Attacking the policy problem from the wrong side?

"The famous deworming experiment showed that it increased students' attendance. Hence, let us deworm the children to increase attendance." This is a general argument made by many. Prof Deepak Lal questioned this approach. He says "If the students have worms, well first treat for worms. Making the 'increase in attendance' as a primary motive for deworming is attacking the problem at the wrong end."

This is an interesting argument. Irrespective of whether deworming increases or decreases the school attendance, we should first treat the children for worms, because they aren't good for child's health. In that case, why should you do an RCT at all, if you have to anyway deworm the children? Well, to find out its side effects, and to find out the truth in hypothesis that worms are the main constraint for the students attendance!

I found another example which presents this conundrum.
Storing rainwater in tanks is the best way to have a reliable supply of fresh, clean water for dairy cows during the dry season. But the storage tanks are expensive and farmers cannot afford them without a loan. Pondering new ways to provide credit, Suri had a eureka moment: she would test an asset-collateralized loan, using the tank itself as collateral. If a farmer falls behind on payments, the tank is repossessed. While this credit model is common in the US, for car loans and mortgages, it is almost unheard of in Kenya.
“Many more farmers purchased tanks; only one tank out of almost 1,000 was repossessed,” reports Suri. “With a more consistent water supply, cows did not get dehydrated and were healthier. But the effects did not end there. We saw an increase in school enrollment for girls, as they no longer had to spend long days fetching water for the household."

In this example, water scarcity was a constraint which was holding back some girls from going to schools. So, how should we view it? We provide water so that girls can come to school? or We provide water because we have to provide water?

This brings us back to the question of using appropriate metrics to judge an intervention, on which I had blogged earlier. What is the expectation from deworming - health or school attendance? What is the expectation from water tanks - reliable water supply or school attendance?

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