Costs of intervention program by item.

IntroductionRates 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.MethodsIn 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.ResultsComposite 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 ConclusionDespite 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.印度小学入学率已有所提升，但学生学习成就水平仍处于低位。在《印度农村公共教育系统支持计划》（Support To Rural India’s Public Education System, STRIPES）一期试验中，辅助教学人员（para-instructor）干预方案成功提升了印度特伦甘纳邦2008—2010年间学生的算术与读写能力。STRIPES2试验旨在评估，针对低龄儿童群体实施同类干预，是否能在印度中央邦萨特纳县与迈哈尔县取得相近效果，同时具备成本效益。 方法 本项整群随机对照试验（cluster-randomized controlled trial）中，196个村庄（整群）被随机分配至健康干预组（CHAMPION2：社区健康促进与医疗服务及新生儿影响研究）或教育干预组（STRIPES2）。健康干预组村庄作为教育干预的对照组，反之亦然。针对新入学小学生，STRIPES2干预方案由经培训的当地社区辅助教学人员提供课内外辅导（每日2小时，每周6天），并配套高频督导、与儿童看护者沟通以激励学生，该项目由普拉塔姆教育基金会（Pratham Education Foundation）实施。受2019冠状病毒病疫情影响，STRIPES2活动两次暂停，累计时长约10.5个月，且部分干预内容被迫调整。试验周期予以延长，主要结局指标为早期读写与数学评估（Early Grade Reading and Mathematics Assessments, EGRMA）的复合读写算术得分，该指标于课程启动后约30个月时完成评估。 结果 试验结束时，干预组（98个村庄；3054名儿童）的复合测试得分显著高于对照组（98个村庄；3275名儿童）。百分比得分的平均差异为14.17；95%置信区间为11.36至16.97；p值。 结论 尽管受到新冠疫情的干扰与中断，STRIPES2仍显著改善了儿童的读写与算术能力。然而，达成此类收益所需投入的成本颇高。