Child and Adolescent Health and Development

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8
DISEASE CONTROL PRIORITIES • THIRD EDITION
Child and Adolescent Health and Development
Optimizing Education Outcomes:
High-Return Investments in School Health for
Increased Participation and Learning
8
Bundy
de Silva
Horton
Jamison
Patton
DISEASE EDITORS WITH A FOREWORD BY WITH A PROLOGUE BY
CONTROL Donald A. P. Bundy Gordon Brown Louise Banham
PRIORITIES Nilanthi de Silva Lesley Drake
THIRD Susan Horton WITH A PREFACE BY Bradford Strickland
EDITION
Dean T. Jamison Julia Gillard
George C. Patton

8
VOLUME
DISEASE CONtROL PRIORItIES tHIRD EDItION
Child and Adolescent Health and Development
Optimizing Education Outcomes:
High-Return Investments in School
Health for Increased Participation
and Learning
EDItORS
Donald A. P. Bundy
Nilanthi de Silva
Susan Horton
Dean t. Jamison
George C. Patton
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Contents
The following chapters present DCP3’s messages for the education sector. They are numbered as they originally
appeared in DCP3 Volume 8, Child and Adolescent Health and Development. The complete table contents for volume 8
may be found at the end of this edition.
Foreword by Gordon Brown v
Preface by Julia Gillard vii
Prologue by Louise Banham, Lesley Drake, and Bradford Strickland ix
Abbreviations xv
1. Child and Adolescent Health and Development: Realizing Neglected Potential 1
Donald A. P. Bundy, Nilanthi de Silva, Susan Horton, George C. Patton,
Linda Schultz, and Dean T. Jamison
4. Global Variation in Education Outcomes at Ages 5 to 19 25
Kin Bing Wu
6. Impact of Interventions on Health and Development during Childhood and Adolescence:
A Conceptual Framework 35
Donald A. P. Bundy and Susan Horton
8. Evidence of Impact of Interventions on Health and Development during Middle
Childhood and School Age 41
Kristie L. Watkins, Donald A. P. Bundy, Dean T. Jamison, Günther Fink,
and Andreas Georgiadis
12. School Feeding Programs in Middle Childhood and Adolescence 49
Lesley Drake, Meena Fernandes, Elisabetta Aurino, Josephine Kiamba, Boitshepo Giyose,
Carmen Burbano, Harold Alderman, Lu Mai, Arlene Mitchell, and Aulo Gelli
13. Mass Deworming Programs in Middle Childhood and Adolescence 67
Donald A. P. Bundy, Laura J. Appleby, Mark Bradley, Kevin Croke, T. Deirdre Hollingsworth,
Rachel Pullan, Hugo C. Turner, and Nilanthi de Silva
iii
14. Malaria in Middle Childhood and Adolescence 85
Simon J. Brooker, Sian Clarke, Deepika Fernando, Caroline W. Gitonga,
Joaniter Nankabirwa, David Schellenberg, and Brian Greenwood
15. School-Based Delivery of Vaccines to 5- to 19-Year Olds 101
D. Scott LaMontagne, Tania Cernuschi, Ahmadu Yakubu, Paul Bloem,
Deborah Watson-Jones, and Jane J. Kim
17. Disability in Middle Childhood and Adolescence 113
Natasha Graham, Linda Schultz, Sophie Mitra, and Daniel Mont
20. The School as a Platform for Addressing Health in Middle Childhood and Adolescence 131
Donald A. P. Bundy, Linda Schultz, Bachir Sarr, Louise Banham, Peter Colenso, and Lesley Drake
24. Identifying an Essential Package for Early Child Development: Economic Analysis 149
Susan Horton and Maureen M. Black
25. Identifying an Essential Package for School-Age Child Health: Economic Analysis 161
Meena Fernandes and Elisabetta Aurino
26. Identifying an Essential Package for Adolescent Health: Economic Analysis 175
Susan Horton, Elia De la Cruz Toledo, Jacqueline Mahon, John Santelli, and Jane Waldfogel
28. Postponing Adolescent Parity in Developing Countries through Education: An Extended
Cost-Effectiveness Analysis 191
Stéphane Verguet, Arindam Nandi, Véronique Filippi, and Donald A. P. Bundy
29. Economics of Mass Deworming Programs 201
Amrita Ahuja, Sarah Baird, Joan Hamory Hicks, Michael Kremer, and Edward Miguel
30. The Effects of Education Quantity and Quality on Child and Adult Mortality: Their Magnitude
and Their Value 211
Elina Pradhan, Elina M. Suzuki, Sebastián Martínez, Marco Schäferhoff, and Dean T. Jamison
DCP3 Series Acknowledgments 229
Volume and Series Editors 231
Contributors 235
Contents of Volume 8, Child and Adolescent Health and Development 239
iv Contents
Foreword
HEALtH AND EDUCAtION DURING tHE Indonesia, and Malawi, as well as the Director-General
8,000 DAyS Of CHILD AND ADOLESCENt of UNESCO, set out to make a new investment case
for global education. What resulted was a credible yet
DEVELOPMENt: twO SIDES Of tHE
ambitious plan capable of ensuring that the Sustainable
SAME COIN
Development Goal of an inclusive and quality education
Today, there is comfort to be found in returning to for all is met by the 2030 deadline. While we continue
the inspired words of others. Until H. G. Wells’ time to work today to ensure our messages become action—
machine is made, words are our emotional anchor from increased domestic spending on schooling to an
to the past and, one hopes, our window to a brighter International Finance Facility for Education—we sought
future. Speaking before the 18th General Assembly of the to produce an authoritative, technically strong report
United Nations in 1963, it was President John F. Kennedy that would spend more time being open on desks than
who noted that the “effort to improve the conditions of collecting dust on a shelf.
