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Scott Rozelle
Journal Articles

Moving Beyond Lewis: Employment and Wage Trends in China’s High- and Low-Skilled Industries and the Emergence of an Era of Polarization

Scott Rozelle, Yiran Xia, Dimitris Friesen, Bronson Vanderjack, Nourya Cohen
Comparative Economic Studies, 2020 October 21, 2020
One of the defining features of China’s economy over the two decades between 1995 and 2015 was the persistent rise of wages for workers and professionals in nearly every segment of the economy—with wage rates for labor-intensive jobs in manufacturing, construction, and the informal service sector rising the fastest. Recently, however, the economic environment in China has begun to change, including changes in both employment and wages. We identify recent employment/wage trends throughout China’s economy and postulate the sources of these trends as well as possible future consequences if they continue. We use official, nationally aggregated data to examine employment and wages in multiple sectors and industries. Our findings indicate that China may have entered a new phase of economic development in the mid-2010s. According to the data, in recent years, wage growth has begun to polarize: Rising for professionals employed in formal skill-intensive industries; and falling for workers in the informal labor-intensive service sector. We attribute this increase in skill-intensive wages to an increase in demand for skill-intensive employment, due to the emergence of a large middle class in China, for whom the demand for high technology, finance, banking, health, and higher education industries is increasing while, at least in the recent short term, the supply of experienced, high-skilled professionals has not kept up. The employment/wage trend in the informal (low-wage) service sector, however, is following a different pattern. While there is a rising demand for services in China’s economy, the growth, due to a number of factors (e.g., large shares of GDP targeted by policymakers to investment; high rates of savings by consumers), is relatively slow. In contrast, due to a number of economic forces, including globalization and automation, the supply of labor into the service sector of the informal economy is being fueled by the flow of labor out of manufacturing and construction (two industries that that have experienced employment declines since 2013). These supply and demand trends, in turn, are leading to the fall in the growth rate of wages in the informal service sector. We conclude by discussing the possible longer-term consequences of these emerging polarization trends based on an examination of recent experience with wage polarization occurring in both middle- and high-income countries, as well as its consequences. We also present policy recommendations for greater investment in education and human capital, as well as for the development of a more comprehensive set of social safety nets for different segments of China’s population.
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Working Papers

Off the Epicenter: COVID-19 Quarantine Controls and Employment, Education, and Health Impacts in Rural Communities

Huan Wang, Sarah-Eve Dill, Huan Zhou, Yue Ma, Hao Xue, Prashant Loyalka, Sean Sylvia, Matthew Boswell, Jason Lin, Scott Rozelle
2020 October 19, 2020

In late January 2020, China’s government initiated its first aggressive measures to combat COVID-19 by forbidding individuals from leaving their homes, radically limiting public transportation, cancelling or postponing large public events, and closing schools across the country. The rollout of these measures coincided with China’s Lunar New Year holiday, during which more than 280 million people had returned from their places of work to their home villages in rural areas. The disease control policies remained in place until late February and early March, when they were gradually loosened to

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Journal Articles

Visual Impairment in Rural and Migrant Chinese School-Going Children: Prevalence, Severity, Correction and Association

Yue Ma, Xinwu Zhang, Fei He, Xiaochen Ma, Hongmei Yi, Nathan Rose, Alexis Medina, Scott Rozelle, Nathan Congdon
BMJ Ophthalmology, 2020 October 11, 2020
Purpose To describe changes in the prevalence of visual impairment and glasses ownership with age and as associated with income and population density for visual impairment among rural and urban migrant Chinese students. Design Meta-analysis of 12 cross-sectional, school-based studies conducted between 2012 and 2017. Setting Rural and urban migrant schools in seven Chinese provinces. Participants A total of 83 273 rural and urban migrant Chinese students aged 6–17 years. Results Prevalence of visual impairment (uncorrected visual acuity ≤6/12 in either eye) rose from 19.0% at age 6 to 66.9% at 17, with the overall age-adjusted prevalence higher for girls (35.8%) than for boys (30.1%, p
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Books

Invisible China: How the Urban-Rural Divide Threatens China’s Rise

Scott Rozelle, Natalie Hell
University of Chicago Press, 2020 October 6, 2020

Book Synopsis:

As the glittering skyline in Shanghai seemingly attests, China has quickly transformed itself from a place of stark poverty into a modern, urban, technologically savvy economic powerhouse. But as Scott Rozelle and Natalie Hell show in Invisible China, the truth is much more complicated and might be a serious cause for concern.

