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Scott Rozelle
Journal Articles

Impact of Spectacles Wear on Uncorrected Visual Acuity among Urban Migrant Primary School Children in China: A Cluster-Randomised Clinical Trial

Xinwu Zhang, Ming Zhou, Xiaochen Ma, Hongmei Yi, Haiqing Zhang, Xiuqing Wang, Ling Jin, Kovin Naidoo, Hasan Minto, Haidong Zou, Scott Rozelle, Nathan Congdon, Yue Ma
British Journal of Opthalmology, 2020 July 30, 2020
Objective: To estimate the effect of providing free spectacles on uncorrected visual acuity (VA) among urban migrant Chinese school children. Design Exploratory analysis from a parallel cluster-randomised clinical trial. Methods: After baseline survey and VA screening, eligible children were randomised by school to receive one of the two interventions: free glasses and a teacher incentive (tablet computer if ≥80% of children given glasses were wearing them on un-announced examination) (treatment group) or glasses prescription and letter to parents (control group). The primary outcome was uncorrected logarithm of the minimal angle of resolution (LogMAR) VA at study closeout, adjusted for baseline uncorrected VA. Results: Among 4376 randomly selected children, 728 (16.6%, mean age 10.9 years, 51.0% boys) at 94 schools failed VA screening and met eligibility criteria. Of these, 358 children (49.2%) at 47 schools were randomised to treatment and 370 children (50.8%) at 47 schools to control. Among these, 679 children (93.3%) completed follow-up and underwent analysis. Spectacle wear in the treatment and control groups was 68.3% and 29.3%(p
Vision Care Migration Journal Articles
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Books

Lockdowns are Protecting China’s Rural Families from COVID-19, but the Economic Burden is Heavy

Scott Rozelle, Heather Rahimi, Huan Wang, Sarah-Eve Dill
International Food Policy Research Institute, 2020 July 28, 2020

In response to the COVID-19 outbreak in December 2019, China implemented a nationwide travel blockade and quarantine policy that required all public spaces, businesses, and schools to shut their doors until further notice and placed restrictions on individuals leaving their homes or traveling. The lockdown was also implemented across China’s vast rural areas, home to more than 700 million people. These quarantine measures started during the annual Spring Festival in mid-January, when most rural residents had returned to their family homes to celebrate the Lunar New Year together.

Public Health Books
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Journal Articles

“At Three Years of Age, We Can See the Future”: Cognitive Skills and the Life Cycle of Rural Chinese Children

Huan Zhou, Ruixue Ye, Sean Sylvia, Nathan Rose, Scott Rozelle
Demographic Research, 2020 July 24, 2020
BACKGROUND: Although the Chinese education system has seen massive improvements over the past few decades, there are still large academic achievement gaps between rural and urban areas that threaten China’s long-term development. In addition, recent literature underscores the importance of early childhood development (ECD) in later-life human capital development. OBJECTIVES: We analyze the life cycle of cognitive development and learning outcomes in rural Chinese children by first exploring whether ECD outcomes affect cognition levels, then determining whether cognitive delays persist as children grow, and finally examining connections between cognition and education outcomes. METHODS: We combine data from four recent studies that examine different age groups (0–3, 4–5, 10–11, 13–14) to track cognitive outcomes. RESULTS: First, we find that ECD outcomes for children in rural China are poor, with almost one in two children who are cognitively delayed. Second, we find that these cognitive delays seem to persist into middle school, with almost 37% of rural junior high school students who are cognitively delayed. Finally, we show that cognition has a close relationship to academic achievement. CONCLUSION: Our results suggest that urban–rural gaps in academic achievement originate at least in part from differences in ECD outcomes. CONTRIBUTIONS: Although many papers have analyzed ECD, human capital, and inequality separately, this is the first paper to explicitly connect and combine these topics to analyze the life cycle of cognitive development in the context of rural China.
Early Childhood Development Education Journal Articles
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Journal Articles

Independent Reading in Rural China's Elementary Schools: A Mixed-Methods Analysis

