Child Centered Approach to Climate Change and Health Adaptation through Schools in Bangladesh: A Cluster Randomized Intervention Trial

Bangladesh is one of the most vulnerable countries to climate change. People are getting
educated at different levels on how to deal with potential impacts. One such educational
mode was the preparation of a school manual, for high school students on climate change
and health protection endorsed by the National Curriculum and Textbook Board, which is
based on a 2008 World Health Organization manual. The objective of this study was to test
the effectiveness of the manual in increasing the knowledge level of the school children
about climate change and health adaptation.

This cluster randomized intervention trial involved 60 schools throughout Bangladesh, with 3293 secondary school students participating. School upazilas (sub-districts) were randomised into intervention and control groups, and two schools from each upazila were ran￾domly selected. All year seven students from both groups of schools sat for a pre-test of 30 short questions of binary response. A total of 1515 students from 30 intervention schools received the intervention through classroom training based on the school manual and 1778 students of the 30 control schools did not get the manual but a leaflet on climate change
and health issues. Six months later, a post-intervention test of the same questionnaire used in the pre-test was performed at both intervention and control schools. The pre and post test scores were analysed along with the demographic data by using random effects model.

None of the various school level and student level variables were significantly different
between the control and intervention group. However, the intervention group had a 17.42%
(95% CI: 14.45 to 20.38, P = <0.001) higher score in the post-test after adjusting for pre-test
score and other covariates in a multi-level linear regression model.
These results suggest that school-based intervention for climate change and health adapta￾tion is effective for increasing the knowledge level of school children on this topic.