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Effect of providing free glasses on children's educational outcomes in China: The "Seeing is Learning" cluster-randomized controlled trial

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Objective: To study for the first time using a clinical trial the effect of free glasses on academic performance in rural Chinese children, among whom uncorrected myopia is the leading cause of visual impairment.

Participants: Among 19,934 children in grades 4 and 5 randomly selected for visual acuity screening, 3177 (15.9%, mean age 10.5 years) had visual acuity < 6/12 in either eye without glasses correctable to > 6/12 with glasses, and were eligible for allocation. Among these, 3052 (96.0%) completed the study.

Interventions: Children were randomized by school (84 schools per arm) to one of three interventions at the beginning of the school year: free glasses provided in class, vouchers for free glasses at a local facility or glasses prescriptions only (Control group).

Results: Among 3177 eligible children, 1036 (32.6%), 988 (31.1%) and 1153 (36.3%) were randomized to Control, Voucher and Free Glasses respectively. All eligible children would benefit from glasses, but only 15% had them at baseline. Intention-to-treat analyses were performed on all 1002 (96.8%), 946 (95.9%) and 1104 (95.8%) children completing final testing in Control, Voucher and Free Glasses groups. Effect on test score was 0.11 SD (95% Confidence Interval [CI] 0.01 to 0.21, p = 0.03) comparing the Free Glasses and Control groups. Adjusted effect of providing free glasses (0.10 SD, 95% CI 0.01 to 0.20; p = 0.04) was greater than parental education (0.03, 95% CI -0.03 to 0.10) or family wealth (0.002, 95% CI -0.07 to 0.07). Closeout glasses wear was 41% (observed), 68% (self-reported) in the Free Glasses group.

Conclusions: Providing free glasses improves children's performance on mathematics testing to a statistically significant degree, despite imperfect compliance. Myopia is common and rarely corrected in this setting.

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Scott Rozelle

State Fragility and Extreme Poverty: What Can be Done?

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Please note that this CDDRL seminar will be held on Wednesday. 

 

Abstract:

Recent estimates place half of the world’s poorest people in fragile and conflict-affected states by 2015. As the world moves towards the next phase of global development goals, which includes a central emphasis on eradicating extreme poverty, it will be necessary to understand the challenges for countries in the most difficult contexts. Is addressing and resolving fragility a condition (or precondition) for successfully addressing poverty?  Or, are there ways to significantly and sustainably reduce poverty even while countries remain fragile?

USAID is seeking to answer these questions as it recommits to working with its partners to end extreme poverty by 2030. And while we acknowledge that ending extreme poverty will not be easy, progress and gains already achieved over the past couple of decades have made us certain that it is possible. As the global community coalesces around this goal, USAID seeks to increase shared understanding of the nature of extreme poverty, where there has been success and why, and what we are already doing and will need to do differently to catalyze and invest in global solutions.

 

Speaker Bio: 

Alex Thier
Alex Thier is USAID’s assistant to the Administrator for Policy, Planning, and Learning (PPL). The PPL Bureau is USAID’s center for policy development, strategic planning, learning and evaluation, and partner engagement. From June 2010‐ June 2013, Thier served as assistant to the administrator for Afghanistan and Pakistan affairs, overseeing USAID’s two largest missions in the world.
Before joining USAID, Thier served with the U.S. Institute of Peace as senior rule of law adviser and director for Afghanistan and Pakistan from 2005‐ 2010. While at the Institute, he co‐authored The Future of Afghanistan (2009) as well as The Next Chapter: The United States and Pakistan, the 2008 report of the Pakistan Working Group. Thier also served as director of the Institute’sConstitution Making, Peacebuilding, and National Reconciliation project, during which he advised numerous governments and civil society organizations engaged in ongoing constitutional drafting and national reconciliation exercises. Thier was also a principal staffer on the Institute’s Genocide Prevention Task Force, and a coauthor of its final report, Preventing Genocide: A Blueprint for U.S. Policymakers. The recommendations from this report formed the backbone of President Barack Obama’s 2011 Directive on Mass Atrocities.
Thier previously served as director of the Project on Failed States at Stanford University’s Center on Democracy, Development, and the Rule of Law. From 2002 to 2004, he was legal adviser to Afghanistan’s Constitutional and Judicial Reform Commissions in Kabul, where he assisted in the development of a new constitution and judicial system. He has also worked as a senior analyst for the International Crisis Group, a legal and constitutional expert to the British Department for International Development, and as an adviser to the Constitutional Commission of Southern Sudan.
From 1993 to 1996, Thier worked as a U.N. and NGO official in Afghanistan and Pakistan during the Afghan civil war. He also served as coordination officer for the U.N. Iraq Program in New York.
An attorney, Thier was a Skadden fellow and a graduate fellow at the U.S. National Security Council’s Directorate for Near‐East and South Asia. He received the Richard S. Goldsmith award for outstanding work on dispute resolution from Stanford University in 2000.
Thier has a J.D. from Stanford Law School, a master’s degree in law and diplomacy from the Fletcher School of Law and Diplomacy at Tufts University, and a Bachelor’s Degree from Brown University.
Discussion Paper: Ending extreme poverty in fragile contexts
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Encina Hall, 3nd Floor
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Stanford, CA 94305

