Evidence Action’s Deworm the World Initiative is proud to provide technical assistance to Thrive Networks and the Government of Vietnam as the government takes action towards keeping children healthy and in school by strengthening and improving school-based deworming. On November 6 and 7, over 700,000 primary school children across 3,000 schools in four provinces in northern Vietnam were targeted to receive a deworming tablet in their classroom. This is the third round of school-based deworming that Thrive Networks and Evidence Action have supported the Government of Vietnam to implement.  

Over the course of our program to date, we have supported key decision-makers from the Government of Vietnam’s health and education sectors to design a program aimed at maximizing the number of children who receive a deworming tablet in a cost-effective way. One way we support the program is to develop a customized training cascade designed to teach key personnel how to safely administer tablets to children. During the week of October 23rd to 27th, our program targeted over 8,000 local health workers and teachers for this training. Additionally, we conduct extensive monitoring and evaluation of each round of deworming facilitating the stakeholders to make programmatic improvements each year. 

 Photo credit: Thrive Networks
Photo credit: Thrive Networks

Improving our Impact

Beyond the support we provide for planning and implementing school-based deworming, a core component of this program is to assess if integrating school-based hygiene education with deworming campaigns can further improve the success of deworming. Thrive Networks and Evidence Action are partnering with researchers from three academic institutions –  Australian National University, QIMR Berghofer Medical Research Institute, and University of Queensland – to conduct a large-scale randomized controlled trial (RCT) to understand whether improving hygiene knowledge amongst children leads to reductions in reinfection. The RCT will rigorously test a hygiene education intervention integrated with school-based deworming in Vietnam.

The Intervention

Our collaborators from Australia previously demonstrated that showing students a hygiene education cartoon video (“Magic Glasses”) in addition to receiving deworming medication, and supplemented with supporting class-based activities throughout the school year, suffered roughly half the worm infections of those receiving deworming medication alone (Bieri et al. 2013). This was a very exciting result and one of the few robust linkages between a WASH intervention and worm reinfection. We are now evaluating whether a similar impact can be achieved in Vietnam when implemented at scale. We know from pre-testing in schools in Vietnam that any intervention too demanding for teachers to implement in the classroom stands little chance of being scaled up, so we have responded to our pre-testing results by refining the intervention that was previously tested by our collaborators to make it more feasible for implementation at scale.

“Magic Glasses” is a 14-minute long cartoon aimed at teaching children how soil-transmitted helminths (STH) are transmitted and ways they can prevent being infected. Our hygiene education intervention involves a showing of “Magic Glasses” coupled with a booklet based on the key messages from the cartoon which children can take home. The cartoon will be shown at schools twice over the course of the school year, during which the children will be dewormed once as part of the government implemented deworming campaign. Watch the version of the cartoon that was previously tested by our collaborators here.

Last week, the “Magic Glasses” intervention was delivered to primary school children at 48 schools across Phu Tho province. The cartoon was well-received by the children – it was amazing to see how engaged the children were by the cartoon, and to look at their reactions as they saw how easy it is to become infected with worms. The same children, along with all primary school children across Phu Tho, were dewormed this week during the province-wide deworming campaign. The cartoon will be shown again towards the end of the current academic year, and at the beginning of the next academic year we will return to all participating schools (the schools that showed the video, as well as the control schools where deworming alone was implemented) and conduct a final analysis.  

This RCT will aim to provide evidence about whether our hygiene education intervention is successful and cost-effective at reducing reinfection among school-age children. This study is being conducted in a single province of Vietnam, but we are focusing beyond that – the RCT will provide lessons about how an integrated deworming and hygiene education program may be taken to scale, not only in Vietnam, but in other countries where school-based deworming is being implemented.

 Photo credit: Thrive Networks
Photo credit: Thrive Networks

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