scholarly journals The impact of a conditional cash transfer programme on determinants of child health: evidence from Colombia

2016 ◽  
Vol 19 (14) ◽  
pp. 2629-2642 ◽  
Author(s):  
Sandra Lopez-Arana ◽  
Mauricio Avendano ◽  
Frank J van Lenthe ◽  
Alex Burdorf

AbstractObjectiveConditional cash transfer (CCT) programmes provide income to low-income families in return for fulfilling specific behavioural conditions. CCT have been shown to improve child health, but there are few systematic studies of their impact on multiple determinants of child health. We examined the impact of a CCT programme in Colombia on: (i) use of preventive health services; (ii) food consumption and dietary diversity; (iii) mother’s knowledge, attitudes and practices about caregiving practices; (iv) maternal employment; and (v) women’s empowerment.DesignSecondary analysis of the quasi-experimental evaluation of theFamilias en Accionprogramme. Children and families were assessed in 2002, 2003 and 2005–06. We applied a difference-in-differences approach using logistic or linear regression, separately examining effects for urban and rural areas.SettingColombia.SubjectsChildren (n1450) and their families in thirty-one treatment municipalities were compared with children (n1851) from sixty-five matched control municipalities.ResultsFamilias en Accionwas associated with a significant increase in the probability of using preventive care services (OR=1·85, 95 % CI 1·03, 3·30) and growth and development check-ups (β=1·36, 95 % CI 0·76, 1·95). It had also a positive impact on dietary diversity and food consumption. No effect was observed on maternal employment, women’s empowerment, and knowledge, attitudes and practices about caregiving practices. Overall,Familias en Accion’s impact was more marked in rural areas.ConclusionCCT in Colombia increase contact with preventive care services and improve dietary diversity, but they are less effective in influencing mother’s employment decisions, empowerment and knowledge of caregiving practices.

2021 ◽  
Vol 29 ◽  
pp. 1
Author(s):  
Monserrat Serio ◽  
Martina Herrera

This paper explores the effect of the principal conditional cash transfer program known as Asignación Universal por Hijo (AUH) of Argentina on educational outcomes such as attendance, performance in reading and mathematics, and grade repetition. Also, we analyze the impact on non-school tasks that students performed which can replace the time dedicated to studying and permanence in the school. We use the Aprender 2016 assessment database focusing on data of students from primary and high school. We use non-experimental data exploiting the question about if the student’s family is a beneficiary of the AUH. We perform a Coarsened Exact Matching (CEM) and estimate the average treatment effect on the treated of the program. The results show that the AUH had a positive impact on attendance augmenting the probability of not being absent from class fewer than eight and seventeen days in 1.3 p.p and 1 p.p., respectively. However, positive effects on educational performance and conducting of non-school tasks are not found. We also found heterogeneous effects, for male students the program increases the probability of missing fewer classes at all levels between 0.4 p.p. and 1.5 p.p. and students from rural areas and public schools have reassigned non-school tasks.


Author(s):  
Syed Irfan Ali ◽  
Jarina Begum ◽  
Manasee Panda

Background: RMNCH services are provided in an integrated manner to it’s beneficiaries under the premise of Primary Health Care. The utilization rates for such services have remained abysmally low and stagnated over the years. The problem lies in failure to generate a demand for such services among it’s beneficiaries. MAMATA a conditional cash transfer scheme implemented in Odisha, aims to bring around radical changes by addressing the issue of demand generation. The objectives of the study were to assess the implementation of MAMATA scheme services in the study area and to assess the impact made by the scheme in their life.Methods: The study was conducted on 200 women, who were randomly selected from the 903 pregnant women registered under Mamata Scheme from a randomly selected block of Odisha. They were then followed up for a period of 15 months.Results: Implementation of the scheme in the district was smooth, the instalments were paid regularly in most of the cases without any delay. Impact of the scheme- 98% got adequate rest during pregnancy, because of the scheme. 95% utilized the money for purchasing nutritious food and procuring medicines. The scheme has also helped develop a health seeking attitude in most of the beneficiaries (85%). 97% felt a sense of empowerment and independence compared to the past.Conclusions: The benefits of MAMATA scheme percolated beyond the boundaries of demand generation. It also brought about a sense of empowerment and independence among it’s beneficiaries.