Huan Wang, Hongyu Guan, Hongmei Yi, Emma Seevak, Reid Manheim, Matthew Boswell, Scott Rozelle, Sarah Kotb
International Journal of Educational Development, 2020 June 21, 2020
Abstract: Independent reading—unassigned reading for personal pleasure—has been shown to be an important driver of reading skills and academic success. Children that commonly read for pleasure exhibit higher academic performance. However, little research has been done on independent reading in rural China, where the education system is charged with schooling tens of millions of students. Many rural students fall behind their urban counterparts in school, with potentially troubling implications for China’s ongoing development. This article explores the prevalence of independent reading and its associations with reading ability and academic performance among rural students. Using a mixed methods approach, we analyze quantitative data from a survey of 13,232 students from 134 rural schools and interviews with students, teachers, principals, and caregivers. We find that independent reading is positively and significantly correlated with reading ability as well as standardized math and Chinese tests scores. Despite such correlations, only 17 percent of students report reading for pleasure for an hour a day. Interview findings suggest that inaccessible bookstores, curriculum constraints, unsupportive home environments, low availability of appealing and level-appropriate books, and insufficient school investment in reading resources may explain the low prevalence of independent reading.
International Development In the Classroom Education Education Journal Articles
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Journal Articles

School Quality and Peer Effects: Explaining Differences in Academic Performance between China’s Migrant and Rural Students

Xiaobing Wang, Zhouhang Yuan, Shi Min, Scott Rozelle
The Journal of Development Studies, 2020 June 10, 2020
In China, parents have a choice to either send their children to private migrant schools in urban areas or to keep them in their own county. It is unclear whether the academic differences of students in rural schools and those in private migrant schools is due to the quality of schools, the quality of students/peers, or the ways that peer effects interact with the quality of the school. Using survey data from students with rural residency who attended either migrant schools or rural public schools, we measure how differences in the quality of the types of schools and how the effect of peers differs in high- versus low-quality schools. An instrumental variable approach is used to identify the causality of a student’s peers on his or her academic outcomes and within the context of each of the school venues. The gap in student academic performance is explained by the differences in each student’s peers as and in how peers interact in the schooling environments. The analysis also demonstrates that there is a significant interaction effect between one’s peers and the quality of a student’s school environment. We found that school quality has a complementary effect with peers on student academic performance.
International Development Education Migration Education Journal Articles
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Working Papers

Why Aren't Rural Children Completing Compulsory Education? A Survey-Based Study in China, 2003 to 2011

Xiaoyun Liu, Scott Rozelle
China Agricultural Economic Review, 2020 May 13, 2020
Purpose: Although China has instituted compulsory education through Grade 9, it is still unclear whether students are, in fact, staying in school. In this paper, the authors use a multi-year (2003–2011) longitudinal survey data set on rural households in 102–130 villages across 30 provinces in China to examine the extent to which students still drop out of school prior to finishing compulsory education. Design/methodology/approach: To examine the correlates of dropping out, the study uses ordinary least squares and multivariate probit models. Findings: Dropout rate from junior high school was still high (14%) in 2011, even though it fell across the study period. There was heterogeneity in the measured dropout rate. There was great variation among different regions, and especially among different villages. In all, 10% of the sample villages showed extremely high rates during the study period and actually rose over time. Household characteristics associated with poverty and the opportunity cost of staying in school were significantly and negatively correlated with the completion of nine years of schooling. Research limitations/implications: The findings of this study suggest that China needs to take additional steps to overcome the barriers keeping children from completing nine years of schooling if they hope to either achieve their goal of having all children complete nine years of school or extend compulsory schooling to the end of twelfth grade. Originality/value: The authors seek to measure the prevalence of both compulsory education rates of dropouts and rates of completion in China. The study examines the correlates of dropping out at the lower secondary schooling level as a way of understanding what types of students (from what types of villages) are not complying with national schooling regulations. To overcome the methodological shortcomings of previous research on dropout in China, the study uses a nationally representative, longitudinal data set based on household surveys collected between 2003 and 2011.
Education Poverty Education Working Papers
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Journal Articles

Depressive Symptoms and the Link with Academic Performance among Rural Taiwanese Children

