Summary
Key findings
- Tanzania’s 2004 malaria eradication programme raised lower-secondary exam performance by 5.8% (≈0.14 SD); girls gained slightly more (6.6%) than boys (5.4%).
- Gains were larger in arts and business subjects (7.4%) than in STEM subjects (5.8%).
- Children born after the programme began gained about 2.4 additional years of schooling; those already of preschool or primary-school age gained 0.58 years.
- Recommends building malaria prevention (bed nets, prenatal care, the School Net Programme) into school-improvement plans, focused on pregnancy to age five.
Methodology & context
- Uses National Examinations Council of Tanzania records of Form IV (lower secondary) exam results for 2003–2010 (about 1.24 million students) and the 2004 and 2022 Demographic and Health Surveys for years of schooling.
- Difference-in-differences comparing high-malaria (below 1,700 metres altitude) and low-malaria (above 1,700 metres) areas before and after the 2004 programme.
- The exam data lack students’ migration histories and have only one pre-programme year, so parallel trends can be checked only graphically; results are similar when the sample is restricted to public schools.
Summary drafted with AI from the AFEP working paper and policy brief, and checked against them. See the full study for details.
Abstract
Improving educational outcomes, particularly test scores, has become increasingly important in light of the persistent learning crisis that has been observed among students in low-income countries. Given the strong link that exists between health and education, public health interventions may offer an avenue to enhance academic performance by improving cognitive development and school participation through disease eradication. This study utilizes exogenous variation in malaria prevalence and the 2004 national malaria eradication intervention in Tanzania to assess the impact reduced malaria exposure has on academic achievement and educational attainment. It relies on administrative data on lower secondary school performance from the National Examinations Council of Tanzania, Demographic and Health Survey results, and a difference-in-differences strategy, and finds that reduced exposure to malaria increased test scores by 0.14 standard deviations, which is equivalent to 5.8% of the mean score. Effects varied by subject: test scores increased by approximately 5.8% in STEM subjects and 7.4% in arts and business subjects. We also find that the malaria eradication intervention led to an increase of 2.4 years of education for individuals born after the policy was implemented and 0.58 years for individuals who were preschoolers or school-aged in 2004. These findings suggest that integrated health interventions can yield substantial returns in terms of educational outcomes in Tanzania and across Sub-Saharan Africa.