Acute Disease, Morbidity
Conditions
Keywords
school-aged children, school-based health program, Zambia, child and adolescent health
Brief summary
This study evaluates the impact of a new and comprehensive school-based health program implemented in Lusaka, Zambia.
Detailed description
While school-aged children in low- and middle-income countries remain highly exposed to acute infections, programs targeting this age group remain limited in scale and scope. In this study, we evaluate the impact of a new and comprehensive primary school-based health intervention program on student health outcomes and academic performance in Lusaka, Zambia. The intervention involved the training of teachers to become school health workers and the provision of vitamin A supplementation and deworming medication on a bi-annual basis. Teachers in intervention schools were trained to deliver health lessons and to refer sick students to care. This study is designed as a prospective matched control study. Students from the seven intervention schools are matched with students from control schools.
Interventions
BEHAVIORALSchool Health Worker Program
The intervention trains selected teachers to deliver health lessons to students, perform basic first aid, recognize common illnesses, refer student to skilled medical attention when needed. The intervention provides schools with basic medical supplies including pain relief medication, thermometers, bandages, antiseptics, and oral rehydration solution. Vitamin A supplementation and presumptive deworming medication are administered to students during biannual health screenings.
Sponsors
Healthy Kids/Brighter Future
Harvard School of Public Health (HSPH)
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Children attending one of the 14 schools in the study.
Exclusion criteria
* Children not attending one of the 14 schools in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in prevalence of acute disease | Baseline, 6 months, and one-year follow-up | Students report on the presence of 14 systemic, genitourinary, respiratory, and gastrointestinal illnesses in the past two week. Acute illnesses are combined into a summary index of morbidity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in weight | Baseline, 6 months, and one-year follow-up | Calculate body mass index (BMI)-for-age z-scores using the World Health Organization AnthroPlus Software macro for Stata. Thinness and overweightness are defined respectively as: BMI-for-age below -2 SD and as BMI-for-age above 1 standard deviation. |
| Change in height | Baseline, 6 months, and one-year follow-up | Calculate standardized height-for-age (HAZ) z-scores using the World Health Organization AnthroPlus Software macro for Stata. Stunting was defined as HAZ below -2 standard deviation. |
| Change in health knowledge | Baseline, 6 months, and one-year follow-up | Calculate the percentage of correct answers on 11-question quiz on various health topics. |
| Change in school attendance | Baseline, 6 months, and one-year follow-up | Calculate percentage of students who missed one or more days from school in the past two weeks. |
| Change in academic performance | Baseline, 6 months, and one-year follow-up | Students report on their own school performance and academic performance is verified by term marks. |
Outcome results
None listed