Yaojiang Shi

Nutrition and Educational Performance in Rural China’s Elementary Schools: Results of a Randomized Control Trial in Shaanxi Province

Despite growing wealth and a strengthening commitment from the government to provide quality education, a significant share of students across rural China still have inadequate access to micronutrient-rich regular diets. Such poor diets can lead to nutritional problems, such as iron-deficiency anemia, that can adversely affect attention and learning in school. The overall goal of this article is to test whether simple nutritional interventions lower rates of anemia and to assess whether this leads to improved educational performance among students in poor areas of rural China. To meet this goal, we report on the results of a randomized control trial involving over 3,600 fourth-grade students, mostly aged 9–12, from 66 randomly chosen elementary schools in eight of the poorest counties in Shaanxi Province in China’s poor northwest region. The design called for random assignment of schools to one of three groups: two different types of treatment/intervention schools and a nonintervention, control group. The two interventions were designed to improve hemoglobin (Hb) levels, which is a measure of iron deficiency. One intervention provided a daily multivitamin with mineral supplements, including 5 milligrams of iron, for 5 months. The other informed the parents of their child’s anemia status and suggested several courses of action (henceforth, the information treatment). We found that 38.3% of the students had Hb levels below 120 grams per liter (g/L), the World Health Organization’s cutoff for anemia for children 9–12 years old. In the schools that received the multivitamins with mineral supplements, Hb levels rose by more than 2 g/L (about 0.2 standard deviations). The standardized math test scores of the students in the schools that received the multivitamin with mineral supplements also improved significantly. In schools that received the information treatment, only students who lived at home (and not the students who lived in boarding schools and took most of their meals at schools) registered positive improvements in their Hb levels. The reductions in anemia rates and improvements in test scores were greater for students who were anemic at the beginning of the study period. Overall, these results should encourage China’s Ministry of Education to begin to widen its view of education (beyond teachers, facilities, and curriculum) and to provide better nutrition and health care for students.

Development challenges, tuition barriers, and high school education in China

China has made remarkable progress along the path of economic transformation over the past three decades. To continue its rapid growth in an economy with increasingly higher wages, Chinas key challenge is whether it can become competitive enough in quasi-skilled and skilled sectors so that more technologically advanced industries and service sector firms eventually take the place of exiting low-wage factories. This study seeks to increase our understanding of high school education in China at a time when the nation is facing challenges in its development path. Using secondary statistics, we have found that educational access at the high school level is quite low, especially in poorer areas of rural China. We argue that the low level of access to high school education in China may be a problem resulting from high tuition and fees. We include empirical evidence about the tuition barrier argument by using a survey of 41 developing and developed countries and a representative survey of 1177 students from one of Chinas poorest provinces. We demonstrate that not only is financing high school a burden for the families of poor students, but there is also little financial aid available. The quality of education of students from poor rural areas prior to entering high school is also a problem. We conclude with a recommendation that in poor rural areas of China high school should be made free, as it is in most of the rest of the world, and efforts should be made to improve rural education in general.

Effect of providing free glasses on children’s educational outcomes in China: cluster randomized controlled trial

