Anemia and School Participation

At the start of the program, more than two-thirds of the children were anemic, and almost a third had intestinal worm infections. The program led to gains in children's nutritional status and increased school participation, particularly for girls.

• Participation in the program resulted in weight increases among children. Children in the program gained 1.1 pounds (.5 kilograms) on average relative to non-program children during the first five months of the project.
• The program increased preschool participation rates by 5.8 percentage points during the first year, reducing absenteeism by one-fifth.
• Gains were especially pronounced for girls and other subgroups that were more likely to be anemic at the start of the program. Girls saw larger gains in weight and school participation than boys.

In short, the results suggest that school-based health programs targeting anemia are an effective and cost-efficient way to promote school attendance, particularly for girls and other groups at higher risk for anemia.

The school-based health program delivered iron supplementation, deworming drugs, and Vitamin A (which may promote iron absorption) to 2 to 6 year-old preschoolers in Delhi, India. The sample included 200 preschools - with a total of 2,392 children - that were randomly divided into groups and then gradually phased into the program. The first group began receiving the program in December 2001, and all schools were receiving the program by November 2003.

Data was collected through two rounds of surveys, measurements taken at health camps, and through school visits. At baseline, 69 percent of the children were anemic, and 30 percent had an intestinal worm infection. Moreover, 21 percent of children were wasted (had a low weight-for-height ratio), 30 percent were underweight, and 24 percent were stunted.