The impact of a participatory intervention to improve learning outcomes and reduce school-based discrimination and community stigma in primary rural schools of Afghanistan: A cluster control randomized trial

Measuring Gender Equality in Education: Lessons from Trends in 43 Countries

PROTOCOL: The effects of K‐12 school enrollment interventions in developing nations

The existence of stigma in the community that farming is dirty, unprestigious, and poor has contributed to the decreasing number of young generation to enter agricultural sector. Hence, reducing the effect of this stigma requires such a systematical, structured, and sustainable effort in the form of campaign which shows the advances in agricultural sector, the success of agricultural entrepreneurs and provides programs of massive development in the community, particularly those living in rural area. A study related to the stigma has been conducted in Cikedung Subdistrict, that is one of wetland rice production centers in Indramayu Regency. The aims of this study were to: (1) Describe the extent of community stigma concerning the unpromising farming sector in Cikedung Subdistrict, (2) Analyze factors affecting community stigma where agriculture cannot provide a promising future and improve welfare in farming business conducted in Cikedung Subdistrict, (3) Formulate the strategy to eliminate negative stigma of rural community on eudaimonic well-being. A total of 215 out of 1,195 wetland rice farmers were selected as research sample by following the formula Harry King. Data collection was done through direct interview using closed-ended that was previously tested for its validity and reliability. Data were analyzed through two methods, namely; descriptive to explain the community stigma about farming sector, and multi-linear regression to investigate factors affecting eudaimonic well-being. Results of study indicated that: 1) respondents were majorly (75%) of quite old (43 years old) and elderly (73 years old), most of them (54.6%) attended Primary School for 5-7 years, and in majority (52.9%) had a long farming experience of above 25 years; 2) factors significantly affected (p<0.005) eudaimonic well-being included: individual characteristics, economic source, capacity, economic condition, commodity farmed, income contribution, and bargaining power.

Background: Children are the most vulnerable and easily influence able part of society and thus when subjected to health education the knowledge they gain and the practices they develop are more likely to stay with them throughout their life hence the study was done to assess the impact of health education among school students.Methods: Educational intervention study was carried out in three primary schools in Hoskote, rural Bangalore among 9-11 years school children. Initial survey was done to assess the KAP levels in 9 to 11 years old school children regarding prevention of common childhood disease and intervention was done using an interactive story board to provide health education and impact of intervention was assessed.Results: The study comprised of 200 students (112 boys and 88 girls). It was found that overall general knowledge and attitude regarding prevention of common childhood diseases was poor among the study participants. Following educational sessions using interactive story board (edutainment) a significant improvement was observed in knowledge and attitude of the students as detected by improved correct response rates.Conclusions: Interactive story board was successful in providing educational intervention in 9 to 11 year old school children which may help to prevent common avoidable childhood diseases.

BackgroundWater, sanitation, and hygiene (WASH) in schools is promoted by development agencies as a modality to improve school attendance by reducing illness. Despite biological plausibility, the few rigorous studies that have assessed the effect of WASH in schools (WinS) interventions on pupil health and school attendance have reported mixed impacts. We evaluated the impact of the Laos Basic Education, Water, Sanitation and Hygiene Programme – a comprehensive WinS project implemented by UNICEF Lao People’s Democratic Republic (Lao PDR) in 492 primary schools nationwide between 2013 and 2017 – on pupil education and health.MethodsFrom 2014-2017, we conducted a cluster-randomized trial among 100 randomly selected primary schools lacking functional WASH facilities in Saravane Province, Lao PDR. Schools were randomly assigned to either the intervention (n = 50) or comparison (n = 50) arm. Intervention schools received a school water supply, sanitation facilities, handwashing facilities, drinking water filters, and behavior change education and promotion. Comparison schools received the intervention after research activities ended. At unannounced visits every six to eight weeks, enumerators recorded pupils’ roll-call absence, enrollment, attrition, progression to the next grade, and reported illness (diarrhea, respiratory infection, conjunctivitis), and conducted structured observations to measure intervention fidelity and adherence. Stool samples were collected annually prior to de-worming and analyzed for soil-transmitted helminth (STH) infection. In addition to our primary intention-to-treat analysis, we conducted secondary analyses to quantify the role of intervention fidelity and adherence on project impacts.ResultsWe found no impact of the WinS intervention on any primary (pupil absence) or secondary (enrollment, dropout, grade progression, diarrhea, respiratory infection, conjunctivitis, STH infection) impacts. Even among schools with the highest levels of fidelity and adherence, impact of the intervention on absence and health was minimal.ConclusionsWhile WinS may create an important enabling environment, WinS interventions alone and as currently delivered may not be sufficient to independently impact pupil education and health. Our results are consistent with other recent evaluations of WinS projects showing limited or mixed effects of WinS.