Objective To assess the effect of provision of free glasses on academic performance in rural Chinese children with myopia. Design Cluster randomized, investigator masked, controlled trial. Setting 252 primary schools in two prefectures in western China, 2012-13. Participants 3177 of 19 934 children in fourth and fifth grades (mean age 10.5 years) with visual acuity <6/12 in either eye without glasses correctable to >6/12 with glasses. 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: prescription for glasses only (control group), vouchers for free glasses at a local facility, or free glasses provided in class. Main outcome measures Spectacle wear at endline examination and end of year score on a specially designed mathematics test, adjusted for baseline score and expressed in standard deviations. Results Among 3177 eligible children, 1036 (32.6%) were randomized to control, 988 (31.1%) to vouchers, and 1153 (36.3%) to free glasses in class. All eligible children would benefit from glasses, but only 15% wore them at baseline. At closeout glasses wear was 41% (observed) and 68% (self reported) in the free glasses group, and 26% (observed) and 37% (self reported) in the controls. Effect on test score was 0.11 SD (95% confidence interval 0.01 to 0.21) when the free glasses group was compared with the control group. The adjusted effect of providing free glasses (0.10, 0.002 to 0.19) was greater than parental education (0.03, −0.04 to 0.09) or family wealth (0.01, −0.06 to 0.08). This difference between groups was significant, but was smaller than the prespecified 0.20 SD difference that the study was powered to detect. Conclusions The provision of free glasses to Chinese children with myopia improves children’s performance on mathematics testing to a statistically significant degree, despite imperfect compliance, although the observed difference between groups was smaller than the study was originally designed to detect. Myopia is common and rarely corrected in this setting. Trial Registration Current Controlled Trials ISRCTN03252665.

Malnutrition in China's Rural Boarding Schools: The Case of Primary Schools in Shaanxi Province.

The main goal of this paper is to document the nature of boarding schools and empirically analyse the difference in nutrition intake and malnutrition status between boarding and non-boarding students in western rural China. By using two data sets on boarding schools and boarding students in Shaanxi Province, a representative province in western rural China, this paper finds that dormitory and student canteen facilities in boarding schools are under-equipped and services are of poor quality, far below that needed for student development. Poor services in boarding schools and inadequate nutrition intake may be an important cause of low student height-for-age Z-scores (HAZ), as students eating at school have a much lower HAZ on average than that of non-boarding students. Furthermore, girls and students with more siblings have relatively lower HAZ, while the higher the number of parents a student has and the more educated they are exerts a positive influence on child nutritional status. Finally, our analysis implies that the effective way to decrease the inequality of health, malnutrition and human capital between urban and rural areas in the long run is to improve the facilities and services of boarding schools in rural China.

Anemia in Rural China's Elementary Schools: Prevalence and Correlates in Shaanxi Province's Poor Counties

Despite growing wealth in China, a significant share of children across rural China still have no access to iron-rich foods, vitamins, and other micronutrients. Such poor diets may result in high incidences of nutritional problems, including anemia. The objective of the study was to increase understanding of the extent of anemia, and identify structural correlates of anemia in poor Shaanxi provinces primary schools. The article shows that the overall anemia rate is 21.5 percent when using a blood hemoglobin cutoff of 115 g/L (39 percent with a cutoff of 120 g/L). We find that those students that are boarding at school and eat lunch away from home are more likely to be anemic. Children with anemia are found to have lower height for age (HAZ) scores. If this part of Shaanxi province is representative of all poor counties in China, these findings mean millions of children in poor rural China may be anemic.

Transfer Paths and Academic Performance: The Primary School Merger Program in China

A B S T R A C T In the late 1990s and early 2000s, China’s Ministry of Education embarked on an ambitious program of primary school mergers by shutting down small village schools and opening up larger centralized schools in towns and county seats. The goal of the program was to improve the teacher and building resources in an attempt to raise the human capital of students in poor rural areas, although it was recognized that students would lose the opportunity to learn in the settings of their own familiar villages. Because of the increased distances to the new centralized schools, the merger program also entailed building boarding facilities and encouraging or mandating that students live at school during the week away from their family. Given the magnitude of the program and the obvious mix of benefits and costs that such a program entails there has been surprisingly little effort to evaluate the impact of creating a new system that transfers students from school to school during their primary school period of education and, in some cases, making student live in boarding facilities at school. In this paper, our overall goal is to examine the impact of the Rural Primary School Merger Program on academic performance of students using a dataset from a survey that we designed to reflect transfer paths and boarding statuses of students. We use OLS and Propensity Score Matching approaches and demonstrate that there is a large ‘‘resource effect’’ (that is, an effect that appears to be associated with the better facilities and higher quality of teachers in the town and county schools) that appears to be associated with the transfers of students from less centralized schools (such as village schools) to more centralized schools. Boarding, however, is shown to have negative impacts on academic performance. However, students who transfer to county school benefit from the transfer no matter where they start and whether they board or not.