man, however, is not a task for the few.” Development The Disease Control Priorities (DCP) series estab-
is a shared, cross-cutting mission I know well. For the lished in 1993 shares this philosophy and acts as a key
breakthroughs we witness—from Borlaug’s wheat to a resource for Ministers of Health and Finance, guiding
vaccine for polio—are the products of cooperation, a them toward informed decisions about investing in
clean break from siloed thinking, and a courage to work health. The third edition of DCP rightly recognizes that
at the sharp edges of disciplines. good health is but one facet of human development
Working as a lecturer for five years in the 1970s and and that health and education outcomes are forever
early 1980s, I came to see—in a way I never had as a intertwined. The Commission report makes clear that
student—that education unlocks talent and unleashes more education equates with better health outcomes.
potential. And as Chancellor, Prime Minister, and most And approaching this reality from the other direction,
importantly a parent, education has remained a cen- this year’s volume of DCP shows that children who are
terpiece in my life because of the hope it delivers. For in good health and appropriately nourished are more
when we ask ourselves what breaks the weak, it is not the likely to participate in school and to learn while there.
Mediterranean wave that submerges the life vest, nor the The Commission report raises the concept of progressive
food convoy that does not make it to the besieged Syrian universalism or giving greatest priority to those children
town. Rather, it is the absence of hope, the soul-crushing most at risk of being excluded from learning. Here, too,
certainty that there is nothing ahead to plan or prepare the alignment with DCP is clear as health strides are
for—not even a place in school. most apparent when directed to the poorest and sickest
Two years ago, the International Commission on children, as well as girls.
Financing Global Education Opportunity, composed It is fitting that one of the Commission’s back-
of two dozen global leaders and convened by the ground papers appears as a chapter in this volume.
Prime Minister of Norway and the Presidents of Chile, The Commission showed that education spending,
v
particularly for adolescent girls, is a moral imperative outcomes; it would bring us closer to achieving all 17
and an economic necessity. Indeed, girls are the least Sustainable Development Goals and unlocking the next
likely to go to primary school, the least likely to enter or stage of global growth.
complete secondary school, highly unlikely to matric- A key message of this volume is that human devel-
ulate to college, and the most likely to be married at a opment is a slow process; it takes two decades—
young age, to be forced into domestic service or traf- 8,000 days—for a human to develop physically and men-
ficked. And with uneducated girls bearing five children tally. We also know a proper education requires time. So
against two children for educated girls, the vicious cycle the world needs to invest widely, deeply, and effec-
of illiterate girls, high birth rates, low national incomes tively—across education, health, and all development
per head, and migration in search of opportunity will sectors—during childhood and adolescence. And while
only worsen so long as we fail to deliver that most fun- individuals may have 8,000 days to develop, we must
damental right to an education. mobilize our resources today to secure their tomorrow.
Here is a projection to remember. If current education Let us not forget that the current generation of young
funding trends hold, by 2030, 800 million children—half people will transition to adulthood in 2030, and it will be
a generation—will lack the basic secondary skills nec- their contribution that will determine whether the world
essary to thrive in an unknowable future. In calling for achieves the Sustainable Development Goals.
more and better results-based education spending, the We have, to again draw on Kennedy’s words, “the
Commission estimated that current total annual edu- capacity to control [our] environment, to end thirst and
cation expenditure is US$1.3 trillion across low- and hunger, to conquer poverty and disease, to banish illiter-
middle-income countries, an anemic sum that must acy and massive human misery.” We have this capacity,
steadily rise to US$3 trillion by 2030. A rising tide must but only when we work together. Both the Commission
lift all ships, and so as education spending at the domes- report and this latest Disease Control Priorities volume
tic and international levels sees an uptick, the same must seek to elevate cross-sector initiatives on the global
be witnessed for health. The numbers may seem large, agenda. In human development, health and education
but the reality is that this relatively inexpensive effort are two sides of the same coin: only when we speak as
would do more than unlock better health and education one will this call be heard.
