Abstract

A well-written and coherent paper. One of the first showing intergenerational effects of childhood health intervention[s] in [a] LMIC, including cost-benefit analysis. Statistical power calculation[s were] not provided. Literature review is slightly one-sided. Some results in tables could be discussed further in [the] text. Some typical outcomes [were] not present (nor mentioned), [… and ] if [they] exist in the data [it] would be interesting to see them.

Summary Measures

We asked evaluators to give some overall assessments, in addition to ratings across a range of criteria. See the evaluation summary “metrics” for a more detailed breakdown of this. See these ratings in the context of all Unjournal ratings, with some analysis, in our data presentation here.1

Overall assessment (See footnote2)

Journal rank tier, normative rating (0-5): On a ‘scale of journals’, what ‘quality of journal’ should this be published in?3 Note: 0= lowest/none, 5= highest/best.

See here for the full evaluator guidelines, including further explanation of the requested ratings.

Written report

This paper is using a widely-studied randomized school-based deworming program in Kenya to explore the presence of intergenerational benefits. In particular, it looks at infant mortality and under-5 mortality, and examines five possible channels. The effects are [a] 20% reduction in mortality rate (though only under-5 is significant), with all examined channels contributing to the reduction. The study also explored heterogeneous effects by parents’ gender and age, with only age being significant.

This is a very interesting and important paper studying [the] intergenerational effects of early childhood health interventions. Overall, the paper is well written, focused on a very specific well-defined hypothesis, which is answered adequately and using appropriate and well-executed methods. The assumptions in the cost-benefit analysis seem plausible and the estimated return can indeed be considered conservative.

Although I found the paper well-written and of high quality, here are some comments/suggestions the authors might find useful:

1. There are several studies analysing impacts of deworming mentioned, although all on the more ‘positive’ side. Perhaps some of the more ‘critical’ papers could also be cited as contrast to provide a more balanced view of the literature. [Note: numbering added.]

2. It would be helpful if the authors comment on (or include) something on statistical power, currently there is no mention of it.

3. It would be helpful to the reader if the authors include a table in the additional exhibits (for online publication) with summary statistics for the covariates discussed in page 6.

4. For the channels analysis in Table 2: The number of observations changes for each outcome. Are results robust to keeping the same observations across all specifications?

5. Dose-response interpretation: Although I wouldn’t rule it out theoretically, [are] the results in Figure 2 providing enough evidence of this? Looking at the two-year bins, it looks more like 0 and 1-2 being together (same) VS 3-4 and 5-6 being together (same), i.e. no dose-response. Perhaps this can be supported via hypothesis testing?

6. It would be interesting to see if there are any effects on birth outcomes, such as birth weight [or] gestational age (if these have been measured in the survey). Additionally, it would be interesting to see if there is an effect on sex ratio for births (proxy/indicator for fetal loss).

7. Are there any other health outcomes measured at (or before) age 5? Height, for example, to examine stunting?

8. If either of the two previous suggestions are true, and provided the same measurement for the parents exists, it would be interesting to compare same outcomes for parents and their children and the impact of the intervention on their correlation.

9. I found the heterogeneous results by parents’ age too interesting and valuable to be pushed to the appendix. Perhaps some could be moved to the main body (e.g. Tables A2 and A5) along with further discussion. Also, Table A.6 is not mentioned anywhere in the text (I can see how column (2) is replication of column (9) Table 2, but would be worth a brief discussion of overall findings).

10. The authors mention in the discussion the study of Duhon et al. (2023)[1] on other aspects of the intergenerational transmission of human capital. Although the discussion of the non-/cognitive gains is beyond the focus of this paper, a brief discussion of the health gains examined in that study would be beneficial for the reader.

11. I think the authors would assist the reader by providing discussion (or direct comparison when possible) of the study of Barham et al. (2023)[2] in Bangladesh, as it’s the one most closely related to theirs (or any other among the ones cited).

References

[1]Duhon, M., Miguel, E., Njuguna, A., Veizaga, D. P., & Walker, M. (2023). Preparing for an Aging Africa: Data-Driven Priorities for Economic Research and Policy. National Bureau of Economic Research. https://doi.org/10.3386/w31750

[2]Barham, T., Champion, B., Kagy, G., & Hamadani, J. (2023). Improving the Early Childhood Environment: Direct and Distributional Effects on Human Capital for Multiple Generations.

Evaluator details

1. How long have you been in this field?

   • 10 years

2. How many proposals and papers have you evaluated?

   • 40