The one-child policy implemented by governments in China since 1971 and the large-scale migration of people from the countryside to cities since the 1980s have led to a natural reduction in number and space flow of school-aged children in the countryside. This has compelled education departments to promote a larger scale of rural school closure and consolidation. Closure and consolidation of rural primary and middle schools in China exhibit the following macro features. First, the scale of rural school closure and consolidation was the largest in the first 10 years of the twenty-first century (or 2000–2010). From 1976 to 2016, approximately 946,100 compulsory schools including primary and middle schools disappeared. A total of 386,500 schools among them were shut down between 2000 and 2016, accounting for 41% of the total number of schools that disappeared in the past 40 years. On average, approximately 66 schools disappeared every day. Moreover, from 2000 to 2010, the decrease in the number of schools was the highest (about 304,100 schools), and approximately 83 schools were closed every day on average. Second, school consolidation has primarily occurred in rural areas since 2000. A total of 357,000 compulsory schools that disappeared after 2000 were rural schools, accounting for 92.36% of the total number (about 386,500 schools). Approximately 61 compulsory schools in the countryside were shut down every day. Third, rural primary schools were the main target of school consolidation. A total of 333,900 primary schools in rural areas were closed, accounting for 93.53% of the total decreasing number of rural schools (about 357,000) and 86.39% of the total decreasing number of schools in urban and rural areas. Why did rural schools disappear rapidly after 2000? What is the development trend? What are the standards for rural school closure and consolidation in China? These are the research questions to be addressed in the chapter.

Imparting nutrition education in schools is an effective tool for inculcating healthy eating behavior in early childhood, which will bestow lifelong positive health implications. Ignorance, illiteracy, lack of nutrition knowledge, and inappropriate nutritional practices and dietary traditions influence the nutritional status of children. This study assesses the existing knowledge, attitude, and practices prevalent amongst the school children (6-14 years) in the consumption of whole grains and examines the impact of nutritional intervention on them. 22% of participants were from primary school in the age group of 6-10 years, and 78% were from middle school between the ages of 11-14 years. Total percentage of girl students was 84% against boys, which was 16%. Nutrition education was imparted to the school children through visual presentation on the importance of consuming whole grains, structure and composition of whole grains, difference between refined and whole grains, food sources, nutritional importance, rich sources of dietary and soluble fibre, besides promoting digestive health and wellness. Self-designed fun nutrition games and food quizzes were employed to engage with the school students. In the pre-assessment survey, the middle school students showed significantly (p≤0.05) higher knowledge than primary school students. Although after implementing the nutrition education program in the post-assessment survey, an increase in knowledge about whole grains was observed both in primary as well as middle school students. However, no significant difference was seen in the knowledge acquisition between male and female students in pre or post-nutrition intervention assessment. The present study showed an incremental rise in the knowledge and attitude of primary and secondary school children in the age group of 6-14 years in all aspects of whole-grain education. Therefore, this intervention showed that in order to bridge the gap of nutrition literacy among school-going children, integrating nutrition education into the school curriculum can be an effective tool for inculcating healthy eating behavior in early childhood.

About 240 million children have disabilities globally. Sustainable Development Goal 4 calls for inclusive and equitable quality education for all, including children with disabilities. Compared to children without disabilities, children with disabilities are more likely to never attend school or to drop out from school due to barriers such as negative attitudes among teachers, parents and peers, lack of trained teachers, inadequate learning materials and inaccessible facilities. Our study examines the effect of a participatory child-centred pedagogy intervention on academic and non-academic learning outcomes of children with disabilities in primary rural schools of Afghanistan and Pakistan. We use an ICF-based disability measure, the Child Functioning Module, to identify children with disabilities. We built a participatory intervention on the ethics of care and the capability approach that aimed at improving the learning process. It did not significantly improve the learning outcomes of children with disabilities compared to non-disabled children. However, we found that children with disabilities overall progressed significantly more than non-disabled children on several learning outcomes while benefiting from a larger reduction in stigma and discrimination. The impact was secured overall for children despite school lockdowns associated with the COVID-19 pandemic and political unrest in both countries. Therefore, we argue that this type of intervention could potentially improve the inclusion of children with disabilities in school with more time for implementation and circumstances allowing schools to stay opened.

