Evaluation of a Comprehensive School Health Programme in Zambia
- Conditions
- MalariaDiarrheaAnemiaCoughHelminth InfectionUTISchistosomiasisSkin Rash
- Interventions
- Other: Deworming and vitamin A supplementation deliveryOther: Comprehensive School Health Programme
- Registration Number
- NCT06560853
- Lead Sponsor
- London School of Economics and Political Science
- Brief Summary
In Zambia, the health and well-being of children aged 5 to 14 has often been overlooked, leading to various health challenges affecting their development and education. The Healthy Learners (HL) program, in collaboration with the Zambian Government, aims to address this gap by implementing a comprehensive school health program. Trained teachers, known as school health workers (SHWs), play a key role by delivering health education, coordinating preventative care with local clinics, and overseeing a 'school health room' for sick students.
This study is a large cluster-randomized control trial in 225 schools. The goal of this trial is to compare the effects of the comprehensive school health programme (SHP) developed by HL against two alternatives: the current level of school health provision and the current school health activities enhanced with deworming and vitamin A coordination by HL, with their technical and financial support ensuring the reliable delivery of all health activities currently planned by the government.
1. What is the impact of the program on health-seeking, health, and education outcomes?
2. What are the indirect effects of the program on teachers and clinics?
3. What is the added value of such a comprehensive SHP, compared to (i) optimized (ii) or imperfect (status-quo) delivery of a limited range of school health activities (e.g., deworming and vitamin A supplements)?
4. How costly is the comprehensive SHP, and what factors affect its implementation?
5. What are the potential benefits of the program for long-term human capital accumulation (learning, well-being etc)?
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 28700
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Deworming and vitamin A supplementation Deworming and vitamin A supplementation delivery Healthy Learners will enusre reliable delivery of the national deworming programme twice a year, during the same period as in the SHP arm, for comparability of the effect of prevention alone to the full SHP. School health programme (SHP) Deworming and vitamin A supplementation delivery SHP developed by Healthy Learners (HL) in collaboration with the Ministry of Education (MOE), which follows the WHO guidelines on school health activities. HL supports the upgrading of basic sanitation facilities and construction of a dedicated 'health room' in the school; trains selected teachers to become school health workers (SHWs) who deliver health and sanitation education, coordinate deworming and vitamin A supplementation in the school, and assess sick learners in the school health room using a clinical decision support system (CDSS), either treating in school or referring to the local health centre. At the health centre, children referred by SHWs are given priority by health care workers who see them within 30 minutes of arriving at the facility. Schools also create student networks (a "buddy" system) whereby learners monitor each other's absence and coordinate with SHWs, who can then follow up with the household. School health programme (SHP) Comprehensive School Health Programme SHP developed by Healthy Learners (HL) in collaboration with the Ministry of Education (MOE), which follows the WHO guidelines on school health activities. HL supports the upgrading of basic sanitation facilities and construction of a dedicated 'health room' in the school; trains selected teachers to become school health workers (SHWs) who deliver health and sanitation education, coordinate deworming and vitamin A supplementation in the school, and assess sick learners in the school health room using a clinical decision support system (CDSS), either treating in school or referring to the local health centre. At the health centre, children referred by SHWs are given priority by health care workers who see them within 30 minutes of arriving at the facility. Schools also create student networks (a "buddy" system) whereby learners monitor each other's absence and coordinate with SHWs, who can then follow up with the household.
- Primary Outcome Measures
Name Time Method Synthetic morbidity index 18 months after intervention start Because the SHP delivers treatment of several diseases, we will create a composite disease burden index of the following outcomes:
* malaria positive (using a rapid diagnostic test)
* moderate to high worm load (using a stool test)
* anaemia (using a hemocue test)
* schistosomiasis (using a urine test)
* diarrhoea in the past week (learner self-report) We test these outcomes in a randomly selected panel of 13,300 learners recruited at baseline, which ensures variety of age groups and balance of genders.Average attendance rate over 24 months 24 months after intervention start We will measure attendance during unannounced attendance spot checks (one per term over a 2-year period). Multiple measurements are required to capture seasonal variation. On each spot check visit, we will check attendance of a panel of learners randomly selected at baseline, which ensures variety of age groups and balance of genders. We will calculate each child's attendance rate across all the spot checks.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (6)
Chingola District Education Board
🇿🇲Chingola, Copperbelt, Zambia
Kawambwa District Education Board
🇿🇲Kawambwa, Luapula, Zambia
Samfya District Education Board
🇿🇲Samfya, Luapula, Zambia
Masaiti District Education Board
🇿🇲Masaiti, Copperbelt, Zambia
Luanshya District Education Board
🇿🇲Luanshya, Copperbelt, Zambia
Mwense District Education Board
🇿🇲Mwense, Luapula, Zambia