In this paper we report the results of a randomized controlled trial designed to measure the impact of a parental training program on the nutritional status of primary school students in rural Shaanxi Province, in Northwest China. Using hemoglobin (Hb) levels as the outcome variable, we first measure the overall impact of a nutritional training program, then measure the impact separately by gender. We use both descriptive and multivariate analyses.

The results for the descriptive and econometric results were robust and consistent with the literature. Overall, we find no impact on students’ Hb levels when we trained their parents about undernutrition and anemia. In both the descriptive and multivariate results, there was no difference in the change of Hb levels between control and treatment students. Parents in the treatment group did learn more about anemia than parents in the control group, but this increased knowledge did not lead to sharp changes in behavior, in general. We did find, however, that there was a measurable impact of parental training on the Hb levels of female students. In both the descriptive and econometric results we found that the Hb levels of female students rose more than that of male students, and that this difference was statistically significant. We conjecture that the parents of female students may have recognized from the training that they were not providing their daughters with sufficient nutrition. Our data show that parents in the treatment group responded by increasing the daily provision of meat, fish, eggs and beans, relative to parents of girls in the control group.

Recent anecdotal reports suggest that dropout rates may be higher and actually increasing over time in poor rural areas. There are many reasons not to be surprised that there is a dropout problem, given the fact that China has a high level of poverty among the rural population, a highly competitive education system and rapidly increasing wages for unskilled workers. The overall goal of this study is to examine if there is a dropout problem in rural China and to explore the effectiveness that a Conditional Cash Transfer (CCT) program could have on dropouts (and mechanism by which the CCT might affect drop outs). To meet this objective, we conducted a randomized controlled trial (RCT) of a CCT using a sample of 300 junior high school students in a nationally-designated poor county in Northwest China. Using our data, we found that the annual dropout rate in the study county was high, about 7%. We find, however, that a CCT program reduces drop outs by 60%; the dropout rate is 13.3%  in the control group and 5.3 % in the treatment group. The program is most effective in the case of girls, younger students and the poorest performing students. 

China's central government incrementally introduced various kinds of student financial aid since the late 1990s in response to public concerns about the rising burden of college prices. Despite the marked increase in financial assistance from governmental as well as non-governmental sources in recent years especially, little is known about how well aid is currently distributed across Chinese universities and whether it is successfully reaching needy students.

We use a unique randomly-sampled dataset of all local senior college students in one northwest province and a combination of non-parametric, semi-parametric and fixed effects methods to examine how various types of financial aid are currently distributed to students of different backgrounds across the university system. We also evaluate whether aid is reaching the main target population of low-income students. We primarily find that government-financed aid is allocated evenly across universities of varying selectivity and is reaching its target population of low-income students within universities. By contrast, university- and society-financed aid is not reaching low-income students. In addition, students in the most selective universities receive large implicit subsidies as they have high instructional costs, get more aid, and pay low tuition fees. Finally, a significant proportion of disadvantaged students do not seem to receive any type of aid.

Background: To study how misaligned supply-side incentives impede health programs in developing countries, we tested the impact of performance pay for anemia reduction in rural China. To the best of our knowledge, our study is the first to evaluate performance pay for actual health improvement.

Methods: We conducted a cluster randomised trial of information, subsidies, and incentives for school principals to reduce anemia among fourth and fifth grade students in 72 randomly-selected rural primary schools across northwest China. Our experiment included a control and three treatment arms: (1) an information arm in which principals received education about anemia; (2) a subsidy arm in which principals received information and unconditional subsidies; and (3) an incentive arm in which principals received information, subsidies, and financial incentives for reducing anemia among students. Students, parents, nursing teams, and survey enumerators were blind to arm assignment. Primary outcomes were student hemoglobin concentrations; secondary outcomes were behavioral responses to the interventions.

Findings: Mean student haemoglobin concentration rose by 1.5 g/L (95% CI –1.1 to 4.1) in information schools, 0.8 g/L (–1.8 to 3.3) in subsidy schools, and 2.4 g/L (0 to 4.9) in incentive schools compared with the control group. This increase in haemoglobin corresponded to a reduction in prevalence of anaemia (Hb <115 g/L) of 24% in incentive schools. Interactions with pre-existing incentives for principals to achieve good academic performance led to substantially larger gains in the information and incentive arms: when combined with incentives for good academic performance, associated effects on student haemoglobin concentration were 9.8 g/L (4.1 to 15.5) larger in information schools and 8.6 g/L (2.1 to 15.1) larger in incentive schools.

Interpretation: Financial incentives for health improvement were modestly effective. Understanding interactions with other motives and pre-existing incentives is critical.