Curriculum Design of “National Training Plan” in View of Professional Development

BackgroundIn Nigeria, similar to many leprosy-endemic countries, leprosy is highly stigmatized. High levels of stigma among community members as well as internalized stigma among persons affected by leprosy often result in negative psychosocial consequences for those affected. To break this vicious cycle, it is important to conduct context-specific behavioral change activities. Although written material has been successful in improving knowledge and perception, it is not suitable for populations with low educational levels. Audio-delivered interventions are likely to be more suitable for people who are illiterate. This study proposes to assess the impact of an audio-delivered intervention on the perception (knowledge, attitudes, and beliefs) of community members with regard to leprosy in Nigeria.ObjectiveThis study aims to assess the impact of audio-delivered and written health education on the perception of leprosy. Specific objectives are to (1) investigate the perception (local beliefs, knowledge, and attitudes) of community members toward leprosy and persons affected by leprosy; (2) investigate whether there is a difference in impact on perception between participants who have received audio-delivered health education and those who have received written health education, with specific reference to gender differences and differences between rural and urban areas; and (3) assess the impact of the participatory development of the audio-delivered and written interventions on empowerment and internalized stigma of persons affected by leprosy who developed the interventions. Additionally, we will translate and cross-culturally validate 4 study instruments measuring outcomes in 2 major Nigerian languages.MethodsWe will use a mixed methods, cross-sectional study design for the intervention development and a 3-arm cluster randomized controlled trial for its implementation and evaluation, comprising (1) baseline assessments of knowledge, attitudes, perceptions, and fears of community members, to develop the audio-delivered content and written material, and the self-esteem and internalized stigma of persons affected by leprosy; and (2) participatory development of the audio-delivered content and written material by persons affected by leprosy and the pilot and implementation of the interventions. This will be done among different groups (selected using cluster randomization) that will be compared (control group, audio-intervention group, and written material group) to evaluate the intervention and the impact of developing the intervention on the persons affected.ResultsThis study was funded in June 2022, and community member participant recruitment started in January 2023. Baseline data collection was completed by May 2023 (n=811). Participatory cocreation of the audio and written health education content began in July 2023, and the materials are currently under development. Study results are expected in September 2024.ConclusionsStudy findings will contribute to developing evidence-based, context-specific behavioral change interventions, which are critical to addressing stigma in many leprosy-endemic communities where leprosy is highly stigmatized, and contribute toward global triple zero leprosy efforts.Trial RegistrationPan African Clinical Trial Registry PACTR202205543939385; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=23667International Registered Report Identifier (IRRID)DERR1-10.2196/53130

BackgroundStigma and discrimination towards people with mental health conditions by their communities are common worldwide. This can result in a range of negative outcomes for affected persons, including poor access to health care. However, evidence is still patchy from low- and middle-income countries (LMICs) on affordable, community-based interventions to reduce mental health-related stigma and to improve access to mental health care.MethodsThis study aims to conduct a feasibility (proof-of-principle) pilot study that involves developing, implementing and evaluating a community-based, multi-component, awareness-raising intervention (titled Indigo-Local), designed to reduce stigma and discrimination and to increase referrals of people with mental health conditions for assessment and treatment. It is being piloted in seven sites in five LMICs—China, Ethiopia, India, Nepal and Tunisia—and includes several key components: a stakeholder group workshop; a stepped training programme (using a ‘Training of Trainers’ approach) of community health workers (or similar cadres of workers) and service users that includes repeated supervision and booster sessions; community engagement activities; and a media campaign. Social contact and service user involvement are instrumental to all components. The intervention is being evaluated through a mixed-methods pre-post study design that involves quantitative assessment of stigma outcomes measuring knowledge, attitudes and (discriminatory) behaviour; quantitative evaluation of mental health service utilization rates (optional, where feasible in sites); qualitative exploration of the potential effectiveness and impact of the Indigo-Local intervention; a process evaluation; implementation evaluation; and an evaluation of implementation costs.DiscussionThe output of this study will be a contextually adapted, evidence-based intervention to reduce mental health-related stigma in local communities in five LMICs to achieve improved access to healthcare. We will have replicable models of how to involve people with lived experience as an integral part of the intervention and will produce knowledge of how intervention content and implementation strategies vary across settings. The intervention and its delivery will be refined to be feasible and ready for larger-scale implementation and evaluation. This study thereby has the potential to make an important contribution to the evidence base on what works to reduce mental health-related stigma and discrimination and improve access to health care.

