Evaluation of a Comprehensive School Health Programme in Zambia

Not Applicable

Active, not recruiting

• Conditions: Malaria; Diarrhea; Anemia; Cough; Helminth Infection; UTI; Schistosomiasis; Skin Rash

• 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

Study Timeline

• Study Start: 2024-02-27
• Status Verified: 2024-08
• Study First Submitted: 2024-08-12
• Study First Submitted QC: 2024-08-15
• Last Update Submitted: 2024-08-15
• Study First Posted: 2024-08-19
• Last Update Posted: 2024-08-19
• Primary Completion: 2026-11-30
• Study Completion: 2026-11-30

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 28700

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

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.

Trial Locations

Locations (6)

Chingola District Education Board; 🇿🇲 Chingola, Copperbelt, Zambia

Luanshya District Education Board; 🇿🇲 Luanshya, Copperbelt, Zambia

Masaiti District Education Board; 🇿🇲 Masaiti, Copperbelt, Zambia

Kawambwa District Education Board; 🇿🇲 Kawambwa, Luapula, Zambia

Mwense District Education Board; 🇿🇲 Mwense, Luapula, Zambia

Samfya District Education Board; 🇿🇲 Samfya, Luapula, Zambia