Yujuan Gao, Derek Hu, Evan Peng, Cody Abbey, Yue Ma, Chyi-In Wu, Chia-Yuan Chang, Wei-Ting Hung, Scott Rozelle
International Journal of Environmental Research and Public Health, 2020 April 17, 2020
Previous studies reflect a high prevalence of depressive symptoms among Taiwanese adolescents (ages 13–18), but there is an absence of literature related to the risk of depression of children in Taiwan (ages 6–12), particularly among potentially vulnerable subgroups. To provide insight into the distribution of depressive symptoms among children in rural Taiwan and measure the correlation between academic performance, we conducted a survey of 1655 randomly selected fourth and fifth-grade students at 92 sample schools in four relatively low-income counties or municipalities. Using the Center for Epidemiological Studies-Depression Scale (CES-D) we assessed the prevalence of depressive symptoms in this sample, in addition to collecting other data, such as performance on a standardized math test as well as information on a number of individual and household characteristics. We demonstrate that the share of children with clinically significant symptoms is high: 38% of the students were at risk of general depression (depression score ≥ 16) and 8% of the students were at risk of major depression (depression score > 28). The results of the multivariate regression and heterogeneous analysis suggest that poor academic performance is closely associated with a high prevalence of depressive symptoms. Among low-performing students, certain groups were disproportionately affected, including girls and students whose parents have migrated away for work. Results also suggest that, overall, students who had a parent who was an immigrant from another country were at greater risk of depression. These findings highlight the need for greater resource allocation toward mental health services for elementary school students in rural Taiwan, particularly for at-risk groups. 
Health and Medicine Health In the Classroom Journal Articles
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Working Papers

Isolating the "Tech" from EdTech: Experimental Evidence on Computer Assisted Learning in China

Yue Ma, Robert Fairlie, Prashant Loyalka, Scott Rozelle
The National Bureau of Economic Research , 2020 April 10, 2020
EdTech which includes online education, computer assisted learning (CAL), and remote instruction was expanding rapidly even before the current full-scale substitution for in-person learning at all levels of education around the world because of the coronavirus pandemic. Studies of CAL interventions have consistently found large positive effects, bolstering arguments for the widespread use of EdTech. However CAL programs, often held after school, provide not only computer-based instruction, but often additional non-technology based inputs such as more time on learning and instructional support by facilitators. In this paper, we develop a theoretical model to carefully explore the possible channels by which CAL programs might affect academic outcomes among schoolchildren. We isolate and test the technology-based effects of CAL and additional parameters from the theoretical model, by designing a novel multi-treatment field experiment with more than four thousand schoolchildren in rural China. Although we find evidence of positive overall CAL program effects on academic outcomes, when we isolate the technology-based effect of CAL (over and above traditional pencil-and-paper learning) we generally find small to null effects. Our empirical results suggest that, at times, the “Tech” in EdTech may have relatively small effects on academic outcomes, which has important implications for the continued, rapid expansion of technologies such as CAL throughout the world.
International Development Technology Education Education Working Papers
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Journal Articles

The Impact of Pay-for-Percentile Incentive on Low-Achieving Students in Rural China

Fang Chang, Huan Wang, Yaqiong Qu, Qiang Zheng, Prashant Loyalka, Sean Sylvia, Yaojiang Shi, Sarah-Eve Dill, Scott Rozelle
Economics of Education Review, 2020 April 1, 2020
In some accountability regimes, teachers pay more attention to higher achieving students at the expense of lower achieving students. The overall goal of this study is to examine, in this type of accountability regime, the impacts of a pay-for-percentile type scheme in which incentives exist for all students but which are larger for improving the achievement of lower achieving students. Analyzing data from a large-scale randomized experiment in rural China, we find that incentives improve average achievement by 0.10 SDs and the achievement of low-achieving students by 0.15 SDs. We find parallel changes in teacher behavior and curricular coverage. Taken together, the results demonstrate that incentive schemes can effectively address teacher neglect of low-achieving students.
In the Classroom Education Education Journal Articles
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Working Papers

Passive versus Active Service Delivery: Comparing the Effects of Two Parenting Interventions on Early Cognitive Development in Rural China

