REAP Publications

Studies have shown that nearly half of rural toddlers in China have cognitive delays due to an absence of stimulating parenting practices, such as early childhood reading, during the critical first three years of life. However, few studies have examined the reasons behind these low levels of stimulating parenting, and no studies have sought to identify the factors that limit caregivers from providing effective early childhood reading practices (EECRP). This mixed-methods study investigates the perceptions, prevalence, and correlates of EECRP in rural China, as well as associations with child cognitive development. We use quantitative survey results from 1748 caregiver–child dyads across 100 rural villages/townships in northwestern China and field observation and interview data with 60 caregivers from these same sites. The quantitative results show significantly low rates of EECRP despite positive perceptions of early reading and positive associations between EECRP and cognitive development. The qualitative results suggest that low rates of EECRP in rural China are not due to the inability to access books, financial or time constraints, or the absence of aspirations. Rather, the low rate of book ownership and absence of reading to young children is driven by the insufficient and inaccurate knowledge of EECRP among caregivers, which leads to their delayed, misinformed reading decisions with their young children, ultimately contributing to developmental delays.

Background: China issued strict nationwide guidelines to combat the COVID-19 outbreak in January 2020 and gradually loosened the restrictions on movement in early March. Little is known about how these disease control measures affected the 600 million people who live in rural China. The goal of this paper is to document the quarantine measures implemented in rural China outside the epicenter of Hubei Province and to assess the socioeconomic effect of the measures on rural communities over time. Methods: We conducted three rounds of interviews with informants from 726 villages in seven provinces, accounting for over 25% of China’s overall rural population. The survey collected data on rural quarantine implementation; COVID-19 infections and deaths in the survey villages; and effects of the quarantine on employment, income, education, health care, and government policies to address any negative impacts. The empirical findings of the work established that strict quarantine measures were implemented in rural villages throughout China in February. Results: There was little spread of COVID-19 in rural communities: an infection rate of 0.001% and zero deaths reported in our sample. However, there were negative social and economic outcomes, including high rates of unemployment, falling household income, rising prices, and disrupted student learning. Health care was generally accessible, but many delayed their non-COVID-19 health care due to the quarantine measures. Only 20% of villagers received any form of local government aid, and only 11% of villages received financial subsidies. There were no reports of national government aid programs that targeted rural villagers in the sample areas. Conclusions: By examining the economic and social effects of the COVID-19 restrictions in rural communities, this study will help to guide other middle- and low-income countries in their containment and restorative processes. Without consideration for economically vulnerable populations, economic hardships and poverty will likely continue to have a negative impact on the most susceptible communities.

Promoting an educated labor force is critical for emerging economies. Educational achievement, in turn, depends heavily on general cognitive abilities as well as non-cognitive skills, such as grit. Current research, however, has not examined how cognition and grit may explain the academic performance of students in an economically disadvantaged context. Thus, this study examines how IQ and grit contribute to academic achievement gains for students in poor areas of rural China. Drawing on data from 2931 students in rural China, we measure general cognitive ability, using the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) and Raven’s Standard Progressive Matrices (Raven IQ); non-cognitive ability, using the Short Grit Scale; and academic achievement, using a curricular-based mathematics exam. We find that IQ and grit each predict achievement gains for the average student. Grit is not positively associated with achievement gains among low-IQ students, however, suggesting that grit does not translate into academic achievement gains for students with delays in general cognitive ability.

Little attention has been paid to the role that low levels of cognitive development (or IQ) play among both left-behind children (LBCs) and children living with parents (CLPs) in the context of poor educational attainment in rural China. In this paper, we examine how general cognitive abilities contribute to the academic achievement gains of both LBCs and CLPs in poor areas of rural China. We measure the general cognitive ability of the 4,780 sample students using the Raven’s Standard Progressive Matrices (Raven IQ) and assess academic achievement using a curriculum-based mathematics exam. We find that IQ and left-behind status predict achievement gains for the average student. Among low-IQ students, however, left-behind status does not correlate with a change in achievement, suggesting that the migration of parents does not immediately/automatically translate into a loss of academic achievement for students with delays in their general cognitive ability.