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Journal Articles

Correlates of Participation in Community-Based Interventions: Evidence from a Parenting Program in Rural China

Yiwei Qian, Yi Ming Zheng, Sarah-Eve Dill, Scott Rozelle
PLOS One, 2020 September 8, 2020
A growing body of literature has documented that community-based early childhood development (ECD) interventions can improve child developmental outcomes in vulnerable communities. One critical element of effective community-based programs is consistent program participation. However, little is known about participation in community-based ECD interventions or factors that may affect participation. This paper examines factors linked to program participation within a community-based ECD program serving 819 infants and their caregivers in 50 rural villages in northwestern China. The results find that more than half of families did not regularly attend the ECD program. Both village-level social ties within the program and proximity to the program significantly predict program participation. Increased distance from the program site is linked with decreased individual program participation, while the number of social ties is positively correlated with participation. The average program participation rates among a family’s social ties is also positively correlated with individual participation, indicating strong peer effects. Taken together, our findings suggest that attention should be given to promoting social interactions and reducing geographic barriers among households in order to raise participation in community-based ECD programs.
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Journal Articles

Safety of Eyeglasses Wear for Visual Acuity among Middle School Students in Northwestern Rural China: A Cluster-randomised Controlled Trial

Yue Ma, Xinwu Zhang, Haoyang Li, Xiaochen Ma, Dimitris Friesen, Scott Rozelle, Xiaopeng Pang, Ming Zhou, Nathan Congdon
BMJ Open Ophthalmology, 2020 September 5, 2020
Objective: To assess the effect of free eyeglasses provision on visual acuity among middle school students in northwestern rural China. Methods and analysis: Among 31 middle schools randomly selected from 47 middle schools in northwestern rural China, students were randomly allocated by school to one of two interventions: free eyeglasses (intervention group), and eyeglasses prescriptions given only to the parents (control group). The main outcome of this study is uncorrected visual acuity after 9 months, adjusted for baseline visual acuity. Results: Among 2095 students from 31 middle schools, 995 (47.5%) failed the visual acuity screening, 515 (51.8%, 15 schools) of which were randomly assigned to the intervention group, with the remaining 480 students (48.2%, 16 schools) assigned to the control group. Among these, a total of 910 students were followed up and analysed. Endline eyeglasses wear in the intervention group was 44%, and 36% in the control group. Endline visual acuity of students in the intervention group was significantly better than students in the control group, adjusting for other variables (0.045 LogMAR units, 95% CI 0.006 to 0.084, equivalent to 0.45 lines, p=0.027), and insignificantly better only for baseline visual acuity (difference of 0.008 LogMAR units, 95% CI −0.018 to 0.034, equivalent to 0.08 lines). Conclusion: We found no evidence that receiving free eyeglasses worsened visual acuity among middle school students in northwestern rural China.
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Journal Articles

Institutions, Implementation, and Program Effectiveness: Evidence from a Randomized Evaluation of Computer-Assisted Learning in Rural China

Di Mo, Yu Bai, Yaojiang Shi, Cody Abbey, LInxiu Zhang, Scott Rozelle, Prashant Loyalka
Journal of Development Economics, 2020 September 1, 2020
There is limited evidence on the degree to which differences in implementation among institutions matter for program effectiveness. To examine this question, we conducted an experiment in rural China in which public schools were randomly assigned to one of three treatments: a computer-assisted learning program (CAL) implemented by a government agency, the same program implemented by an NGO, and a pure control. Results show that compared to the pure control condition and unlike the NGO program, the government program did not improve student achievement. Analyzing impacts along the causal chain, we find that government officials were more likely to substitute CAL for regular instruction (contrary to protocol) and less likely to directly monitor program progress. Correlational analyses suggest that these differences in program implementation were responsible for the lack of impacts.
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Journal Articles

Conditional Cash Transfers, Uptake of Maternal and Child Health Services, and Health Outcomes in Western Rural China