Alex Thier Assistant to the Administrator for Policy, Planning, and Learning Assistant to the Administrator for Policy, Planning, and Learning United States Agency for International Development
Seminars

Everything that Can Go Wrong in a Field Experiment

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Join Global Development and Poverty Initiative (GDP) for a stimulating discussion on the opportunities, obstacles, and unforeseen events encountered while conducting field research in the developing world.

The panelists will share stories of challenges and successes from their own experiences and will offer insights on conducting effective research in the field.

Panelist

Jenna Davis

473 Via Ortega, Y2E2, Room 255
Stanford, CA 94305-4020

(650) 725-9170
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Professor, Department of Civil and Environmental Engineering
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Jennifer (“Jenna”) Davis is a Professor in the Department of Civil and Environmental Engineering and the Higgins-Magid Senior Fellow at the Woods Institute for the Environment, both of Stanford University. She also heads the Stanford Program on Water, Health & Development. Professor Davis’ research and teaching is focused at the interface of engineered water supply and sanitation systems and their users, particularly in developing countries. She has conducted field research in more than 20 countries, including most recently Zambia, Bangladesh, and Uganda.

Higgins-Magid Faculty Senior Fellow, Stanford Woods Institute for the Environment
Panelist
Katherine Casey Panelist

Stephen P. Luby

Y2E2
473 Via Ortega
Stanford, CA 94305

(650) 723-4129 (650) 725-3402
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Faculty Lead, Center for Human and Planetary Health
Professor of Medicine (Infectious Diseases)
Professor of Epidemiology & Population Health (by courtesy)
Senior Fellow at the Freeman Spogli Institute for International Studies
Senior Fellow at the Woods Institute for the Environment
Faculty Affiliate at the Stanford Center on China's Economy and Institutions
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Prof. Stephen Luby studied philosophy and earned a Bachelor of Arts summa cum laude from Creighton University. He then earned his medical degree from the University of Texas Southwestern Medical School at Dallas and completed his residency in internal medicine at the University of Rochester-Strong Memorial Hospital. He studied epidemiology and preventive medicine at the Centers for Disease Control and Prevention.

Prof. Luby's former positions include leading the Epidemiology Unit of the Community Health Sciences Department at the Aga Khan University in Karachi, Pakistan, for five years and working as a Medical Epidemiologist in the Foodborne and Diarrheal Diseases Branch of the U.S. Centers for Disease Control and Prevention (CDC) exploring causes and prevention of diarrheal disease in settings where diarrhea is a leading cause of childhood death.  Immediately prior to joining the Stanford faculty, Prof. Luby served for eight years at the International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), where he directed the Centre for Communicable Diseases. He was also the Country Director for CDC in Bangladesh.

During his over 25 years of public health work in low-income countries, Prof. Luby frequently encountered political and governance difficulties undermining efforts to improve public health. His work within the Center on Democracy, Development, and the Rule of Law (CDDRL) connects him with a community of scholars who provide ideas and approaches to understand and address these critical barriers.

 

Director of Research, Stanford Center for Innovation in Global Health
Affiliated faculty at the Center on Democracy, Development and the Rule of Law
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272- Soil-Transmitted Helminths in Southwestern China: Links to Cognitive Ability, Nutrition, and School Performance among Children

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Empirical evidence suggests that the prevalence of soil-transmitted helminth (STH) infections in remote and poor rural areas is still high among children, the most vulnerable to infection. There is concern that STH infections may detrimentally affect children’s healthy development, including their cognitive ability, nutritional status, and school performance. Medical studies have not yet identified the exact nature of the impact STH infections have on children. The objective of this study is to examine the relationship between STH infections and developmental outcomes in 2,180 school-aged children in seven nationally-designated poverty counties in rural China. We conducted a large-scale survey in Guizhou province in southwest China in May, 2013. Overall, 42 percent of elementary school-aged children were infected with one or more of the three types of STH—Ascarislumbricoides (ascaris), Trichuris trichuria (whipworm) and the hookworms Ancylostoma duodenaleor Necator americanus. After controlling for socioeconomic status, we observed that children infected with one or more STHs have worse cognitive ability, worse nutritional status, and worse school performance than their uninfected peers.