Jingdong Zhong, Renfu Luo, Sean Sylvia, Sarah-Eve Dill, Alexis Medina, Scott Rozelle
2020 March 31, 2020
We present the results of a cluster-randomized controlled trial that evaluates the effects of a free, center-based parenting intervention on early cognitive development and parenting practices in 100 rural villages in China. We then compare these effects to a home-based intervention conducted in the same region, using the same parenting curriculum and public service system. We find that the center-based intervention significantly improved children’s cognitive skills by 0.11 standard deviations, accompanied by increases in the material investments, time investments, and parenting skills of caregivers. The average impact of the center-based intervention, however, was approximately half that of the home-visiting intervention. Analysis of the possible mechanisms suggests that the difference in effects was driven primarily by different patterns of compliance. Although children with lower levels of initial skills at baseline benefited the most from the center-based intervention, they were less likely to participate in the program. Keywords: Center-based parenting intervention; home-based parenting intervention; early cognitive development; randomized controlled trial; program participation
Early Childhood Development Education Working Papers
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Journal Articles

Epidemiology, Causes, Clinical Manifestation and Diagnosis, Prevention and Control of Coronavirus Disease (COVID-19) During the Early Outbreak Period: A Scoping Review

Sasmita Poudel Adhikari, Sha Meng, Yuju Wu, Yuping Mao, Ruixue Ye, Qingzhi Wang, Chang Sun, Sean Sylvia, Scott Rozelle, Hein Raat, Huan Zhou
Infectious Diseases of Poverty, 2020 March 17, 2020
Background The coronavirus disease (COVID-19) has been identified as the cause of an outbreak of respiratory illness in Wuhan, Hubei Province, China beginning in December 2019. As of 31 January 2020, this epidemic had spread to 19 countries with 11 791 confirmed cases, including 213 deaths. The World Health Organization has declared it a Public Health Emergency of International Concern. Methods A scoping review was conducted following the methodological framework suggested by Arksey and O’Malley. In this scoping review, 65 research articles published before 31 January 2020 were analyzed and discussed to better understand the epidemiology, causes, clinical diagnosis, prevention and control of this virus. The research domains, dates of publication, journal language, authors’ affiliations, and methodological characteristics were included in the analysis. All the findings and statements in this review regarding the outbreak are based on published information as listed in the references. Results Most of the publications were written using the English language (89.2%). The largest proportion of published articles were related to causes (38.5%) and a majority (67.7%) were published by Chinese scholars. Research articles initially focused on causes, but over time there was an increase of the articles related to prevention and control. Studies thus far have shown that the virus’ origination is in connection to a seafood market in Wuhan, but specific animal associations have not been confirmed. Reported symptoms include fever, cough, fatigue, pneumonia, headache, diarrhea, hemoptysis, and dyspnea. Preventive measures such as masks, hand hygiene practices, avoidance of public contact, case detection, contact tracing, and quarantines have been discussed as ways to reduce transmission. To date, no specific antiviral treatment has proven effective; hence, infected people primarily rely on symptomatic treatment and supportive care. Conclusions There has been a rapid surge in research in response to the outbreak of COVID-19. During this early period, published research primarily explored the epidemiology, causes, clinical manifestation and diagnosis, as well as prevention and control of the novel coronavirus. Although these studies are relevant to control the current public emergency, more high-quality research is needed to provide valid and reliable ways to manage this kind of public health emergency in both the short- and long-term.
Comparative effectiveness research Public Health Journal Articles
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Journal Articles

Targeted Poverty Alleviation through Education: A Study of Myopia Among Rural Students in China and Prevention and Control Policy Recommendations

Jin Zhao, Huan Wang, Yaojiang Shi, Robin Li, Scott Rozelle
Journal of East China Normal University , 2020 March 17, 2020
Providing vision care to students in rural areas may serve the purpose of poverty alleviation by improving education and health. This study aims to provide a comprehensive review of myopia studies among rural students in China and offer policy recommendations for the national myopia prevention and control plan under “Targeted poverty alleviation through education”. The results show that in rural China, 25% of primary school students and 50% of lower secondary school students are myopic. Moreover, more than 70% of rural myopic students suffer from uncorrected vision, which negatively affects student academic performance and mental health. Correcting myopia also has a significant positive impact on student academic achievement. Studies show that vision screening is an effective way to identify myopia among rural students. Providing subsidies for the families of myopic students to obtain eyeglasses, and providing incentives to teachers, can significantly improve the uptake and usage rates of eyeglasses. A county hospital-based vision center may be an effective platform for reducing children's visual impairment in rural China.
Vision Care Education Education Journal Articles
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Journal Articles