Huan Zhou, Yuju Wu, Chengfang Liu, Chang Sun, Yaojiang Shi, Linxiu Zhang, Alexis Medina, Scott Rozelle
BMC Public Health, 2020 August 17, 2020
Background: Empirical evidence suggests that the uptake of maternal and child health (MCH) services is still low in poor rural areas of China. There is concern that this low uptake may detrimentally affect child health outcomes. Previous studies have not yet identified the exact nature of the impact that a conditional cash transfer (CCT) has on the uptake of MCH services and, ultimately, on child health outcomes. The objective of this study is to examine the relationship between CCT, uptake of MCH services, and health outcomes among children in poor rural areas of western China. Methods: We designated two different sets of villages and households that were used as comparisons against which outcomes of the treated households could be assessed. In 2014, we conducted a large-scale survey of 1522 households in 75 villages (including 25 treatment and 50 comparison) from nine nationally designated poverty counties in two provinces of China. In each village, 21 households were selected based on their eligibility status for the CCT program. Difference-in-difference analyses were used to assess the impact of CCT on outcomes in terms of both intention-to-treat (ITT) and average-treatment-effects-on-the-treated (ATT). Results: Overall, the uptake of MCH services in the sample households were low, especially in terms of postpartum care visits, early breastfeeding, exclusive breastfeeding, and physical examination of the baby. The uptake of the seven types of MCH services in the CCT treatment villages were significantly higher than that in the comparison villages. The results from both the ITT and ATT analyses showed that the CCT program had a positive, although small, impact on the uptake of MCH services and the knowledge of mothers of MCH health issues. Nonetheless, the CCT program had no noticeable effect on child health outcomes. Conclusions: The CCT program generated modest improvements in the uptake of MCH services and mothers’ knowledge of MCH services in poor rural areas of Western China. These improvements, however, did not translate into substantial improvements in child health outcomes for two potential reasons: poor CCT implementation and the low quality of rural health facilities.
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Working Papers

The Impact of Computer Assisted Learning on Rural Taiwanese Children: Evidence from a Randomized Experiment

Yue Ma, Cody Abbey, Derek Hu, Oliver Lee, Weiting Hung, Xinwu Zhang, Chiayuan Chang, Chyi-In Wu, Scott Rozelle
2020 August 10, 2020
The effectiveness of educational technology (EdTech) in improving the outcomes of poor, marginalized students has primarily been documented by studies conducted in developing countries; however, relevant research involving randomized studies in developed country contexts is relatively scarce. The objective of the current study is to examine whether an in-school computer assisted learning (CAL) intervention can improve the math performance (the primary outcome) and academic attitudes (secondary outcomes) of rural students in Taiwan, including a marginalized subgroup of rural students called Xinzhumin. We also seek to identify which factors are associated with the effectiveness of the intervention. In order to achieve this, we conducted a randomized control trial involving 1,840 sixth-grade students at 95 schools in four relatively poor counties and municipalities of Taiwan during the spring semester of 2019. According to the ITT analysis, the O-CAL intervention had no significant ITT impacts on the primary outcome of student math performance as well as on most secondary outcomes of the overall treatment group (who on average used the software for only about one quarter of the protocol’s minimum required time of 30 minutes per week, indicating that compliance was low). However, the LATE analysis revealed significant improvements in the math performance of the 30% most active students in the treatment group (who used the software for about two thirds of the minimum required time). Effect sizes of active users overall (0.16 SD-0.22 SD) increased in accordance with increases in usage and were larger for active Xinzhumin users specifically (0.21 SD-0.35 SD). A wide range of student-level and (in particular) teacher-level characteristics were associated with the low compliance to the intervention, which are findings that may help inform educational policymakers and administrators of the potential challenges of introducing school-based interventions that depend heavily on teacher adoption and integration.  
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Working Papers

Education and EdTech during COVID-19: Evidence from a Large-Scale Survey during School Closures in China

Guirong Li, Xinwu Zhang, Delei Liu, Hao Xue, Derek Hu, Oliver Lee, Chris Rilling, Yue Ma, Cody Abbey, Robert Fairlie, Prashant Loyalka, Scott Rozelle
2020 August 10, 2020
In response to the COVID-19 epidemic, many education systems have relied on distance learning and educational technologies to an unprecedented degree. However, rigorous empirical research on the impacts on learning under these conditions is still scarce. We present the first large-scale, quantitative evidence detailing how school closures affected education in China. The data set includes households and teachers of 4,360 rural and urban primary school students. We find that although the majority of students engaged in distance education, many households encountered difficulties including barriers to learning (such as access to appropriate digital devices and study spaces), curricular delays, and costs to parents equivalent to about two months of income. We also find significant disparities across rural and urban households.
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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
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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.

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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.
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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.
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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.
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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.
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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. 
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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.
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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.
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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
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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.
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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.
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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.
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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.
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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
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