Single interventions for helminthic infections and micronutrient deficiencies are effective, but it is not clear whether combined interventions will provide equal, additive or synergistic effects to improve children's health. The study objective was to determine the impact of single and combined interventions on nutritional status and scholastic and cognitive performance of school children. A double-blind, randomized, placebo-controlled trial in 11 rural South African primary school randomly allocated 579 children aged between 8 and 10 years into six study groups, half of whom received antihelminthic treatment at baseline. The de-wormed and non-de-wormed arms were further divided into three groups and given biscuits, either unfortified or fortified with vitamin A and iron or with vitamin A only, given daily for 16 weeks. The outcome measures were anthropometric, micronutrient and parasite status, and scholastic and cognitive test scores. There was a significant treatment effect of vitamin A on serum retinol (p < 0.01), and the suggestion of an additive effect between vitamin A fortification and de-worming. Fortified biscuits improved micronutrient status in rural primary school children; vitamin A with de-worming had a greater impact on micronutrient status than vitamin A fortification alone and antihelminthic treatment significantly reduced the overall prevalence of parasite infection. The burden of micronutrient deficiency (anaemia, iron and vitamin A) and stunting in this study population was low and, coupled with the restricted duration of the intervention (16 weeks), might have limited the impact of the interventions.

Nursing interventions to promote patient engagement in cancer care: A systematic review

Purpose: This study set out to investigate the impact of music mediated intervention on the language ability of learners with dyslexia in primary schools in Fako division of the Southwest region of Cameroon. Dyslexia is a condition characterised by difficulties in reading, writing, and language processing, and it presents significant challenges to affected students. Materials and Methods: The study employed a quasi-experimental design with a pre-test and post-test approach, involving two groups an experimental and a control (10 in each group) of primary school learners 8-12 years diagnosed of dyslexia using two diagnostic tools the Clinical Evaluation of language fundamentals (CELF) and the Ihenacho Culture Free test for language development. The experimental group received the music mediated intervention that is musical exercises designed to enhance phonological awareness, auditory discrimination, vocabulary, articulation pronunciation retention and language processing skills. Over a period of eight weeks participants in the experimental group engaged in music sessions twice a week with each session ranging between 45-50 minutes. Quantitative data was collected using the pre-and post test tool, and qualitative data was collected using interview guide and session observation guide, analysed descriptively, inferentially and thematically. Findings: Statistically, results showed that music mediated intervention significantly impact the language ability of learners with dyslexia (t test value=6.198, p-value &lt; 0.001 far less than 0.05) for learners in the experimental group having a mean score of 44.65 two times higher than the mean score of learners in the control group who were not exposed to music mediated intervention at the post test level with a mean score of 22.30 and the mean difference between both groups is 22.35. Qualitatively the teachers and therapist attested to the improvement in phonological awareness, vocabulary acquisition, retention, pronunciation and articulation of abilities for learners who took the intervention. Implications to Theory, Practice and Policy: The study therefore concludes that music mediated intervention can greatly improve the language ability of learners with dyslexia in primary schools and recommends that music-based activities and strategies be incorporated into regular classroom instruction to support language development for learners with dyslexia.

This paper investigates the outstanding challenges facing primary schools’ computerization in rural Kenya. Computerization of schools is often envisaged as a ‘magic’, or at least a particularly efficient, solution to many of the problems that developing countries face in improving primary school education. However, while a great deal of consideration is given to the technical issues surrounding computer implementation, government policy makers, administrators, aid organizations and individuals participating in school computerization programs often have not carefully considered the contextual questions surrounding this endeavour. Specifically: 1.) what problems do rural schools actually want to solve with computerization; 2.) is computerization the most important priority for rural schools; 3.) are schools ready, in terms of infrastructure, for a computer in the classroom; or 4.) might there be better avenues for implementing access to the benefits of the digital age? These questions and the issue of school computerization are considered via results from a survey of thirty‐seven rural Kenyan primary public schools. Results indicate that, while all schools had low ICT status making them primary targets for computerization, only eleven percent had at least one ICT compliant teacher, of which all were considered to require further training. In addition we found inadequate infrastructural preparedness – lack of access to electricity, internet; no classroom computer space, few desks, secure walls and protective roofing – posing severe challenges to the outstanding conception of computerization. We consider these results and make recommendations for better adapting programs for computer introduction, and also suggest the use of new innovative devices, such as cell phones, which might already have overcome many of the technical challenges found.