Effect of Chinese Eye Exercises on Change in Visual Acuity and Eyeglasses Wear among School-Aged Children in Rural China: A Propensity-Score-Matched Cohort Study

Huan Wang, Yiwei Qian, Nathan Congdon, Matthew Boswell, Scott Rozelle, Xiaochen Ma
BMC Complementary Medicine and Therapies, 2020 March 13, 2020
Background Daily “eye exercises,” massaging of periocular acupuncture pressure points, have been part of China’s national vision care policy in schools for some 50 years. However, the effect of eye exercises on myopia progression and eyeglasses wear has not been definitively investigated. This study evaluates the effectiveness of eye exercises on visual acuity and the propensity of rural children to wear eyeglasses. Methods Cohort study in 252 randomly-selected rural schools with baseline in September 2012 and follow up surveys 9 and 21 months later. Outcomes were assessed using propensity-score matching (PSM), multivariate linear regression and logistic regression to adjust for differences between children performing and not performing eye exercises. Results Among 19,934 children randomly selected for screening, 2374 myopic (spherical equivalent refractive error ≤ − 0.5 diopters in either eye) children (11.9%, mean age 10.5 [Standard Error 1.08] years, 48.5% boys) had VA in either eye ≤6/12 without eyeglasses correctable to > 6/12 with eyeglasses. Among these who completed the 21-month follow up, 1217 (58.2%) children reported practicing eye exercises on school days and 874 (41.8%) did not. After propensity-score matching, 1652 (79%) children were matched: 826 (50%) in the Eye Exercises group and 826 (50%) in the No Exercise group. Performing eye exercises was not associated with change in LogMAR uncorrected visual acuity and wear of eyeglasses, using either logistic regression or PSM at 9 or 21 months. Conclusions We found no evidence for an effect of eye exercises on change in vision or eyeglasses wear.
Vision Care Journal Articles
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Journal Articles

Parental Migration and Early Childhood Development in Rural China

Ai Yue, Yu Bai, Yaojiang Shi, Renfu Luo, Scott Rozelle, Alexis Medina, Sean Sylvia
Demography, 2020 March 12, 2020
Nearly one-quarter of all children under age 2 in China are left behind in the countryside as parents migrate to urban areas for work.We use a four-wave longitudinal survey following young children from 6 to 30 months of age to provide first evidence on the effects of parental migration on development, health, and nutritional outcomes in the critical first stages of life. We find that maternal migration has a negative effect on cognitive development: migration before children reach 12 months of age reduces cognitive development by 0.3 standard deviations at age 2. Possible mechanisms include reduced dietary diversity and engagement in stimulating activities, both known to be causally associated with skill development in early life. We find no effects on other dimensions of physical and social-emotional health.
Early Childhood Development Migration Demographics Journal Articles
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Journal Articles

Visual Impairment and Spectacles Ownership among Upper Secondary School Students in Northwestern China

J Zhao, H Guan, K Du, Huan Wang, Matthew Boswell, Yaojiang Shi, Scott Rozelle, Nathan Congdon, Annie Osborn
Hong Kong Medical Journal, 2020 February 6, 2020
PURPOSE: To assess the prevalence of visual impairment and spectacles ownership among academic and vocational upper secondary school students in rural China. METHODS: This cross-sectional study included 5583 students from four academic upper secondary schools (AUSSs) and two vocational upper secondary schools (VUSSs) in Mei and Qianyang counties, Baoji Prefecture, Shaanxi Province. In March and April 2016, students underwent assessment of visual acuity (VA) and completed a questionnaire regarding spectacles use and family characteristics. Students with visual impairment (presenting VA ≤6/12 in the better eye) and students needing spectacles (uncorrected VA ≤6/12 in the better eye, which could be improved to >6/12 with refraction) were identified. RESULTS: Among 5583 students (54% boys, mean age 16.4±1.0 years) in grades 10 and grade 11 attending AUSSs (n=4549) and VUSSs (n=1034), visual impairment was detected in 4026 students. Among the AUSS students, 3425 (75%) needed spectacles; 2551 (75%) had them. Among the VUSS students, 601 (58%) needed spectacles; this proportion was significantly smaller (P=0.004), as was the proportion who had spectacles (n=212, 35%, P
Vision Care Journal Articles
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Journal Articles

