Worms: Education and
Health Externalities in
Kenya
Michael Kremer and Edward Miguel
Poverty Action Lab Paper No.6
Sept 2001
Presented By:
Anonymous MIT student
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Objective
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Health (Worms) Æ Education (School Participation)
To evaluate the effect of a school-level randomized
deworming treatment on primary school participation
by boys and girls under age 13
Key words:
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Randomization – program participation not correlated in
expectation with either observed or unobserved individual
characteristics
Externalities – impact on any party not directly involved in
the economic decision
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Worms - Background
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3.7 billion people are infected by Intestinal Helminth
(roundworm, hookworm. schistosomiasis)
Infection rates highest amongst school-age children
in Sub-Saharan Africa
Transmission
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Effects
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contact with or ingestion of infected fecal matter
Infected freshwater streams or lakes (Lake Victoria)
Anemia, stunting, protein energy malnutrition
Treatment
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Low-cost single-dose oral therapies (Albendazole,
Praziquantel)
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Primary School Deworming
Project in Busia, Kenya
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How is
randomization used
in the experimental
setup?
Courtesy of Michael Kremer and Edward Miguel. Used with permission.
Experimental Design
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Treatment vs Control Groups
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What might be the difference between within
school treatment and across school treatment?
Measuring effects
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What are some of the ways you can measure
effect of treatment? Is school participation okay?
What else is there?
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Results
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What is obvious to expect?
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Naïve treatment effect
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Health Externalities
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Courtesy of Michael Kremer and Edward Miguel. Used with permission.
Effects on School Participation
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Girls <13 years of age and all boys versus
Girls>=13 years of age?
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Grades 1-2 versus Grades 7-8?
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Why would younger students face greater changes in school participation?
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Courtesy of Michael Kremer and Edward Miguel. Used with permission.
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Courtesy of Michael Kremer and Edward Miguel. Used with permission.
Implications
Should we implement a deworming treatment
policy in Kenya? Is it cost effective?
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