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Research, Malaria Elimination

Malaria Elimination Initiative in Southern Mozambique Leads to Better School Attendance and Performance

A reduction in malaria cases led to improved presence and grades in schoolchildren in the district targeted by the intervention

Photo: Andalu Vila San Juan

Evidence is lacking on the relationship between malaria and school outcomes in countries such as Mozambique, where low educational attainment is a consequence of many factors. Such evidence is highly sought-after, since school outcomes are a key indicator of a country’s economic growth. A new study led by the Barcelona Institute for Global Health (ISGlobal) has found that a malaria elimination initiative in southern Mozambique resulted in higher school attendance in the district where the intervention took place, as well as better school grades.

Despite substantial progress over the past decade, malaria remains one of the leading causes of death and disease in Africa, which is home to 94% of the world’s malaria cases, according to the World Health Organisation. Children face the highest risk and bear most of the disease burden.

In the Magude district of southern Mozambique, a malaria elimination intervention launched in 2015 as part of the Mozambican Alliance Towards the Elimination of Malaria (MALTEM) led to a remarkable decrease in cases in the first year. The ISGlobal-coordinated study assessed a number of non-health indicators to determine whether the decrease in malaria incidence in the district had led to an improvement in school indicators, namely absenteeism and grades. Data from Magude district—the site of the intervention—were compared with data from a neighbouring district (Manhiça) with similar socioeconomic and epidemiological characteristics. Using information from school records, the researchers collected data on attendance and grades for a total of 9,848 students between the ages of 6 and 12 years from nine primary schools (four in the intervention district and five in the control district).

“The study showed that the elimination initiative led to a 28% decrease in school absenteeism and a 2% increase in average grades,” explained ISGlobal researcher Laia Cirera, lead author of the study. “These findings suggest that the toll of malaria goes beyond health, affecting key indicators for the development of societies, such as education, and provide evidence of the economic benefits of malaria elimination.”

As for the effect on school grades, the research team—which includes Francisco Saúte, Director General of the Manhiça Health Research Centre (CISM)—points out that healthier children can spend more time at school and acquire more knowledge, while also enjoying a greater capacity to assimilate and retain that knowledge.

“One interesting thing about the study,” added last author Elisa Sicuri, head of ISGlobal’s Health Economics group, “is that it showed that the malaria elimination initiative had an independent and significant impact on both school attendance and student performance, but also that school attendance contributed to better outcomes.”


Laia Cirera, Judit Vall Castelló, Joe Brew, Francisco Saúte, Elisa Sicuri. The impact of a malaria elimination initiative on school outcomes: Evidence from Southern Mozambique. Economics & Human Biology. Volume 44, 2022, 101100.