Agricultural and Rural Development in China During the Past Four Decades: An Introduction

Jikun Huang, Scott Rozelle, Xinkai Zhu, Shiji Zhao, Yu Sheng
The Australian Journal of Agricultural and Resource Economics, 2019 December 13, 2019
The past four decades have witnessed unprecedented economic growth and rapidly rising food demand in China. This paper provides an introduction to readers with useful information summarising the development of China’s agricultural sector and the transformation of its rural economy over the 40 years of economic reform. It is, however, impossible to cover all aspects of this recent and rich history in a single journal special issue. Nevertheless, we are of the view that these papers address the most fundamentally important and insightful topics including: land reform and rural development; technology progress and productivity growth; changing food consumption patterns; rural education and human capital accumulation; and poverty alleviation.
Agricultural trade International Development Agricultural trade Economic Affairs Agricultural trade Journal Articles
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Journal Articles

Seeing is Believing: Experimental Evidence on the Impact of Eyeglasses on Academic Performance, Aspirations, and Dropout among Junior High School Students in Rural China

Jingchun Nie, Xiaopeng Pang, Lei Wang, Scott Rozelle, Sean Sylvia
Economic Development and Cultural Change, 2019 December 12, 2019

We present the results of a randomized trial testing the impact of providing free eyeglasses on academic outcomes of junior high school students in a poor rural area of western China. We find that providing free prescription eyeglasses approximately halves dropout rates over a school year among students who did not own eyeglasses at baseline. Effects on dropout are mirrored by improvements in student performance on standardized exams in math and aspirations for further schooling

Vision Care Education Education Journal Articles
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Journal Articles

Impact of Second-Parent Migration on Student Academic Performance in Northwest China and its Implications

Yu Bai, Michael Neubauer, Tong Ru, Yaojiang Shi, Kaleigh Kenny, Scott Rozelle
The Journal of Development Studies, 2019 November 25, 2019
ABSTRACT The migration of hundreds of millions of rural Chinese workers to the city has contributed substantially to China’s economic growth since the beginning of the country’s economic reform in 1978. However, this migration has also led to societal issues, including more than 60 million left-behind children. Empirical studies that seek to measure the impact of being left-behind on academic performance have led to inconsistent results, perhaps because the effects may be different for first-parent migration (migration during the first period of time in which one parent migrates) and second-parent migration (migration when the remaining parent leaves the home). Here we have examined how school performance changes before and after the second parent out-migrates. We use a panel dataset of over 5,000 students from 72 primary schools in rural China. Using a difference-in-difference approach, supported by a placebo test, we find that second-parent migration has statistically significant negative impacts on student performance. Importantly, our data provide convincing evidence that second-parent migration has a more negative impact on academic performance than first-parent migration. Our results have broad implications for China’s future economic growth and inequality.
Education Migration Education Journal Articles
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Journal Articles

The Returns to Education in Rural China: Some New Estimates

Chengfang Liu, Ye Li, Shaoping Li, Renfu Luo, Linxiu Zhang, Scott Rozelle, Spencer Hagist, Jack Hou
The Australian Journal of Agricultural and Resource Economics, 2019 November 12, 2019
We estimate the rates of return to education in rural China using primary survey data collected in 2016. Estimated average returns to education are 3.1 per cent. However, careful statistical analysis is required when estimating the returns to education. The paper demonstrates that when employment interruptions are accounted for, the measured returns to education rise. Our results also confirm that mismeasurement of the wage rate by using an hourly wage rate (versus daily or monthly earnings) raises the estimation of rates of return to education. Finally, our results suggest that the return to education is nonlinear in education levels but only when it reaches the tertiary level.
 
Education Education Journal Articles
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Journal Articles

Can School Feeding Programs Reduce Malnutrition in Rural China?

Huan Wang, Qiran Zhao, Matthew Boswell, Scott Rozelle
Journal of School Health, 2019 November 8, 2019
BACKGROUND
Childhood malnutrition is commonplace among poor rural communities in China. In 2012, China launched its first nationwide school‐feeding program (SFP) to address this problem. This study examines the prevalence of malnutrition before and after the SFP and identifies possible reasons for the trends observed.
 