Despite both requirements of and support for universal education up to grade 9, there are concerning reports that China is still suffering from high and maybe even rising dropout rates in some poor rural areas. Unfortunately, besides aggregated statistics from the Ministry of Education (which show almost universal compliance with the nine year compulsory education law), there is little independent, survey-based evidence on the nature of dropout in China. Between 2009 and 2010 we surveyed over 7,800 grade 7, 8, and 9 students from 46 randomly selected junior high schools in four counties in two provinces in North and Northwest China to measure the dropout rate. We also used the survey data to examine the factors that are correlated with dropping out, such as the opportunity cost of going to school, household poverty, and poor academic performance. According to the study’s findings, dropout rates between grade 7 and grade 8 reached 5.7 percent; dropout rates between grade 8 and grade 9 reached 9.0 percent. This means of the total number of students that matriculated into junior high school (those who were attending school during the first month of the first term of grade 7), 14.2 percent had left school by the first month of grade 9. Dropout rates were even higher for students that were older, from poorer families (and families in which the parents were not healthy), or were performing more poorly academically. We conclude that although the government’s policy of reducing tuition and fees for junior high students may be necessary, it is not sufficient to solve the dropout problem.

Background. Despite growing wealth and a strengthening commitment from the government to provide quality education, a significant share of students across rural China still have inadequate access to micronutrient-rich regular diets. Such poor diets can lead to nutritional problems, such as iron-deficiency anemia, that can adversely affect attention and learning in school.

Objective. The overall goal of this paper is to test whether simple nutritional interventions lower rates of anemia and to assess whether this leads to improved educational performance among students in poor areas of rural China.

Approach: We report on the results of a randomized control trial (RCT) involving over 3600 fourth grade students, mostly aged 9 to 12, from 66 randomly-chosen elementary schools in 8 of the poorest counties in Shaanxi Province in China’s poor northwest region. The design called for random assignment of schools to one of three groups: two different types of treatment/intervention schools; a non-intervention, control group. The two interventions were designed to improve hemoglobin (Hb) levels, which is a measure of iron deficiency. One intervention provided a daily multivitamin with mineral supplements, including 5 milligrams of iron, for 5 months. The other informed the parents of their child’s anemia status and suggested several courses of action (henceforth, the information treatment).

Findings: Some 38.3 percent of the students had Hb levels of below 120 g/L, the World Health Organization’s cutoff for anemia for children 9 to 12 years old. In the schools that received the multivitamins with mineral supplements, Hb levels rose by more than 2 g/L (about 0.2 standard deviations). The standardized math test scores of the students in the schools that received the multivitamin with mineral supplements also improved significantly. In schools that received the information treatment, only students that lived at home (and not the students that lived in boarding schools and took most of their meals at schools) registered positive improvements in their Hb levels. The reductions in anemia rates and improvements in test scores were greater for students that were anemic at the beginning of the study period. Overall, these results should encourage China’s Ministry of Education (MOE) to begin to widen its view of education (beyond teachers, facilities and curriculum) and provide better nutrition and health care for students.

The education of disadvantaged populations has been a long-standing challenge to the education system in both developed and developing countries. Although computer-assisted learning (CAL) has been considered one alternative to improve learning outcomes in a cost-effective way, the empirical evidence of its impacts on improving learning outcomes is mixed. This paper uses a cluster randomized field experiment in 57 schools (26 schools were part of the CAL program; 31 control schools were not) to explore the effects of the CAL program on student academic and non-cognitive outcomes for students in public schools in minority rural areas in China. Our results show that a remedial, game-based CAL program that focused on teaching Chinese (held out of regular school hours) improved the standardized Chinese scores of the students in the treatment schools by 0.14-0.19 standard deviations more than those in the control schools. Moreover, CAL also had significant spillover effects on student standardized math test scores. Still further, our results also show insignificant positive effects of CAL intervention on student non-academic outcomes of interest in studying and metacognition, and significant positive effect on student self-efficacy of Chinese studying. In general, low-performing students benefited more from the program. The CAL intervention also had mixed effects on the non-academic outcomes of students from different ethnic minority groups. 

China’s New Cooperative Medical Scheme, launched in 2003, was designed to protect rural households from the financial risk posed by health care costs and to increase the use of health care services. This article reports on findings from a longitudinal study of how the program affected the use of health care services, out-of-pocket spending on medical care, and the operations and financial viability of China’s township health centers, which constitute a middle tier of care in between village clinics and county hospitals. We found that between 2005 and 2008 the program provided some risk protection and increased the intensity of inpatient care at township health centers. Importantly, the program appears to have improved the centers’ financial status. At the same time, the program did not increase the overall number of patients served or the likelihood that a sick person would seek care at a township center. These findings serve as a benchmark of the program’s early impact. The results also suggest that the composition of health care use in China has changed, with people increasingly seeking outpatient care at village clinics and inpatient care at township health centers.