Conditional Cash Transfers Are Associated with a Small Reduction in the Rate of Weight Gain of Preschool Children in Northeast Brazil

Abstract

Programs providing cash transfers to poor families, conditioned upon uptake of preventive health services, are common in Latin America. Because of the consistent association between undernutrition and poverty, and the role of health services in providing growth promotion, these programs are supposed to improve children's growth. The impact of such a program was assessed in 4 municipalities in northeast Brazil by comparing 1387 children under 7 y of age from program beneficiary households with 502 matched nonbeneficiaries who were selected to receive the program but who subsequently were excluded as a result of quasi-random administrative errors. Anthropometric status was assessed 6 mo after benefits began to be distributed, and beneficiary children were 0.13 Z-scores lighter (weight-for-age) than excluded children, after adjusting for confounders (P = 0.024). The children's growth trajectories were reconstructed by copying up to 10 recorded weights from their Ministry of Health growth monitoring cards and by relating each weight to the child's age, gender, and duration of receipt of the program benefit in a random effects regression model. Totals of 472 beneficiary and 158 excluded children under 3 y of age were included in this analysis. Each additional month of exposure to the program was associated with a rate of weight gain 31 g lower than that observed in excluded children of the same age (P < 0.001). This failure to respond positively to the program may have been due to a perception that benefits would be discontinued if the child started to grow well. Nutrition programs should guard against giving the impression that poor growth will be rewarded.

An impact assessment of the Child Growth, Development and Care Program in the Caribbean Region of Colombia

“…A similar result was found by an assessment of the Bangladesh Integrated Nutrition Project (PINB) which also showed that the project had no significant impact on wasting in children 22 . However, our results differ from those found by an assessment of the Bolsa Familia program in Brazil which found that the intervention led to an improvement in nutritional status among participating children 23 . Our results also differ from the findings of a study conducted by the ICBF of the HCB program.…”

Social determinants of health: an economic perspective

“…For example, a range of econometric methods has recently been applied to study the outcomes of the Conditional Cash Transfer initiative (CCT), variants of which operate in Mexico, Brazil and many other countries (Gertler, 2004;Morris et al, 2004;Attanasio et al, 2005). Families enrolled in CCT programmes receive cash in exchange for complying with certain conditions: preventative health requirements, nutrition supplements, enrollment in school and monitoring.…”

The contribution of Bolsa Família to the educational achievement of economically disadvantaged children in Brazil

“…Amongst the few papers that can be found on BF's effects, many have focused on economic effects related to poverty, income inequality, and consumption (Soares et al, 2006;Osório et al, 2007;Resende and Oliveira, 2007;Tavares, 2008;Lignani et al, 2011), and more recently on adults' participation in the labour market (Tavares, 2008;Foguel and Barros, 2010). Studies of the impacts of BF on child development, health, and nutritional status of children can also be found in the literature (Morris et al, 2004;Castiñeira, Nunes and Rungo, 2009;Reis, 2010;Lima, Rabito and Dias, 2011;Paes-Sousa, Santos and Miazak, 2011;Piperata et al, 2011). As to effects on education and child labour, although there are very few studies to date, these were, in fact, the primarily areas of interest at the time of the first CCT experiences, when education was the heart of the programmes.…”