PHA-Exch> Role of cash in conditional cash transfer programmes for child health, growth, and development: Mexico

[Claudio Schuftan]

From: Ruggiero, Mrs. Ana Lucia (WDC) <ruglucia at paho.org>
crossposted from: EQUIDAD at listserv.paho.org

 *Role of cash in conditional cash transfer programmes for child health,
growth, and development:
an analysis of Mexico's Oportunidades*

* *

Lia CH Fernald,   Paul J Gertler and   Lynnette M Neufeld

*The Lancet,  Volume 371, Number 9615, 8 March 2008*

* *

Available online at:
http://www.thelancet.com/journals/lancet/article/PIIS0140673608603827/fulltext

"……Many governments have implemented conditional cash transfer (CCT)
programmes with the goal of improving options for poor families through
interventions in health, nutrition, and education. Families enrolled in CCT
programmes receive cash in exchange for complying with certain conditions:
preventive health requirements and nutrition supplementation, education, and
monitoring designed to improve health outcomes and promote positive
behaviour change. Our aim was to disaggregate the effects of cash transfer
from those of other programme components.

*Methods*

In an intervention that began in 1998 in Mexico, low-income communities
(n=506) were randomly assigned to be enrolled in a CCT programme (*
Oportunidades*, formerly *Progresa*) immediately or 18 months later. In
2003, children (n=2449) aged 24–68 months who had been enrolled in the
programme their entire lives were assessed for a wide variety of outcomes.
We used linear and logistic regression to determine the effect size for each
outcome that is associated with a doubling of cash transfers while
controlling for a wide range of covariates, including measures of household
socioeconomic status.

*Findings*

A doubling of cash transfers was associated with higher height-for-age
*Z*score (β 0·20, 95% CI 0·09–0·30; p<0·0001), lower prevalence of
stunting
(−0·10, −0·16 to −0·05; p<0·0001), lower body-mass index for age percentile
(−2·85, −5·54 to −0·15; p=0·04), and lower prevalence of being overweight
(−0·08, −0·13 to −0·03; p=0·001). A doubling of cash transfers was also
associated with children doing better on a scale of motor development, three
scales of cognitive development, and with receptive language.

*Interpretation*

Our results suggest that the cash transfer component of *Oportunidades* is
associated with better outcomes in child health, growth, and development.

* *

*Affiliations*
a. School of Public Health, University of California, Berkeley, CA, USA
b. Haas School of Business, University of California, Berkeley, CA, USA
c. Instituto Nacional de Salud Pública, Cuernavaca, Mexico
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