The Oportunidades Program's Fortified Food Supplement, but Not Improvements in the Home Diet, Increased the Intake of Key Micronutrients in Rural Mexican Children Aged 12–59 Months

Abstract

Mexico's Oportunidades program provides conditional cash transfers, nutrition education, health services, and fortified food supplements for the young children of poor families. We have documented the effects of the program on growth and reduction of anemia. To better understand the impact pathways and disentangle the relative effects on dietary intake of the food supplements compared with other program components, we analyzed data from a randomized effectiveness evaluation of the Oportunidades program in rural children aged 12-59 mo. All Oportunidades beneficiaries received the cash transfers and the health and education components, but some children did not consume the supplements. The children's diet was evaluated using a single 24-h recall. The impact was estimated using multiple linear regression models with community-level random effects. Comparisons were made among children who received all the benefits of Oportunidades, including the fortified food supplement (SG), beneficiaries of the program who did not consume the food supplement (NSG), and the control group (CG). Relative to the NSG and CG, respectively, the SG consumed greater amounts of [mean (95% CI)]: energy, 94 (28, 160) and 111 (43, 180) kcal/d; iron, 7.6 (6.3, 8.9) and 7.7 (6.5, 9.0) mg/d; zinc, 7.5 (6.4, 8.6) and 7.6 (6.5, 8.7) mg/d; and vitamin A, 0.109 (0.071, 0.147) and 0.120 (0.080, 0.159) mg retinol equivalents/d. No differences were found between the NSG and CG (P > 0.05). To conclude, the Oportunidades program had a positive impact on the diet of children. The effects of the program on dietary intake resulted from the food supplement and not from improvements in the home diet. Our findings are useful for identifying which program components contributed to the effects on the nutritional status of children.

Family and community factors shaping the eating behaviour of preschool-aged children in low and middle-income countries: A systematic review of interventions

“…A summary of the characteristics of the eligible studies is presented in Table 3. The fourteen papers comprising 13 interventions, included RCTs (n = 6 papers) (da Costa Louzada et al, 2012;Hu et al, 2009;Kusuma et al, 2017;Lin et al, 2016;Ramírez-Silva et al, 2013;Vitolo et al, 2010), NRCTs (n = 5 papers) (Knueppel et al, 2010;Low et al, 2007;Mascie-Taylor et al, 2010;Mujibur Rahman et al, 1994;Olney et al, 2009), and pre-post studies (n = 3 papers) (Darrouzet-Nardi et al, 2016;Noradilah and Zahara, 2012;Sirikulchayanonta et al, 2010).…”

“…Eating behaviour outcomes were assessed through parent/ caregiver report in all studies and an additional researcher report (spot checking) was conducted in two studies (Mujibur Rahman et al, 1994;Noradilah and Zahara, 2012). Questionnaires were the most frequently used measure (n = 7 papers) (Hu et al, 2009;Kusuma et al, 2017;Lin et al, 2016;Mascie-Taylor et al, 2010;Mujibur Rahman et al, 1994;Olney et al, 2009;Sirikulchayanonta et al, 2010) followed by single 24-hr recall (n = 2 papers) (Darrouzet-Nardi et al, 2016;Ramírez-Silva et al, 2013), multiple 24-hr recalls (n = 2 papers) (da Costa Louzada et al, 2012;Vitolo et al, 2010), FFQ (n = 1 paper) (Knueppel et al, 2010), FFQ and a 24-hr recall (n = 1 paper) (Low et al, 2007) and researcher recorded food record (n = 1 paper) (Noradilah and Zahara, 2012) . The study sample size ranged from 26 to 2876 children, with an age of birth to 8 years.…”

Effectiveness of the national food supplementary program on children growth and nutritional status in Iran

“…In Opportunidades program in Mexico, using milk‐based micronutrient fortified food was an effective program on children's linear growth and anaemia (Ramírez‐Silva, Rivera, Leroy, & Neufeld, ). Commercially prepared products were the most common supplements used for investigating the effect of supplementary feeding on child malnutrition (Dong et al, ; Karakochuk, van den Briel, Stephens, & Zlotkin, ; Matilsky, Maleta, Castleman, & Manary, ; Singh et al, ).…”

“…In Opportunidades program in Mexico, using milk-based micronutrient fortified food was an effective program on children's linear growth and anaemia (Ramírez-Silva, Rivera, Leroy, & Neufeld, 2013).…”

Welfare and redistributive effects of social assistance in the Global South

“…Di Maro 2008;Angelucci and Attanasio 2009;Gertler, Martinez, and Rubio-Codina 2012;Skoufias, Unar, and Gonzalez de Cossio 2013); education and learning(Barrera-Osorio et al 2011;Benhassine et al 2015;Baird, McIntosh, and Ozler 2011;Macours, Schady, and Vakis 2012;Filmer and Schady 2011); health care(Fernald, Gertler, and Neufeld 2008;Barham and Maluccio 2009;Attanasio, Oppedisano, and Vera-Hernández 2015;Barber and Gertler 2008;Behrman and Parker 2013); nutrition(Behrman and Hoddinott 2005;Fernald and Hidrobo 2011;Leroy et al 2008;Miller, Tsoka, and Reichert 2011;Ramírez-Silva et al 2013), assets protection, and asset accumulation(Covarrubias, Davis, and Winters 2012;Maluccio 2010;Masino and Niño-Zarazúa 2018;Todd, Winters, and Hertz 2010); and employment and labor market outcomes(Asfaw et al 2014;Barrientos and Villa 2015;Alzúa, Cruces, and Ripani 2013;Ardington, Case, and Hosegood 2009;Attanasio et al 2010).…”