2018 ◽  
Vol 52 (5) ◽  
Author(s):  
Ma-Ann M. Zarsuelo ◽  
Madeline M. Suva ◽  
Clarissa B. Juanico ◽  
Wilma A. Hurtada

Background. The Philippines adopted the Conditional Cash Transfer (CCT) program as the Pantawid Pamilyang Pilipino Program (4Ps) that serves as the government’s flagship social assistance program for the poor. This provides short-term income support to poor families while investing on health and education to overcome future poverty. Objective. This study aimed to characterize the beneficiary and non-beneficiary households and evaluate the impact of 4Ps program on housing facilities and diet diversity. Methods. Quasi-experimental design was used to evaluate survey outcomes between 91 randomly sampled beneficiaries and 91 completely enumerated non-beneficiaries (incoming grantees). FANTA Household Dietary Diversity Score (HDDS) was used as an indicator for dietary diversity while structured questionnaire on housing profile was based on BIDANI and CEM-UPLB tools. Results. The 4Ps beneficiaries had significantly higher maternal education, household size (ρ=0.038), and improved water source (ρ=0.004) than non-beneficiaries. Cash transfer among 4Ps households provided 11% increase in the average monthly income of P7,324 pre-transfer. Diet diversity using FANTA scoring (0-12) showed that nonbeneficiaries were significantly lower by 0.4 than 4Ps score of 7.9 (ρ=0.003). Maternal education was found to have significant positive correlation with diet diversity. Both groups had high cereals and fats intake (>90%) while low in complex carbohydrates and legumes (<31%). Conclusion. The 4Ps had positive correlation on housing profile and diet diversity among beneficiaries. Family Development Session should integrate practical methods on improving variety of foods, specifically, the low consumption food groups. Additionally, a review on the selection criteria based on the provincial poverty threshold vis a vis income of grantees must be implemented to accurately target intended beneficiaries.


2020 ◽  
Vol 5 (12) ◽  
pp. e003621
Author(s):  
James Manley ◽  
Yarlini Balarajan ◽  
Shahira Malm ◽  
Luke Harman ◽  
Jessica Owens ◽  
...  

BackgroundCash transfer (CT) programmes are implemented widely to alleviate poverty and provide safety nets to vulnerable households with children. However, evidence on the effects of CTs on child health and nutrition outcomes has been mixed. We systematically reviewed evidence of the impact of CTs on child nutritional status and selected proximate determinants.MethodsWe searched articles published between January 1997 and September 2018 using Agris, Econlit, Eldis, IBSS, IDEAS, IFPRI, Google Scholar, PubMed and World Bank databases. We included studies using quantitative impact evaluation methods of CTs with sample sizes over 300, targeted to households with children under 5 years old conducted in countries with gross domestic product per capita below US$10 000 at baseline. We conducted meta-analysis using random-effects models to assess the impact of CT programmes on selected child nutrition outcomes and meta-regression analysis to examine the association of programme characteristics with effect sizes.ResultsOut of 2862 articles identified, 74 articles were eligible for inclusion. We find that CTs have significant effects of 0.03±0.03 on height-for-age z-scores (p<0.03) and a decrease of 2.1% in stunting (95% CI −3.5% to −0.7%); consumption of animal-source foods (4.5%, 95% CI 2.9% to 6.0%); dietary diversity (0.73, 95% CI 0.28 to 1.19) and diarrhoea incidence (−2.7%, 95% CI −5.4% to −0.0%; p<0.05). The effects of CTs on weight-for-age z-scores and wasting were not significant (0.02, 95% CI −0.03 to 0.08; p<0.42) and (1.2%, 95% CI: −0.1% to 2.5%; p<0.07), respectively. We found that specific programme characteristics differentially modified the effect on the nutrition outcomes studied.ConclusionWe found that CT programmes targeted to households with young children improved linear growth and contributed to reduced stunting. We found that the likely pathways were through increased dietary diversity, including through the increased consumption of animal-source foods and reduced incidence of diarrhoea. With heightened interest in nutrition-responsive social protection programmes to improve child nutrition, we make recommendations to inform the design and implementation of future programmes.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Layana Costa Alves ◽  
Mauro Niskier Sanchez ◽  
Thomas Hone ◽  
Luiz Felipe Pinto ◽  
Joilda Silva Nery ◽  
...  

Abstract Background Malaria causes 400 thousand deaths worldwide annually. In 2018, 25% (187,693) of the total malaria cases in the Americas were in Brazil, with nearly all (99%) Brazilian cases in the Amazon region. The Bolsa Família Programme (BFP) is a conditional cash transfer (CCT) programme launched in 2003 to reduce poverty and has led to improvements in health outcomes. CCT programmes may reduce the burden of malaria by alleviating poverty and by promoting access to healthcare, however this relationship is underexplored. This study investigated the association between BFP coverage and malaria incidence in Brazil. Methods A longitudinal panel study was conducted of 807 municipalities in the Brazilian Amazon between 2004 and 2015. Negative binomial regression models adjusted for demographic and socioeconomic covariates and time trends were employed with fixed effects specifications. Results A one percentage point increase in municipal BFP coverage was associated with a 0.3% decrease in the incidence of malaria (RR = 0.997; 95% CI = 0.994–0.998). The average municipal BFP coverage increased 24 percentage points over the period 2004–2015 corresponding to be a reduction of 7.2% in the malaria incidence. Conclusions Higher coverage of the BFP was associated with a reduction in the incidence of malaria. CCT programmes should be encouraged in endemic regions for malaria in order to mitigate the impact of disease and poverty itself in these settings.