Gordon Brown
United Nations Special Envoy for Global Education
Chair of the International Commission on
Financing Global Education Opportunity
Prime Minister of the United Kingdom, 2007–2010
Chancellor of the Exchequer, 1997–2007
vi Foreword
Preface
There is much to be proud of the achievements in Schools can be effective places to support children’s
global education over the past 15 years. Good planning, health, and some countries are implementing school
funding, and collaborative efforts have contributed to health programs. The 2017 report of the International
a tremendous increase in access to primary school for Commission on Financing Global Education
many millions of girls and boys in developing countries. Opportunity highlighted some of the best-proven health
Today, there are more schools, more students, and more practices for increasing enrollment, attendance, partic-
and better trained teachers than ever before. ipation, and learning for primary school–age girls and
And yet, an estimated 264 million children and youth boys. It highlighted school-based malaria prevention,
find themselves unable to go to school; many millions feeding, water and sanitation, and deworming. For girls,
more are in school but are not learning at the levels they in particular, investments in comprehensive sexuality
should. The reasons are complex, but if you are poor, a education, reproductive health knowledge and related
girl, or living in a rural location—or, as is often the case, a services, and sanitary facilities are effective in supporting
combination of these—your chances of success in school enrollment and retention.
are far less likely than others. Where you come from Optimizing Education Outcomes draws on the latest
affects not only your education achievements but also evidence and analysis available in volume 8, Child and
your health status and your life chances and opportunities. Adolescent Health and Development of Disease Control
For the poorest students, enrolling in school, attend- Priorities, third edition (DCP3). It makes clear the syn-
ing regularly, and learning are often made more difficult ergies between education and health investments and
by illness, hunger, and malnutrition. In low- and mid- outcomes. It also confirms that our efforts and resources
dle-income countries, an estimated 500 million days off must focus on both health and education to achieve
school that are due to sickness affect student attendance, further gains in human development and progress
concentration, growth, and learning. toward the Sustainable Development Goals. Long-term
Consider Sier Leap, for example. She lives in goals in health are unattainable without an educated
Cambodia, is in grade 9, and is doing well now. But population, and children cannot learn if they suffer from
not so long ago, Sier was struggling in class, her eyes the effects of poor health and nutrition.
hurt, and she found it difficult to concentrate. Through DCP3 volume 8 proposes a package of school
a school health program delivered by the Ministry health investments that can effectively address the most
of Education, funded by the Global Partnership for pressing health problems and health knowledge needs of
Education, and implemented by the World Bank and school-age children in low- and lower-middle- income
specialist eye health organizations, Sier was among many countries. It contains evidence that policy makers, prac-
thousands of school-age children who had simple vision titioners, and planners can use to make the case for
testing carried out by trained teachers at her school. high-return, affordable school health interventions to
After a follow-up exam at a nearby health clinic, she improve not only school-age children’s health and devel-
received glasses to correct her vision and transform her opment, but also their participation and learning.
life. Sier is happier and more confident now, performing For school-age children between ages 5 and 14, selected
well in school and hoping to become a lawyer. vaccinations, vision screening, insecticide-treated
vii
mosquito net promotion and use to prevent malaria, support—to do the necessary planning work to ensure
deworming in high-load areas, and school meals are that teachers and health workers, local communities, and
among the report’s recommendations. It calls also for students work together to implement effective school-
older children, ages 10 to 19 approximately, to have based health programs. Many also include programs that
access to healthy lifestyle and comprehensive sexuality alleviate hunger and provide healthy school environ-
education, adolescent-friendly health services within ments in their national education sector plans.
schools, and mental health education and counseling. Optimizing Learning Outcomes sets out the latest
School-age children—approximately 400 million evidence to support ministries of education, health,
worldwide—typically have the highest burden of worm and finance to review existing programs for children’s
infection of any age group. They struggle with fatigue, health in school and invest in what works. Their goal is
sickness, anemia, and malnutrition, which in turn keep to increase student health, well-being, participation, and
them out of school or sap their ability to concentrate and learning. This makes sound economic sense, increasing
learn. However, for a cost of less than US$0.50 a year, the effectiveness of investments that are beneficial for
school-based deworming can reduce absenteeism by up students now and that build stronger societies and more
to 25 percent, and the benefits of school health interven- successful economies in the future.
tions can be dramatic and immediate. Implementing these essential packages for school-
Jyoti, age 12, took part in the Indian state of Bihar’s age children and adolescents will help secure a healthy,
school deworming day, along with 18 million other better-educated, successful, and more prosperous future
students, half of whom are estimated to be infected. for up to 870 million children and young people in the
“I felt like I couldn’t live any longer,” she said. “I had so poorest countries. The clock is ticking toward 2030, the
much trouble, I had stomach pain, nausea. I used to feel deadline the world has set to educate all the world’s
like vomiting, it was terrible.” She adds, “I took the pill children. The time is right to work together, across sec-
at night, and immediately, in the morning I felt good. tors, in a collaborative effort to ensure all girls and boys
I suddenly felt lively and energetic.” are healthy and able to complete a free, equitable, and
To be successful, school health programs need to be quality primary and secondary education.
designed and implemented and funded in collabora-
tion with others. The Global Partnership for Education Julia Gillard
has supported teams from ministries of education Board Chair, Global Partnership for Education
and health—in almost one-third of the countries we and former Prime Minister of Australia
viii Preface