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| Name | Class |
|---|---|
| Swiss Tropical & Public Health Institute | OTHER |
| Centre Suisse de Recherches Scientifiques en Cote d'Ivoire | OTHER |
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Secondary school completion rates remain low in many low- and middle-income countries, including Côte d'Ivoire. Limited progression through lower secondary education may affect future educational and employment opportunities. In rural areas, pass rates on the Grade 10 national examination are modest, and some students leave school before completing lower secondary education. This study will evaluate whether tutoring improves academic outcomes and school continuation in the Taabo region of Côte d'Ivoire.
Approximately 1,000 adolescents will participate in two related substudies. The first substudy will include 500 Grade 10 students identified by schools as being at risk of not passing the national examination. The second substudy will include 500 adolescents who previously attended Grades 7-9 but are not currently enrolled in school. Within each substudy, participants will be randomly assigned to one of three groups: peer tutoring, teacher tutoring, or no additional tutoring (control group).
Students assigned to tutoring may receive up to 15 sessions over approximately 6 to 8 months. Tutoring sessions will focus on reviewing core curriculum content, preparing for examinations, and strengthening academic skills.
The primary outcomes are (1) passing the Grade 10 national examination and (2) enrollment in lower secondary school in the following academic year. Secondary outcomes include grade progression, study time, academic confidence, cost-effectiveness of the tutoring models, academic and well-being outcomes among peer tutors, and other longer-term outcomes (educational attainment, early family formation, mental health).
Secondary school completion rates remain limited in many low- and middle-income countries, including Côte d'Ivoire. In rural areas, a substantial share of students do not pass the Grade 10 national examination, and some adolescents leave school before completing lower secondary education. There is limited evidence on the comparative effectiveness and cost-effectiveness of different tutoring models at the secondary level in West Africa, particularly for both currently enrolled students and adolescents who are no longer enrolled.
This study is a randomized controlled education trial conducted in approximately 25 lower secondary schools in the Taabo Health and Demographic Surveillance System (HDSS) area of Côte d'Ivoire. The study consists of two related substudies.
Substudy 1 focuses on Grade 10 students identified by schools as being at risk of not passing the national examination. Substudy 2 focuses on adolescents who previously attended Grades 7-9 but are not currently enrolled in school at the start of the academic year.
Within each substudy, approximately 500 eligible participants will be enrolled and randomly assigned at the individual level to one of three groups:
Tutoring will be delivered in small groups and may include up to 15 sessions over approximately 6 to 8 months. Peer tutors will be selected from higher-performing students nominated by school principals and randomly chosen among eligible candidates. Teacher tutoring will be delivered by trained teachers following structured lesson plans emphasizing curriculum review and examination preparation.
Primary outcomes are:
Secondary outcomes include grade progression, attendance, study time, academic confidence, and cost-effectiveness of each tutoring model. The study will also assess academic performance and well-being among peer tutors and longer-term outcomes.
Study documents will be retained for 15 years to assess long-term education and health impacts of the intervention (educational attainment, early family formation, mental health). Long-term follow-up will occur only for participants who are registered in the Taabo HDSS.
Results from this trial will contribute evidence on scalable tutoring approaches to improve secondary school progression in rural West African settings.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Peer tutoring | Experimental | Peer tutoring led by older and higher-performing peers from the same school. |
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| Teacher tutoring | Experimental | Teacher tutoring led by trained teachers. |
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| Control group | No Intervention | Control: No additional tutoring from the study; students continue to receive the usual teaching and any school-based remedial support. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Peer tutoring | Behavioral | Peer tutoring led by older and higher-performing peers from the same school implemented in small groups (e.g., 3-6 students). Tutors will be nominated by school principals and then randomly selected among eligible candidates to allow causal assessment of tutoring opportunities on tutors. Sessions will focus on: (i) reviewing core curriculum content; (ii) supporting homework and exam preparation; and (iii) building basic skills and academic confidence. Tutors will receive training on pedagogy, content, and classroom management, as well as simple monitoring tools (attendance sheets, short exercises). Student tutoring will involve up to 15 sessions, typically 1-2 sessions per week. For budgeting and planning, we assume an average of 10 sessions per student, with flexibility to increase up to 15 sessions where feasible. |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of participants passing the Grade 10 national examination (Substudy 1) | Defined as achieving a passing score on the official Grade 10 national examination administered by the Ministry of Education of Côte d'Ivoire. Pass/fail status will be obtained from official examination records. This is a binary outcome (pass vs. fail). | Up to 12 months after enrollment |
| Proportion of participants enrolled in lower secondary school in the following academic year (Substudy 2) | Defined as official enrollment in lower secondary school (or equivalent formal education program) in the academic year following baseline participation. Enrollment status will be verified using school administrative records and, where necessary, household confirmation. This is a binary outcome (enrolled vs. not enrolled). | Up to 18 months after enrollment |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of participants enrolled in senior secondary school following the Grade 10 examination (Substudy 1) | Defined as enrollment in senior secondary school in the academic year following the Grade 10 national examination. Enrollment status will be obtained from school administrative records. This is a binary outcome (enrolled vs. not enrolled). | Up to 18 months after enrollment |
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Inclusion Criteria (Substudy 1)
Inclusion Criteria (Substudy 2)
Exclusion Criteria (both substudies)
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jan-Walter De Neve, MD ScD | Contact | 857-333-9297 | jdeneve@sdsu.edu | |
| Günther Fink, PhD | Contact | guenther.fink@swisstph.ch |
| Name | Affiliation | Role |
|---|---|---|
| Jan-Walter De Neve, MD ScD | San Diego State University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre suisse de recherche scientifique en Côte d'Ivoire | Taabo | Côte d’Ivoire |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25433704 | Background | Kone S, Baikoro N, N'Guessan Y, Jaeger FN, Silue KD, Furst T, Hurlimann E, Ouattara M, Seka MC, N'Guessan NA, Esso EL, Zouzou F, Boti LI, Gonety PT, Adiossan LG, Dao D, Tschannen AB, von Stamm T, Bonfoh B, Tanner M, Utzinger J, N'Goran EK. Health & Demographic Surveillance System Profile: The Taabo Health and Demographic Surveillance System, Cote d'Ivoire. Int J Epidemiol. 2015 Feb;44(1):87-97. doi: 10.1093/ije/dyu221. Epub 2014 Nov 29. |
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A fully de-identified dataset (with no participant names, phone numbers, addresses, exact birth dates, or HDSS identifiers) will be created on a public data repository after publication of the main results and will be made available to other researchers.