Author(s):  
Turk T ◽  
◽  
Safdar NF ◽  
Hashmi S ◽  
Shah N ◽  
...  

Background: Adequate nutrition is a public health priority, particularly in low-income rural areas where there is a high prevalence of malnutrition and stunting. Baluchistan is an arid desert and mountainous province with the worst health indicators in Pakistan. The objective of this research study was to identify current knowledge, attitudes and practices of vulnerable women with young children residing in remote areas of Baluchistan and assess their information needs to guide the development of a BCC nutrition strategy materials and activities. Methods: This study design incorporated formative research via eight focus group discussions with demand and supply-side program beneficiaries (n=124) to assess current nutrition knowledge, attitudes and beliefs toward kitchen gardens and proposed nutrition resources. Semi-structured interviews (n=16) were also conducted to provide program intelligence from key informants. A literature review supported the development of discussion agenda based on predominant behavioral theories. Data analysis was conducted with in vivo qualitative software coupled with grounded theory with qualitative findings triangulated. Results: The study identified important factors for the development of BCC resources and activities. Opportunities included effective nutrition education, improved income and livelihoods from kitchen gardens, women’s empowerment and gender equality. Challenges included traditional cultural practices, entrenched food preparation behaviour, environmental and infrastructural constraints. Conclusions: Lessons learned highlight the benefits of integrating formative research methods with a comprehensive literature review and behavioural theories for the development of BCC resources for nutrition programs in insecure and resource-constrained settings.


Author(s):  
Robespierre Pita ◽  
Clicia Pinto ◽  
Marcos Barreto ◽  
Samila Sena ◽  
Rosemeire Fiaccone ◽  
...  

ABSTRACTBackground and aimsA cooperation Brazil-UK was set in mid-2013 aiming at to build a huge cohort comprised by individuals registered in CadastroÚnico (CADU), a socioeconomic database used in social programmes of the Brazilian government. Epidemiologists and statisticians wish to assess the impact of Bolsa Família (PBF), a conditional cash transfer programme, on the incidence of several diseases (tuberculosis, leprosy, HIV etc). The cohort must contain all individuals who received at least one payment from PBF between 2007 and 2012, which results in a 100-million records according to our preliminary analysis. These individuals must be probabilistically linked with databases from the Unified Health System (SUS), such as hospitalization (SIH), notifiable diseases (SINAN), mortality (SIM), live births (SINASC), to produce data marts (domain-specific data) to the proposed studies. Within this cooperation, our first goal was to design and evaluate probabilistic methods to routine link the cohort, PBF, and SUS outcomes. ApproachWe implemented two probabilistic linkage methods: a full probabilistic, based on the Dice similarity (Sorensen index) of Bloom filters; and an hybrid approach, based on rules to deterministic and probabilistic matching. We performed linkages involving CADU (2011 extraction) and SUS outcomes (SIH, SINAN, and SIM) with samples from 3 states (Sergipe, Santa Catarina and Bahia) with an increasing size (from 1,447,512 to 12,036,010). ResultsUsing a Dice between 0.90 and 0.92, our methods retrieved more than 95% of true positive pairs amongst the linked pairs. For Sergipe, we obtained as <linked pairs,true positives>: <23,22>, <315,300>, <32,32>, respectively for SIH, SINAN, and SIM. For Bahia: <771,593>, <2677,2626>, <208,207>. Another linkage between CADU (1,447,512 records) and SINAN (624 records), for tuberculosis in Sergipe, returned 397 (full probabilistic) and 311 (hybrid) linked pairs, being 306 and 300 true positives. Another execution considering CADU (1,988,599 records) and SINAN (2,094 records), for tuberculosis in Santa Catarina, returned 791 (full probabilistic) and 500 (hybrid) linked pairs, with 667 and 472 true positives. Linking CADU (1.685,697 records) and SIM, for mortality of children under-4, returned 18 linked pairs, all of them true positives, for a Dice between 0.90 and 0.92 and with 100% of sensitivity, specificity, and positive predictive value. ConclusionDue to the absence of gold standards, we use samples with increasing sizes and manual review when adequate. Our results are quite accurate, although obtained with an unique extraction of CADU. We are starting to run linkages with the entire cohort.


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