How deworming promotes learning and health
Deworming can prevent debilitating illness and keep children in school.
July 20, 2011 by Tara O'Connell
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6 minutes read
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GPE/Natasha Graham

A simple pill costing just 50 cents per child, per year, can prevent a widespread debilitating illness afflicting children in the poorest countries and limiting their chances to attend school and to learn.

Intestinal worms in children cause anemia, stunting, lethargy, impaired cognitive development, poor short-term memory, and increased absenteeism. Long-term, worm infections can lead to an average IQ loss of 3.75 points per child. In short, worm infections limit boys’ and girls’ ability to concentrate, think, and learn.

But the treatment is simple and a “phenomenal return on investment,” says Michael Kremer, co-founder and President ofDeworm the World, that has achieved major success in tackling this sickness, which affects one person in four, globally, including over 400 million children.

Schools are central to delivery of such treatment. They present an already-existing infrastructure, staffed with a sizable workforce that reaches even the most rural areas of most countries (where the burden of intestinal worms is generally highest). At a presentation by Professor Kremer, in Washington recently, Elizabeth King, Director of Education of the World Bank, stressed how critical it is for both the health and education sectors to work together to deliver basic health services like deworming tablets in schools.

Sick children are not ready to learn, she said, and children’s health is central to their education: “The most important input is the student. With poor health, all other educational inputs − better classrooms, textbooks, and so on − are weakened in terms of learning outcomes. Yes, deworming is a narrow intervention but it is almost a ‘magic bullet’, and most impactful.”

Utilizing schools as networks for the delivery of basic school health services like deworming encourages countries to piggy-back onto systems already in place rather than use limited human and financial resources to create new, stand-alone methods for delivery.

The private sector also has a significant role to play in the deworming of children. Andy Wright, Director of Disease Programs at GlaxoSmithKline, explained that GSK takes this role seriously, with current donations of some 400 million albendazole deworming tablets to the World Health Organization each year to support deworming. William Lin, Johnson & Johnson’s Director of Worldwide Contributions and Community Relations, reported that the company’s Children Without Worms program now reaches some 20 million children in eight countries each year.

EFA FTI Secretariat head, Bob Prouty, is passionate about countries prioritizing deworming and ensures health interventions in schools continue annually, and over the long-term:

“Education is a health intervention.For many families, especially in rural areas, schools are the only branch of ‘government’ they know and basing deworming programs in schools, as a platform, is a great way to deliver the pills. Parents don’t have to be sold on this. Who we have to work on are the aid donors, who know the importance of deworming but often have seen this intervention as ‘exotic,’ so that their interest has been inconsistent. And at FTI we also see the need for a strong partnership in this area between the ministries of education and health, working together, to implement delivery of medicine.”

That’s why the FTI Secretariat works with FTI partner countries to support national deworming programs as well as other school health interventions including school feeding, HIV prevention, and malaria prevention.

Michael Kremer has recently published a study of 75 schools in Kenya which testifies to the success of a pilot program of deworming in schools there which used sophisticated mapping technology to pinpoint where deworming actions could be targeted to communities particularly affected.

This allows government, NGOs, and international organizations like the WHO to concentrate their interventions and use their funds efficiently. Professor Kremer’s study (with Sarah Baird, Joan Hamory Hicks, and Edward Miguel) shows higher test scores and increased enrollment for children dewormed, but also suggests additional benefits of deworming including an increase in the number of hours worked and meals eaten as an adult.

The longer-term implications for countries implementing nation-wide deworming programs could be significant– as New York Timescolumnist, Nicholas Kristof, recently wrote about Michael Kremer’s deworming work.

Sometimes the biggest problems in education, and health, have simple, inexpensive solutions that can best be delivered through effective partnerships involving all stakeholders. In this case, better health means better education opportunities; and better education services mean better health.

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