Supporting Materials:
Study Protocol
Supporting Materials:
Statistical Analysis Plan (SAP)
Supporting Materials:
Informed Consent Forms (ICF)
Supporting Materials:
Analytic Code
After publication of the main results
Public data repository
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| Teacher tutoring | Behavioral | Teacher tutoring led by trained teachers and implemented in small groups (e.g., 3-6 students). Teachers will follow structured lesson plans emphasizing remedial instruction and exam-relevant material. Sessions will emphasize active learning, practice exercises, and frequent low-stakes assessments. Teacher tutoring will involve up to 15 sessions, typically 1-2 sessions per week. For budgeting and planning, we assume an average of 10 sessions per student, with flexibility to increase up to 15 sessions where feasible. |
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| Proportion of participants not enrolled in any secondary institution after Grade 10 examination results (Substudy 1) | Defined as non-enrollment in any recognized secondary school in the academic year following the Grade 10 examination results. Enrollment status will be obtained from school records. This is a binary outcome (not enrolled vs. enrolled). | Up to 18 months after enrollment |
| Study time, homework completion, and exam confidence (Substudy 1) | Defined as self-reported weekly study hours, frequency of homework completion, and self-reported confidence in examination performance, collected through structured survey instruments. These are continuous and ordinal outcomes. | Up to 18 months after enrollment |
| Proportion of participants promoted to the next grade at endline (Substudy 2) | Defined as successful completion of the current grade and promotion to the next grade level, verified using administrative records where available. This is a binary outcome (promoted vs. not promoted). | Up to 18 months after enrollment |
| School attendance (Substudy 2) | Defined as the total number of days attended during the academic year, measured using school administrative records where available and supplemented by self-report. This is a continuous outcome (days attended). | Up to 18 months after enrollment |
| Persistence in school at the end of the 2026/27 academic year (Substudy 2) | Defined as enrollment status at the end of the 2026/27 academic year, verified through school records. This is a binary outcome (enrolled vs. not enrolled). | Up to 18 months after enrollment |
| Term and final grades (Tutors) | Defined as official term grades and final average grades obtained from school administrative records during the study period. These grades will be recorded as continuous numeric scores (e.g., 0-20 scale or school-specific grading scale). | Up to 18 months after enrollment |
| Examination pass rates (Tutors) | Defined as achieving a passing score on official school examinations during the study period. Pass/fail status will be based on school administrative records. This is a binary outcome (pass vs. fail). | Up to 18 months after enrollment |
| Educational aspirations and perceived returns to schooling (Tutors) | Defined as self-reported expectations regarding future education and perceived benefits of secondary schooling, collected using structured survey questions. These are continuous and ordinal outcomes. | Up to 18 months after enrollment |
| Time allocation, stress, and well-being (Tutors) | Defined as self-reported weekly time use, perceived stress, and general well-being measured through structured questionnaires. These are continuous and ordinal outcomes. | Up to 18 months after enrollment |
| Cost per additional student passing the Grade 10 national examination (Substudy 1) | Defined as the total program costs (USD) divided by the estimated incremental number of additional students passing the Grade 10 national examination relative to the control group. | Up to 18 months after enrollment |
| Cost per additional student enrolled and cost per additional student promoted (Substudy 2) | Defined as total program costs (USD) divided by the estimated incremental number of additional students enrolled in school and/or promoted to the next grade relative to the control group. | Up to 18 months after enrollment |
| Total years of schooling completed (Long-term outcome) | Defined as the total number of completed years of formal schooling as recorded in administrative education records and follow-up data. This is a continuous outcome (years completed). | Up to 15 years after enrollment |
| Total number of children before age 20 years (Long-term outcome) | Defined as the total number of biological children reported before age 20. This is a count outcome. | Up to 15 years after enrollment |
| Number of days in which mental health was reported as not good (Long-term outcome) | Defined as the self-reported number of days during the past 30 days in which mental health was described as "not good." This is a continuous outcome (days). | Up to 15 years after enrollment |