In Taiwan, thousands of students from Yuanzhumin (aboriginal) families lag far behind their Han counterparts in academic achievement. When they fall behind, they often have no way to catch up. There is increased interest among both educators and policymakers in helping underperforming students catch up using computer-assisted learning (CAL). The objective of this paper is to examine the impact of an intervention aimed at raising the academic performance of students using an in-home CAL program. According to intention-to-treat estimates, in-home CAL improved the overall math scores of students in the treatment group relative to the control group by 0.08 to 0.20 standard deviations (depending on whether the treatment was for one or two semesters). Furthermore, Average Treatment Effect on the Treated analysis was used for solving the compliance problem in our experiment, showing that in-home CAL raised academic performance by 0.36 standard deviations among compliers. This study thus presents preliminary evidence that an in-home CAL program has the potential to boost the learning outcomes of disadvantaged students.

Policymakers in developing countries have prioritized the mass expansion of vocational education and training (VET). Evidence suggests, however, that the quality of VET can be poor. One possible reason given by policymakers for this is a lack of resources per student. The goal of this study is to examine whether the quality of VET in developing countries increases by investing greater resources per student. To achieve this goal, we examine the impacts of attending model schools (which have far more resources per student) compared with non-model schools (which have fewer resources) on a range of student cognitive, non-cognitive, and behavioral outcomes. Using representative data from a survey of approximately 12,000 VET students from China, multivariate regression and propensity score matching analyses show that there are no significant benefits, in terms of student outcomes, from attending model vocational high schools, despite their substantially greater resources.

早期阅读能力的健康发展有利于提高小学生的学业成绩并改善其长期教育表现。本研究从 学校和教师的角度探究我国农村小学阅读教学现状，为促进农村学生早期阅读发展奠定基础。基于贵 州、江西150 所农村小学调查数据，通过国际比较发现，现阶段我国农村小学阅读教学仍存在教师学历 水平相对较低、阅读培训时间较短、阅读教学基础教材单一、学校培养学生阅读技能时间较晚等不足。 回归结果发现，农村小学阅读教学与学生阅读成绩存在显著正相关关系；教师学历与其参加阅读培训时 长对农村小学生阅读成绩的提高尤为重要。学校应加强教师阅读培训的力度，丰富阅读教学资源，优化 学校阅读环境。

Background:  The Baby-Friendly Hospital Initiative is generally considered an effective way to promote breastfeeding. Although China has the largest number of baby-friendly hospitals in the world, research on baby-friendly practices in China is limited, and the rate of exclusive breastfeeding (EBF) at 6 months, 20.7%, compared to the 2025 global goal of 50% is low. It is, therefore, important to determine the factors that remain significant barriers to EBF in China. To explore how the key baby-friendly practices affect EBF duration in China, we used a case-control study to compare the effects of baby-friendly-related practices on both EBF and non-breastfeeding (NBF) mothers at 3 months and to investigate the effects of both single and comprehensive baby-friendly practices in promoting EBF duration at 3 months, which is one step toward EBF at 6 months. Methods:  Participants were recruited from four maternal and child health hospitals in western (Chongqing), eastern (Qingdao), southern (Liuzhou), and central China (Maanshan). A total of 421 mothers (245 in the EBF group, 176 in the NBF group) of infants aged 3 months were surveyed through a self-reported questionnaire from April 2018 to March 2019. The experience of baby-friendly practices and breastfeeding during hospitalization were assessed with yes/no questions. Socio-demographic factors that influenced breastfeeding at 3 months were analyzed using bivariate and multivariate logistic regression analyses. Results:  Of mothers in the EBF group, 65.57% reported engaging in at least seven baby-friendly practices compared to 47.72% of mothers in the NBF group. Significantly more mothers in the EBF group engaged in baby-friendly practices than in the NBF group. These practices included “breastfeeding within one hour after birth” (74.29% vs. 59.09%), “breastfeeding on demand” (86.48% vs. 75.00%), and “never use a pacifier” (46.53% vs. 31.25%). After adjusting for confounding variables, we found that the mothers who engaged in fewer than seven baby-friendly practices were about 1.7 times less likely to breastfeed than were those who engaged in seven or more baby-friendly practices (odds ratio [OR] 1.720, 95% confidence interval [CI] 1.106, 2.667). Further, the mothers who did not breastfeed on demand were as likely to not breastfeed up to 3 months (OR 2.263, 95% CI 1.265, 4.049), as were mothers who did not breastfeed during hospitalization (OR 4.379, 95% CI 1.815, 10.563). Conclusions:  These data from hospitals in China suggest that higher compliance with baby-friendly practices may have a positive impact on EBF at 3 months, particularly in terms of promoting the implementation of breastfeeding on demand and breastfeeding during hospitalization in China.

