suggests that this is the case. However, a recent meta-analysis by Taylor-Robinson et al. (2015), (hereafter TMSDG), disputes these findings. The authors conclude that while treatment of children known to be infected increases weight by 0.75 kg (95 percent CI: 0.24, 1.26; p=0.0038), there is substantial evidence that MDA has no impact on weight or other child outcomes. This paper updates the TMSDG analysis by including studies omitted from that analysis and extracting additional data from included studies, and finds that the TMSDG analysis is underpowered: Power is inadequate to rule out weight gain effects that would make MDA cost effective relative to comparable interventions in similar populations, and underpowered to reject the hypothesis that the effect of MDA is different from the effect that might expected, given deworming's effects on those known to be infected. The hypothesis of a common zero effect of multiple-dose MDA deworming on child weight at longest follow-up is rejected at the 10 percent level using the TMSDG dataset, and with a p value

Suggested Citation

  • Croke,Kevin & Hicks,Joan Hamory & Hsu,Eric & Kremer,Michael Robert & Miguel,Edward A., 2016. "Does mass deworming affect child nutrition ? meta-analysis, cost-effectiveness, and statistical power," Policy Research Working Paper Series 7921, The World Bank.
  • Handle: RePEc:wbk:wbrwps:7921
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    References listed on IDEAS

    as
    1. Eva Vivalt, 2015. "Heterogeneous Treatment Effects in Impact Evaluation," American Economic Review, American Economic Association, vol. 105(5), pages 467-470, May.
    2. repec:aea:aejapp:v:10:y:2018:i:3:p:235-62 is not listed on IDEAS
    3. repec:aph:ajpbhl:10.2105/ajph.69.10.987_3 is not listed on IDEAS
    4. Edward Miguel & Michael Kremer, 2004. "Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities," Econometrica, Econometric Society, vol. 72(1), pages 159-217, January.
    5. McKenzie, David, 2012. "Beyond baseline and follow-up: The case for more T in experiments," Journal of Development Economics, Elsevier, vol. 99(2), pages 210-221.
    6. Owen Ozier, 2018. "Exploiting Externalities to Estimate the Long-Term Effects of Early Childhood Deworming," American Economic Journal: Applied Economics, American Economic Association, vol. 10(3), pages 235-262, July.
    7. Hoyt Bleakley, 2007. "Disease and Development: Evidence from Hookworm Eradication in the American South," The Quarterly Journal of Economics, Oxford University Press, vol. 122(1), pages 73-117.
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    Cited by:

    1. Fox, Jonathan & Grigoriadis, Theocharis, 2018. "A rural health supplement to the hookworm intervention in the American South," Discussion Papers 2018/5, Free University Berlin, School of Business & Economics.
    2. Garret Christensen & Edward Miguel, 2018. "Transparency, Reproducibility, and the Credibility of Economics Research," Journal of Economic Literature, American Economic Association, vol. 56(3), pages 920-980, September.
    3. Isaiah Andrews & Maximilian Kasy, 2017. "Identification of and Correction for Publication Bias," NBER Working Papers 23298, National Bureau of Economic Research, Inc.
    4. repec:eee:wdevel:v:106:y:2018:i:c:p:149-160 is not listed on IDEAS

    More about this item

    Keywords

    Education For All; Education for Development (superceded); Public Health Promotion; School Health; Disease Control&Prevention; Educational Populations;

    JEL classification:

    • C49 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods: Special Topics - - - Other
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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