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

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

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

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

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

Over the past decade, China has implemented reforms designed to expand access to health care in rural areas. Little objective evidence exists, however, on the quality of that care. This paper reports results from a standardized patient study designed to assess the quality of care delivered by village clinicians in rural China. To measure quality, we recruited individuals from the local community to serve as undercover patients and trained them to present consistent symptoms of two common illnesses (dysentery and angina). Based on 82 covert interactions between the standardized patients and local clinicians, we find that the quality of care is low as measured by adherence to clinical checklists and the rates of correct diagnoses and treatments. Further analysis suggests that quality is most strongly correlated with provider qualifications. Our results highlight the need for policy action to address the low quality of care delivered by grassroots providers. 

This paper contributes to the assessment of China’s rural labor markets. According to our data, the increase in off-farm employment that China experienced during the 1980s and 1990s continued during the 2000s. Our analysis shows that migration has become the most prevalent off-farm activity, although the destination of migrants is shifting from outside of one’s province to destinations closer to home. The present paper finds that large shares of male and female individuals, especially those under 40 years, are working off the farm. These findings represent an important contribution to the labor economics field. First, the results of the present paper reveal that the labor transition from the agricultural sector to the non-agricultural sector for key segments of China’s rural labor force is nearly complete. Second, although a large share of China’s rural labor force work in agriculture, most of these workers are older men and women (and likely would not be willing to take low-wage, labor-intensive jobs). Third, the rising unskilled wage rate in China is partially a result of the tightening of the labor force in the young age cohorts. Finally, due to factors associated with the one child policy and other demographic transition forces, successive age cohorts will continue to fall in absolute number in the coming decade. Assuming China’s growth continues, we expect to see further wage increases since it will take higher wages to coax more workers to work off the farm.

Despite their recent deterioration, village clinics have historically been an important source of health care for the poor and elderly in rural China. In this paper, we examine the current role of village clinics, the patients who use them and some of the services they provide. We focus specifically on the role of village clinics in meeting the health-care needs of the rural poor and elderly. We find that although clinics are continuing to decline financially, they remain a source of care for the rural elderly and poor. We estimate that the elderly are 10–15 percent more likely than young individuals to seek care at a clinic. We show that clinics provide many unique services to support the rural elderly (and the elderly poor), such asin-home patient care, the option for patients to pay on credit, and free and discounted services.

Drawing on a survey of 106 secondary vocational schools and 7309 students in two provinces of China, this descriptive paper assesses whether vocational schooling is measuring up to government benchmarks for quality and whether poor students are able to access quality schools. We find that secondary vocational schools have met government benchmarks for teacher qualification and training, student opportunities for practical training and adequate facilities. Furthermore, poor students access schools of similar quality to non-poor students, even though 34 percent of poor students do not receive financial aid. We conclude that recent policies are successfully ensuring secondary vocational school quality and equity of access to school quality between poor and non-poor students. However, financial aid policies should be re-examined, such that poor students receive sufficient coverage. Moreover, given that input-based measures only proxy school quality, the government should consider holding schools accountable for outcomes such as student learning.

This paper reports on a survey conducted among more than 800 engineering students at elite universities in China and the United States. Results from the survey reveal that US and Chinese students are roughly equivalent in their desire to form or join startup ventures. Far more US students, however, plan on actually doing so. In contrast, Chinese students are more likely to join the state/government sector. Our results also reveal a wide gap in perceptions on the availability of financing, mentorship and other innovation resources. The findings suggest that the innovation ecosystem in China remains underdeveloped in certain important respects.

Past studies find that disadvantaged students in the United States are often misinformed about college costs and financial aid opportunities and thus may make sub-optimal decisions regarding college. This information problem may be even more serious in developing countries. We therefore conducted a cluster-randomized controlled trial to examine the effects of providing information on college costs and financial aid to high school students in poor regions of northwest China. We find that information increases the likelihood that students receive some types of financial aid. Information also positively affects the choice to attend college but does not seem to affect more specific college choices.

Despite increasing institutional and financial support, certain public health issues are still neglected by the Chinese Government. The present paper examines the soil-transmitted helminth (STH) infection and reinfection rates by conducting a survey on 1724 children in Guizhou Province, China. Our results indicate that 37.5 percent of children had been infected with one or more of the three types of tested STH. However, only 50.4 percent of children reported having taken deworming medicine during the 18-month period before the survey. Of those who reported being dewormed, 34.6 percent tested positive for STH infections. Poverty and number of siblings are significantly and positively correlated with infection and reinfection, and parental education is significantly and negatively correlated with infection and reinfection. Given the ineffectiveness of treatment in these areas to date, for anthelminthic campaigns to actually succeed, China must pay more attention to locallevel incentives to improve children’s health.