Western countries have spent the last few years asking questions pertaining to acquiring essential skills for the 21st century, and the diminishing need for theoretical degrees, or what many call “over-education”. On the other hand, in third-world countries the meaning of school attendance is often the only opportunity to escape poverty. Since the ambition is to educate future generations so they will be able to pull themselves and their countries out of the cruel cycle of poverty and hunger, tremendous resources have been dedicated to encouraging children to come to school and complete their studies since the beginning of the 1990s.
Researchers dealt with the influence of classroom size, textbook distribution, and encouragement of students, parents and teachers. Unfortunately, the data shows that neither the classroom size nor access to study materials significantly influence the students’ achievements. These findings brought about an investment in a variety of programs like the Mexican PROGRESA which pours huge funds into various incentives designed to encourage children to come to school and improve learning conditions, when the cost-effect ratio of the program is $6,000 for one “child-year”. And when the breakthrough came as a result of the following experiment being conducted, it did so from an unexpected direction: comprehensive treatment of intestinal worms.
Researchers dealt with the influence of classroom size, textbook distribution, and encouragement of students, parents and teachers. Unfortunately, the data shows that neither the classroom size nor access to study materials significantly influence the students’ achievements. These findings brought about an investment in a variety of programs like the Mexican PROGRESA which pours huge funds into various incentives designed to encourage children to come to school and improve learning conditions, when the cost-effect ratio of the program is $6,000 for one “child-year”. And when the breakthrough came as a result of the following experiment being conducted, it did so from an unexpected direction: comprehensive treatment of intestinal worms.
When the researchers began investigating a sample group of parents whose children were absent from school as to the reasons for their absences, it turned out that in the majority of cases the child stayed home because of pain caused by intestinal worms, or because they were forced to keep watch over a sibling suffering from a similar problem.
Michael Kramer’s team collaborated with schools in the Busia area of western Kenya. They conducted an in-depth examination of the reasons for children’s absences from school in the Budalangi and Poniola districts, stretching across the shore of Lake Victoria. When the researchers began investigating a sample group of parents whose children were absent from school as to the reasons for their absences, it turned out that in the majority of cases the child stayed home because of pain caused by intestinal worms, or because they were forced to keep watch over a sibling suffering from a similar problem.
An in-depth examination discovered that a lethal combination of contaminated lake water, and the absence of basic sanitation conditions, caused children to be infected with worms while playing in the water or mud, and infect each other in an infinite loop upon return. The necessary solution was to deal with the worms. In 1997, the researchers chose 75 schools in the area and randomly divided them into three experimental test groups – 25 schools in each group. Each of the test groups underwent a different stage of worm treatment – the experiment ran for three years, allowing monitoring of long-term treatment results.
An in-depth examination discovered that a lethal combination of contaminated lake water, and the absence of basic sanitation conditions, caused children to be infected with worms while playing in the water or mud, and infect each other in an infinite loop upon return. The necessary solution was to deal with the worms. In 1997, the researchers chose 75 schools in the area and randomly divided them into three experimental test groups – 25 schools in each group. Each of the test groups underwent a different stage of worm treatment – the experiment ran for three years, allowing monitoring of long-term treatment results.
Calculating the school years to be earned by investing $100 in various programs.
The results were no less than amazing. Among the children who underwent treatment, attendance rose by nearly ten percentage points, and in addition a chain reaction was created where children who did not belong to one of the test groups and therefore did not undergo treatment themselves, but lived within a 3-kilometer radius of those who were treated, were infected less frequently because of the reduction in carriers; and they, in turn, did not infect their brothers and sisters, and so on. The process of treating the worms ultimately increased the attendance of children at schools across the entire population by 8.5 percentage points, a rate equal to the decrease by a third of the sum total of absences from school (from 25.5 percentage points).
The result was an unprecedented increase in the cost-efficiency ratio of only $2.92 per “child-year” – the best ratio, by an enormous gap, compared to any other solution ever attempted. The calculation by MIT’s J-PAL lab reveals that treating the worms is 20 times more efficient than hiring another teacher, and for $100 invested in anti-worm treatment you can earn 11.91 school years. The dizzying success of the program led to similar projects in Ethiopia, India, Kenya, Nigeria and Vietnam.
The result was an unprecedented increase in the cost-efficiency ratio of only $2.92 per “child-year” – the best ratio, by an enormous gap, compared to any other solution ever attempted. The calculation by MIT’s J-PAL lab reveals that treating the worms is 20 times more efficient than hiring another teacher, and for $100 invested in anti-worm treatment you can earn 11.91 school years. The dizzying success of the program led to similar projects in Ethiopia, India, Kenya, Nigeria and Vietnam.
Among the children who underwent treatment, attendance increased by nearly ten percent. In addition, a chain reaction was created where children who did not belong to one of the test groups were infected less frequently because of the reduction in carriers.
Surprisingly, the insights were also new for local organizations who had been dealing with the problem for many years and were operated by local residents. The same association that funded the first anti-worm pilot was no less thrilled by the subsidization plan for school uniforms – which ultimately amounted to a cost-efficiency ratio of $100 per “child-year”, thirty times more than anti-worm treatment. It was one of the first research projects to surface the fact that when working with complex systems and particularly social problems of poverty and health, it is better to set aside intuition and perform controlled and close-field examinations of the causes of the problem and the possible solutions.