We examine the effects of computer-based versus paper-based assessment of critical thinking skills, adapted from English (in the U.S.) to Chinese. Using data collected based on a random assignment between the two modes in multiple Chinese colleges, we investigate mode effects from multiple perspectives: mean scores, measurement precision, item functioning (i.e. item difficulty and discrimination), response behavior (i.e. test completion and item omission), and user perceptions. Our findings shed light on assessment and item properties that could be the sources of mode effects. At the test level, we find that the computer-based test is more difficult and more speeded than the paper-based test. We speculate that these differences are attributable to the test’s structure, its high demands on reading, and test-taking flexibility afforded under the paper testing mode. Item-level evaluation allows us to identify item characteristics that are prone to mode effects, including targeted cognitive skill, response type, and the amount of adaptation between modes. Implications for test design are discussed, and actionable design suggestions are offered with the goal of minimizing mode effect.

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.

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

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.

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.

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.

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.

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.

The wide-scale global movement of school education to remote instruction due to Covid-19 is unprecedented. The use of educational technology (EdTech) offers an alternative to in-person learning and reinforces social distancing, but there is limited evidence on whether and how EdTech affects academic outcomes. Recently, we conducted two large-scale randomized experiments, involving ~10,000 primary school students in China and Russia, to evaluate the effectiveness of EdTech as a substitute for traditional schooling. In China, we examined whether EdTech improves academic outcomes relative to paper-and-pencil workbook exercises of identical content. We found that EdTech was a perfect substitute for traditional learning. In Russia, we further explored how much EdTech can substitute for traditional learning. We found that EdTech substitutes only to a limited extent. The findings from these large-scale trials indicate that we need to be careful about using EdTech as a full-scale substitute for the traditional instruction received by schoolchildren. The wide-scale global movement of school education to remote instruction due to Covid-19 is unprecedented. The use of educational technology (EdTech) offers an alternative to in-person learning and reinforces social distancing, but there is limited evidence on whether and how EdTech affects academic outcomes, and that limited evidence is mixed.1,2 For example, previous studies examine performance of students in online courses and generally find that they do not perform as well as in traditional courses. On the other hand, recent large-scale evaluations of supplemental computer-assisted learning programs show large positive effects on test scores. One concern, however, is that EdTech is often evaluated as a supplemental after-school program instead of as a direct substitute for traditional learning. Supplemental programs inherently have an advantage in that provide more time learning material. Recently, we conducted two large-scale randomized experiments, involving ~10,000 primary school students in China and Russia, to evaluate the effectiveness of EdTech as a substitute for traditional schooling.3,4 In both, we focused on whether and how EdTech can substitute for in-person instruction (being careful to control for time on task). In China, we examined whether EdTech improves academic outcomes relative to paper-and-pencil workbook exercises of identical content. We followed students ages 9–13 for several months over the academic year. When we examined the impacts of each supplemental program we found that EdTech and workbook exercise sessions of equal time and content outside of school hours had the same effect on standardized math test scores and grades in math classes. As such, EdTech appeared to be a perfect substitute for traditional learning. In Russia, we built on these findings by further exploring how much EdTech can substitute for traditional learning. We examined whether providing students ages 9–11 with no EdTech, a base level of EdTech (~45 min per week), and a doubling of that level of EdTech can improve standardized test scores and grades. We found that EdTech can substitute for traditional learning only to a limited extent. There is a diminishing marginal rate of substitution for traditional learning from doubling the amount of EdTech use (that is, when we double the amount of EdTech used we do not find that test scores performance doubles). We find that additional time on EdTech even decreases schoolchildren’s motivation and engagement in subject material. The findings from the large-scale trials indicate that we need to be careful about using EdTech as a full-scale substitute for the traditional instruction received by schoolchildren. There are two general takeaways: First, to a certain extent, EdTech can successfully substitute for traditional learning. Second, there are limits on how much EdTech may be beneficial. Admittedly, we need to be careful about extrapolating from the smaller amount of technology substitution in our experiments to the full-scale substitution in the face of the coronavirus pandemic. However, these studies may offer important lessons. For example, a balanced approach to learning in which schoolchildren intermingle work on electronic devices and work with traditional materials might be optimal. Schools could mail workbooks to students or recommend that students print out exercises to break up the amount of continuous time schoolchildren spend on devices. This might keep students engaged throughout the day and avoid problems associated with removing the structure of classroom schedules. Schools and families can devise creative remote learning solutions that include a combination of EdTech and more traditional forms of learning. Activities such as reading books, running at-home experiments, and art projects can also be used to break up extensive use of technology in remote instruction.

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.