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Alexis Medina
Scott Rozelle

Jenny Bowen: What China’s Orphans Taught Me About Moving Mountains

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Jenny Bowen is the founder and chief executive officer of Half the Sky Foundation, which strives to enrich the lives of orphaned children in China. A former screenwriter and independent filmmaker, Bowen founded Half the Sky in 1998 in order to give something back to her adopted daughters’ home country and to the many children then languishing behind institutional walls. Half the Sky’s five innovative programs now provide nurturing, family-like care for thousands of children of all ages. In partnership with China’s Ministry of Civil Affairs, Half the Sky has embarked on a groundbreaking Integrated National Training Plan that will eventually make the Half the Sky approach the approved national standard of care for all children in the welfare system.

In 2008, Bowen received the Skoll Award for Social Entrepreneurship. She serves on China’s National Committee for Orphans and Disabled Children and on the Expert Consultative Committee for Beijing Normal University’s Philanthropy Research Institute. She is the author of the recently released memoir, Wish You Happy Forever: What China’s Orphans Taught Me About Moving Mountains.

About REAP

The Rural Education Action Program (REAP) at Stanford is an impact evaluation organization that aims to inform sound education, health and nutrition policy in China. REAP’s goal is to help students from vulnerable communities in China enhance their human capital and overcome obstacles to education so that they can escape poverty and better contribute to China’s developing economy.

The author will be available to sign copies of her book after the event.

Reuben W. Hills Conference Room

Jenny Bowen Founder of Half the Sky Foundation Speaker

Scott Rozelle

Encina Hall East, E404
Stanford, CA 94305-6055

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Faculty Co-director of the Stanford Center on China's Economy and Institutions
Helen F. Farnsworth Endowed Professorship
Senior Fellow at the Freeman Spogli Institute for International Studies
Senior Fellow at the Stanford Institute for Economic Policy Research
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Scott Rozelle is the Helen F. Farnsworth Senior Fellow and the co-director of Stanford Center on China's Economy and Institutions in the Freeman Spogli Institute for International Studies and Stanford Institute for Economic Policy Research at Stanford University. He received his BS from the University of California, Berkeley, and his MS and PhD from Cornell University. Previously, Rozelle was a professor at the University of California, Davis and an assistant professor in Stanford’s Food Research Institute and department of economics. He currently is a member of several organizations, including the American Economics Association, the International Association for Agricultural Economists, and the Association for Asian Studies. Rozelle also serves on the editorial boards of Economic Development and Cultural Change, Agricultural Economics, the Australian Journal of Agricultural and Resource Economics, and the China Economic Review.

His research focuses almost exclusively on China and is concerned with: agricultural policy, including the supply, demand, and trade in agricultural projects; the emergence and evolution of markets and other economic institutions in the transition process and their implications for equity and efficiency; and the economics of poverty and inequality, with an emphasis on rural education, health and nutrition.

Rozelle's papers have been published in top academic journals, including Science, Nature, American Economic Review, and the Journal of Economic Literature. His book, Invisible China: How the Urban-Rural Divide Threatens China’s Rise, was published in 2020 by The University of Chicago Press. He is fluent in Chinese and has established a research program in which he has close working ties with several Chinese collaborators and policymakers. For the past 20 years, Rozelle has been the chair of the International Advisory Board of the Center for Chinese Agricultural Policy; a co-director of the University of California's Agricultural Issues Center; and a member of Stanford's Walter H. Shorenstein Asia-Pacific Research Center and the Center on Food Security and the Environment.

In recognition of his outstanding achievements, Rozelle has received numerous honors and awards, including the Friendship Award in 2008, the highest award given to a non-Chinese by the Premier; and the National Science and Technology Collaboration Award in 2009 for scientific achievement in collaborative research.

Stanford Center on China’s Economy and Institutions

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Faculty affiliate at the Center on Democracy, Development, and the Rule of Law
Faculty Affiliate at the Walter H. Shorenstein Asia-Pacific Research Center
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