METHODS
Ordinary least squares regression and propensity score matching were used to analyze data from 2 cross‐sectional surveys of 100 rural primary schools in northwestern China. Participants were fourth‐and fifth‐grade students. Outcome measures include anemia rates, hemoglobin levels, body mass index, and height for age Z scores.
 
RESULTS
Three years after implementation of the SFP, malnutrition rates among sample students had not fallen. The SFP had no statistically significant effect on either anemia rates or BMI, but was linked to an increase in the proportion of students with below normal height for age Z scores. Meals provided to students fell far short of national recommendations that the SPF should provide 40% of the recommended daily allowance of micronutrients.
 
CONCLUSIONS
Despite significant budgetary outlays between 2012 and 2015, China's SFP has not reduced the prevalence of malnutrition among sample students. To make the SFP more effective, funding and human resources both need to be increased.
Health International Development Education Education Journal Articles
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Journal Articles

Academic Achievement and Mental Health of Left-behind Children in Rural China

Lei Wang, Yaojia Zheng, Guirong Li, Yanyan Li, Zhenni Fang, Cody Abbey, Scott Rozelle
China Agricultural Economic Review, 2019 November 4, 2019
Purpose – China’s rapid pace of urbanization has resulted in millions of rural residents migrating from rural areas to urban areas for better job opportunities. Due to economic pressures and the nature of China’s demographic policies, many of these migrants have been forced to leave their children with relatives – typically paternal grandparents – at home in the countryside. Thus, while income for most migrant families has risen, a major unintended consequence of this labor movement has been the emergence of a potentially vulnerable sub-population of left-behind children (LBCs). The purpose of this paper is to examine the impacts of parental migration on both the academic performance and mental health of LBCs. Design/methodology/approach – Longitudinal data were drawn from three waves of a panel survey that . followed the same students and their families – including their migration behavior (i.e. whether both parents, one parent, no parent migrated) – between 2015 and 2016. The survey covers more than 33,000 students in one province of central China. The authors apply a student fixed-effects model that controls for both observable and unobservable confounding variables to explicate the causal effects of parental migration on the academic and mental health outcomes for LBC. The authors also employ these methods to test whether these effects differ by the type of migration or by gender of the child.
Findings – The authors found no overall impact of parental migration on either academic performance or mental health of LBCs, regardless of the type of migration behavior. The authors did find, however, that when the authors examined heterogeneous effects by gender (which was possible due to the large sample size), parental migration resulted in significantly higher anxiety levels for left-behind girls. The results suggest that parental migration affects left-behind boys and girls differently and that policymakers should take a more tailored approach to addressing the problems faced by LBCs.
Health Education Society Migration Education Journal Articles
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Journal Articles

Heterogeneous Impacts of Basic Social Health Insurance on Medical Expenditure: Evidence from China's New Cooperative Medical Scheme

Conglong Fang, Chaofei He, Scott Rozelle, Qinghua Shi, Jiayin Sun, Ning Yu
Healthcare, 2019 November 3, 2019

This paper examines the effects of China’s New Cooperative Medical Scheme (NCMS) on medical expenditure. Utilizing the quasi-random rollout of the NCMS for a difference-in-difference analysis, we find that the NCMS increased medical expenditure by 12.3%. Most significantly, the good-health group witnessed a 22.1% rise in medical expenditure, and the high-income group saw a rise of 20.6%. The effects, however, were not significant among the poor-health or low-income groups. The findings are suggestive of the need for more help for the very poor and less healthy.

Health Health policy Journal Articles
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Working Papers

EdTech for Equity in China: Can Technology Improve Teaching for Millions of Rural Students?

Cody Abbey, Yue Ma, Guirong Li, Matthew Boswell, Claire Cheng, Robert Fairlie, Oliver Lee, Prashant Loyalka, Andrew Mi, Evan Peng, Scott Rozelle, Adrian Sun, Andy Zeng, Jenny Zhao
2019 October 21, 2019

Previous literature suggests subpar teaching is a primary reason why rural Chinese students lag behind academically. We initiate an investigation into the potential of educational technology (EdTech) to increase teaching quality in rural China. First, we discuss why conventional approaches of improving teaching in remote schools are infeasible in China’s context, referring to past research. We then explore the capacity of technology-assisted instruction to improve academic performance by examining previous empirical analyses. Third, we show that China is not limited by the resource constraints of other developing countries due to substantial policy support and a thriving EdTech industry. Finally, we identify potential implementation-related challenges based on the results of a preliminary qualitative survey of pilots of EdTech interventions. With this paper, we lay the foundation for a long-term research investigation into whether EdTech can narrow China’s education gap.

