School-based malaria chemoprevention as a cost-effective approach to improve cognitive and educational outcomes: a meta-analysis

Abstract: There is limited evidence of health interventions impact on cognitive function and educational outcomes. We build on two prior systematic reviews to conduct a meta-analysis, exploring the effects of one of the most consequential health interventions, malaria chemoprevention, on education outcomes. We pool data from nine study treatment groups (N=4,075) and outcomes across four countries. We find evidence of a positive effect (Cohen's d = 0.12, 95% CI [0.08, 0.16]) on student cognitive function, achieved at low cost. These results show that malaria chemoprevention can be highly cost effective in improving some cognitive skills, such as sustained attention. Moreover, we conduct simulations using a new common metric (learning-adjusted years of development) to compare cost-effectiveness across diverse interventions. While we might expect that traditional education interventions provide an immediate learning gain, health interventions such as malaria prevention can have surprisingly cost-effective education benefits, enabling children to achieve their full human capital potential.