Fazzio Ila, Shivalli Siddharudha, Magill Nicholas, Elbourne Diana, Keddie Suzanne, Sharma Dropti, Shekhawat Sajjan Singh, Agarwal Arjun, Banerji Rukmini, Karnati Sridevi, Reddy Harshavardhan, Brady Tony, Gawron Piotr, Hsieh Pei-Tseng Jenny, Eble Alex, Boone Peter, Frost Chris
Effective Intervention, London, United Kingdom.
London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLoS One. 2025 Sep 12;20(9):e0330203. doi: 10.1371/journal.pone.0330203. eCollection 2025.
Rates of primary school enrolment have improved in India, but levels of learning achievement remain low. In the Support To Rural India's Public Education System (STRIPES) trial, a para-instructor intervention improved numeracy and literacy levels in Telangana, India (2008-10). The STRIPES2 trial was designed to assess whether a similar intervention in a younger cohort of children would have similar effects in Satna and Maihar districts of Madhya Pradesh, India, and be cost-effective.
In this Madhya Pradesh cluster-randomized controlled trial, 196 villages (clusters) were randomized to receive either a health (CHAMPION2: community health promotion and medical provision and impact on neonates) or education (STRIPES2) intervention. Villages receiving the health intervention were controls for the education intervention and vice versa. For children newly enrolled in primary school, the STRIPES2 intervention comprised before/after-school classes (2 hours per day, 6 days a week) given by trained para-instructors from the local community, frequent monitoring, and engagement with caregivers to motivate children, delivered by the Pratham Education Foundation. STRIPES2 activities had to be suspended twice for around ten and a half months, and some components of the intervention modified due to the COVID-19 pandemic. The period of the trial was extended with the primary outcome (a composite literacy and numeracy score of Early Grade Reading and Mathematics Assessments) assessed around 30 months after classes started.
Composite test scores were significantly higher in the intervention arm (98 villages; 3054 children) than in the control arm (98 villages; 3275 children) at the end of the trial. The mean difference on a percentage point scale was 14.17; 95% CI 11.36 to 16.97; p < 0.001, equating to a 0.58 (95% CI 0.47 to 0.71) standard deviation difference. The cost per child per 0.1 SD increase in composite test score was INR 2476 (US$33.5).
Despite COVID-19 interruptions and disruptions, STRIPES2 resulted in a major improvement in children's literacy and numeracy. However, the cost of achieving such benefits was substantial.
印度小学入学率有所提高，但学习成绩水平仍然较低。在“支持印度农村公共教育系统”（STRIPES）试验中，一项辅助教师干预措施提高了印度特伦甘纳邦的算术和识字水平（2008 - 2010年）。STRIPES2试验旨在评估在印度中央邦萨特纳和迈哈尔地区对较年幼儿童群体进行类似干预是否会产生类似效果，以及是否具有成本效益。
在这项中央邦整群随机对照试验中，196个村庄（群组）被随机分配接受健康干预（CHAMPION2：社区健康促进、医疗提供及对新生儿的影响）或教育干预（STRIPES2）。接受健康干预的村庄作为教育干预的对照，反之亦然。对于新入学的小学生，STRIPES2干预包括由当地社区训练有素的辅助教师提供的课前/课后辅导课程（每天2小时，每周6天）、频繁监测以及与照顾者合作以激励儿童，由普拉塔姆教育基金会实施。由于2019年冠状病毒病疫情，STRIPES2活动不得不暂停两次，时长约十个半月，并且干预的一些组成部分也进行了调整。试验期延长，主要结局（早期年级阅读和数学评估的识字和算术综合得分）在课程开始约30个月后进行评估。
在试验结束时，干预组（98个村庄；3054名儿童）的综合测试得分显著高于对照组（98个村庄；3275名儿童）。百分点尺度上的平均差异为14.17；95%置信区间为11.36至16.97；p < 0.001，相当于标准差差异为0.58（95%置信区间为0.47至0.71）。综合测试得分每增加0.1标准差，每个儿童的成本为2476印度卢比（33.5美元）。
尽管受到2019年冠状病毒病疫情的干扰和中断，STRIPES2仍使儿童的识字和算术能力有了显著提高。然而，实现这些益处的成本很高。
