Balwadi Health Program

This study evaluates the impact of a non-governmental organization (NGO) pre-school nutrition and health project in the slums of Delhi, India, which delivers a cheap package consisting of iron supplementation and deworming drugs to young children through an existing pre-school network. Approximately 68 percent of children in the sample were anemic and 24 percent suffered from intestinal helminth (worm) infections at baseline. Anemia and intestinal worm infections are among the world's most widespread health problems, especially for children.

The pre-schools in the study were randomly divided into three groups, and the schools were gradually phased into the program as it expanded over the course of two years. The design of the project is similar to the Kenya Primary School Deworming Project, and allows the reseachers to to isolate the impact of the program from other factors that may affect child health and education.

Sample:
Over 4000 children, 2-6 years old

Main Results:
After the first year of the project, we find:

• Large gains in child weight - roughly 0.6 kg on average - in the treatment schools relative to comparison schools.
• Most importantly for this study, average pre-school participation rates increased sharply by 6.3 percentage points among assisted children, reducing pre-school absenteeism by roughly one-fifth.
• Given the low cost of the intervention - less than 2 USD per child per year, on average - these results suggest that the package of iron supplementation and deworming are a highly cost-effective means of improving child school participation in a poor urban setting where anemia and worm infections are widespread.

The results of this study largely confirm the Kenya Primary School Deworming Project [link to PSDP page] findings that child health gains translate into higher school participation. A robust demonstration that a nearly identical relationship holds in another geographic setting (urban India), with a younger age group, and a different health intervention provides additional confidence that there does indeed exist a relationship between child nutrition, health, and school participation in poor countries.

Principal Investigators:
Edward Miguel, Gustavo J. Bobonis (Toronto), and Charu Puri Sharma (UT Southwestern)

Academic Publications :

Gustavo J. Bobonis, Edward Miguel, and Charu Puri Sharma. forthcoming. Iron Deficiency Anemia and School Participation. Journal of Human Resources.