School-based Health Programs on Children's Wellbeing in Lusaka, Zambia

Study Overview
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Brief Summary
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This study evaluates the impact of a new and comprehensive school-based health program implemented in Lusaka, Zambia.

Detailed Description
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While school-aged children in low- and middle-income countries remain highly exposed to acute infections, programs targeting this age group remain limited in scale and scope. In this study, we evaluate the impact of a new and comprehensive primary school-based health intervention program on student health outcomes and academic performance in Lusaka, Zambia. The intervention involved the training of teachers to become school health workers and the provision of vitamin A supplementation and deworming medication on a bi-annual basis. Teachers in intervention schools were trained to deliver health lessons and to refer sick students to care. This study is designed as a prospective matched control study. Students from the seven intervention schools are matched with students from control schools.

Official Title
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Evaluating the Impact of School-based Health Programs on Children's Well-being and Academic Performance

Conditions
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Acute Disease, Morbidity

Intervention / Treatment
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* Behavioral: School Health Worker Program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Children attending one of the 14 schools in the study. Exclusion Criteria: Children not attending one of the 14 schools in the study.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>The intervention group receives a school health program that has two components: the training of selected teachers to become school Health Workers and bi-annual health screenings of all students. | Behavioral: School Health Worker Program<br>* The intervention trains selected teachers to deliver health lessons to students, perform basic first aid, recognize common illnesses, refer student to skilled medical attention when needed. The intervention provides schools with basic medical supplies including pain relief medication, thermometers, bandages, antiseptics, and oral rehydration solution. Vitamin A supplementation and presumptive deworming medication are administered to students during biannual health screenings.<br>|
| No Intervention: Control<br>The control group receives regular school programming. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in prevalence of acute disease | Students report on the presence of 14 systemic, genitourinary, respiratory, and gastrointestinal illnesses in the past two week. Acute illnesses are combined into a summary index of morbidity. | Baseline, 6 months, and one-year follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in weight | Calculate body mass index (BMI)-for-age z-scores using the World Health Organization AnthroPlus Software macro for Stata. Thinness and overweightness are defined respectively as: BMI-for-age below -2 SD and as BMI-for-age above 1 standard deviation. | Baseline, 6 months, and one-year follow-up | 
| Change in height | Calculate standardized height-for-age (HAZ) z-scores using the World Health Organization AnthroPlus Software macro for Stata. Stunting was defined as HAZ below -2 standard deviation. | Baseline, 6 months, and one-year follow-up | 
| Change in health knowledge | Calculate the percentage of correct answers on 11-question quiz on various health topics. | Baseline, 6 months, and one-year follow-up | 
| Change in school attendance | Calculate percentage of students who missed one or more days from school in the past two weeks. | Baseline, 6 months, and one-year follow-up | 
| Change in academic performance | Students report on their own school performance and academic performance is verified by term marks. | Baseline, 6 months, and one-year follow-up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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school-aged children, school-based health program, Zambia, child and adolescent health