The proposed project will examine an ongoing health program in seventy-five rural Kenyan primary schools. The project has two main components. The study will examine the benefits of improved child health status on later educational and labor market outcomes within the context of a prospective study. The Primary School Deworming Project (PSDP) began providing free medical treatment for intestinal worms - a serious health problem in rural Kenya - to Kenyan primary school children in 1998. Medical treatment was randomly phased into a subset of schools while other schools served as comparison schools, allowing differences in educational outcomes to be attributed to program health gains. The proposed study will track pupils in these schools for four additional years; the resulting dataset -containing data from current research and the proposed project - will contain longitudinal educational, demographic, and socioeconomic information for 30,000 children over seven years. The impact of child health on later education and labor market outcomes is currently poorly understood. The study will investigate the determinants of health behavior, and in particular the adoption of deworming drugs. This component will examine the respective roles that information factors and price factors play in determining individual health practices. The results may have implications for other health issues - including the spread of HIV in sub-Saharan Africa. The study will examine the role that social networks play in the decision to participate in a new health project in this case a school-based deworming program. The prospective design and staggered phase-in of the deworming intervention across schools helps identify the influence of social networks: the project will test if families with more social links to the first wave of treatment schools had better information about deworming, and if they were more likely to participate in the health project, when their schools were phased into the project. The final aspect of the project will examine how individuals respond to higher prices for deworming medical treatment in the PSDP. A random subset of primary schools in the sample will share medical costs with the non-governmental organization carrying out the project, while the remaining schools will receive free treatment, helping to identify the impact of cost-sharing on health care utilization. Evidence on the impact of cost-sharing on health service utilization in less developed countries is inconclusive.
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