Computer assisted learning as extracurricular tutor? Evidence from a randomised experiment in rural boarding schools in Shaanxi

This paper uses a clustered randomised field experiment to explore the effects of a computer assisted learning (CAL) programme on student academic and non-academic outcomes in poor, rural public schools in China. Our results show that a remedial, game-based CAL programme in math held outside of regular school hours with boarding students in poor rural public schools improved standardised math scores by 0.12 standard deviations. Students from poorer families tended to benefit more from the programme. However, CAL did not have any significant impact on either Chinese language standardised test scores or non-academic outcomes.

Dropping Out of Rural China's Secondary Schools: A Mixed-methods Analysis*

Students in rural China are dropping out of secondary school at troubling rates. While there is considerable quantitative research on this issue, no systematic effort has been made to assess the deeper reasons behind student decision making through a mixed-methods approach. This article seeks to explore the prevalence, correlates and potential reasons for rural dropout throughout the secondary education process. It brings together results from eight large-scale survey studies covering 24,931 rural secondary students across four provinces, as well as analysis of extensive interviews with 52 students from these same study sites. The results show that the cumulative dropout rate across all windows of secondary education may be as high as 63 per cent. Dropping out is significantly correlated with low academic performance, high opportunity cost, low socio-economic status and poor mental health. A model is developed to suggest that rural dropout is primarily driven by two mechanisms: rational cost-benefit analysis or impulsive, stress-induced decision making.

College is a Rich, Han, Urban, Male Club: Research Notes from a Census Survey of Four Tier One Colleges in China

The opportunity to attend college and earn a degree has increased dramatically in China. However, that does not mean that everyone has an equal opportunity. Historically, there has been well-documented systematic discrimination against minorities, women and the rural poor. The main question of this paper is whether or not this discrimination has persisted since the recent expansion of Chinas tertiary education system. Using a census of incoming freshmen from four tier one universities, this paper assesses if certain types of students are over-represented while other types of students are under-represented. Comparing the shares of students from different socioeconomic and ethnic backgrounds from our primary survey data with government generated census statistics, we conclude that poor, minority and rural female students are systematically under-represented. In contrast, rich, Han, urban males are dominant in college.

Multiple Micronutrient Supplementation Reduces Anemia and Anxiety in Rural China’s Elementary School Children

Despite growing wealth and a strengthening government commitment to improve livelihoods and welfare, many students across rural China have inadequate access to micronutrient-rich diets. Poor diets can lead to nutritional problems, such as iron-deficiency anemia, that can adversely affect health, attention, learning, and mental health. The overall goal of this paper is to assess the impact of multiple micronutrient supplementation (MMS) on anemia and anxiety among students in poor areas of rural China. To achieve this goal, we conducted a randomized controlled trial in 54 randomly chosen elementary schools in 8 of the poorest counties in Shaanxi Province in Northwest China. Study participants were 2730 fourth-grade students, mostly aged 10-12 y. Schools were randomly assigned to 1 of 2 groups: a control group that received no intervention and an intervention group that received a daily MMS with 5 mg of iron (ferrous sulfate) for 5 mo. Our primary outcome measures were hemoglobin (Hb) concentrations (assessed by HemoCue 201+ technology), anemia prevalence (defined as Hb) concentrations ≤120 g/L), and anxiety (using a written mental health test). The results showed that 42.4% of students were anemic at baseline. The Hb concentration was 121.7 ± 10.7 g/L in the treatment group and 123.4 ± 11.4 g/L in the control group. MMS increased Hb concentrations by 1.7 g/L ± 0.15 and reduced anemia rates by 7.0 percentage points (P < 0.05). Anxiety was reduced by 0.30 SDs (P < 0.01). MMS reduced both anemia and anxiety. Our results should encourage further research on the linkages between nutrition and mental health in a development context.