Freeman Spogli Institute for International Studies Program on Energy and Sustainable Development Stanford University

Research at PESD

Teachers, Parents and Students Teaming up to Learn about Overcoming Anemia

REAP Project


Recent studies by REAP and our affiliates show that from 25 to 40 percent of children are anemic, and those who live away from home and eat lunch in school cafeterias are more at risk.

Poor health and nutrition are a set back to rural children's performance

Is poor nutrition and health a constraint to the educational performance of students from poor rural areas? When a REAP intervention team gave students multivitamins in 24 elementary school schools in Shaanxi, anemia rates fell and standardized test scores rose by 0.4 standard deviations (akin to moving from a “C+” to a “B”).


When we shared the results with policy leaders, Wen Jiabao, (the Premiere); the Vice Premier in charge of Education--Li Keqiang; and Liu Yandong, a standing member of Central Committee, all approved further policy action. Having three such prominent members sign our brief and begin to put it into policy is a HUGE step forward for the Nutrition & Education agenda.


Partly in response to our work, the provincial governor of Shaanxi announced in that he was committing the province to providing every student in the province one egg per day. His hope was that improved nutrition would result in healthier students and better educational performance. The Ningxia provincial Department of Education followed suit. Unfortunately, eggs contain almost no iron, so we sent a note saying: One egg is not enough!

Giving children nutritional supplements in the form of multivitamins or vitameal can enhance their academic performance

Opportunity for another innovation: Taking the message to the parents and making it “stick”

Now we have opportunity to try another innovative way to battle anemia: education. Will teaching teachers, students and parents about ways to overcome anemia make a difference? Will the message "stick" with the help of technology?



Understand if developing an innovative curriculum kit that will supplement health class for 3rd to 6th grade students and teachers and directly give the message to parents in a set of pilot schools will 1) reduce anemia rates, 2) improve nutrition, and 3) boost school performance.

We will also develop and examine the effectiveness of using technology to reinforce the message.


A teaching program will be implemented for the pilot group on important aspects of nutrition 

We conducted the baseline survey at pilot schools in 40 towns in January 2011. Over the next several months, two rounds of interventions and evaluation surveys were completed. The first intervention involved rolling out an innovative nutrition curriculum among teachers, parents, and students. The second intervention used mobile phones to reinforce the curriculum in a series of 25 weekly text messages.


Evaluation of the program will hinge on students' Hb levels, anthropometric measures, sstandardized test results, school/parent/student characteristics for pilot and control counties.


This project is classified as on-going.