International Development Technology Education Education Working Papers
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Journal Articles

Using Community Health Workers to Deliver a Scalable Integrated Parenting Program in Rural China: A Cluster-Randomized Controlled Trial

Renfu Luo, Ai Yue, Dorien Emmers, Nele Warinnier, Scott Rozelle, Sean Sylvia
Social Science & Medicine, 2019 September 9, 2019

Inadequate care during early childhood can lead to long-term deficits in skill development. Parenting programs are promising tools for improving parenting practices and opportunities for healthy development. We implemented a non-masked cluster-randomized controlled trial in rural China in order to assess the effectiveness of an integrated home-visitation program that includes both psychosocial stimulation and health promotion at fostering development and health outcomes of infants and toddlers in rural China. All 6-18 month-old children of two rural townships and their main caregiver were enrolled. Villages were stratified by township and randomly assigned to intervention or control. Specifically, in September 2015 we assigned 43 clusters to treatment (21 villages, 222 caregiver-child dyads) or control (22 villages, 227 caregiver-child dyads). In the intervention group, community health workers delivered education and training on how to provide young children with psychosocial stimulation and health care (henceforth psychosocial stimulation and health promotion) during bi-weekly home visits over the period of one year. The control group received no home visits. Primary outcomes include measures of child development (i.e. the Bayley Scales of Infant and Toddler Development, third edition—or Bayley-III) and health (i.e. measures of morbidity, nutrition, and growth). Secondary outcomes are measures of parenting practices. Intention-to-treat (ITT) effects show that the intervention led to an improvement of 0·24 standard deviations (SD) [95% CI 0·04 SD-0·44 SD] in cognitive development and to a reduction of 8·1 [95% CI 3·8–12·4] percentage points in the risk of diarrheal illness. In addition, we find positive effects on parenting practices mirroring these results. We conclude that an integrated psychosocial stimulation and health promotion program improves development and health outcomes of infants and toddlers (6–30 month-old children) in rural China. Because of low incremental costs of adding program components (that is, adding health promotion to psychosocial stimulation programs), integrated programs may be cost-effective.

Early Childhood Development Education Education Journal Articles
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Journal Articles

Concurrent Validity of the Ages and Stages Questionnaire and the Bayley Scales of Infant Development III in China

Ai Yue, Qi Jiang, Biaoyue Wang, Cody Abbey, Alexis Medina, Yaojiang Shi, Scott Rozelle
PLoS ONE, 2019 September 5, 2019

Choosing a valid and feasible method to measure child developmental outcomes is key to addressing developmental delays, which have been shown to be associated with high levels of unemployment, participation in crime, and teen pregnancies. However, measuring early childhood development (ECD) with multi-dimensional diagnostic tests such as the Bayley Scales of Infant and Toddler Development III (Bayley-III) can be time-consuming and expensive; therefore, parental screening tools such as the Ages and Stages Questionnaire (ASQ-3) are frequently an alternative measure of early childhood development in largescale research. The ASQ is also becoming more frequently used as the first step to identify children at risk for developmental delays before conducting a diagnostic test to confirm. However, the effectiveness of the ASQ-3 is uncertain. In this study, we evaluate the accuracy of the ASQ-3 as a screening measure for children at risk of developmental delay in rural China by age group. To do so, we administered the Bayley-III, widely considered to be the “gold standard” of ECD diagnostic tests, to a sample of 1,831 five to twenty-four monthold children and also administered the ASQ-3 to their caregivers. We then compared the outcomes of the ASQ-3 test to those of the Bayley-III. We find that the ASQ-3 was significantly though weakly correlated with the Bayley-III and that the strength of this correlation increased with child age and was stronger when the mother was the primary caregiver (as compared to the grandmother). We also find that the sensitivity and specificity of ASQ-3 ranged widely. The overall findings suggest that the ASQ-3 may not be a very accurate screening tool for identifying developmentally delayed children, especially for children under 13 months of age or children whose primary caregiver is not the mother.

Early Childhood Development Education Journal Articles
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