Document is current

Article History

Received: 2 August 2019

Accepted: 4 December 2019

First Online: 6 January 2020

Ethics approval and consent to participate

: Ethics approval was obtained from the institutional review board at Makerere University College of Health Sciences School of Medicine (reference number 2013-105) and the Uganda National Council for Science and Technology (reference number SS3328) at the beginning of the study, and renewal of approval was sought for the follow-up study. Informed consent for all grade 5 classes to participate in the trial was obtained from school heads (the head teacher or school director) and grade 5 teachers. We provided the head teacher of each school with information about the study and obtained written consent from them on behalf of their school to participate in the first trial (at the end of the intervention term) and the second trial (1-year follow up). In addition, we obtained written consent from the primary 5 (year 5 of primary school) teachers identified by the head teachers. Informed consent was not required from the children or their parents. We did not obtain assent from individual primary 5 children or consent from their parents, because the intervention posed minimal risk and no more risk than other teaching materials [], almost none of which have been evaluated [,]. Informed consent by individual children or their parents, in effect, would be meaningless once the decision to participate was taken by the head teacher and the teachers, who have the responsibility and authority to make decisions about lesson plans and the administration of tests []. Individual children and their parents had the same right to refuse participation as they do for any other lesson or test in primary schools.

: Not applicable.

: The authors declare that they have no competing interests.