Conditional cash transfer programs (Mexico)

MexicoLatin AmericaScale-upRandomized Control TrialEarly ChildhoodPovertyPast

Nov 8

In Mexico, in collaboration with researchers at the Instituto Nacional de Salud Publica and other institutions, I examined the effects of participation in Mexico’s conditional cash transfer program on health, nutrition and early childhood development outcomes. We found benefits of program participation at 3-5 years, as well as 8-10 years old. As a follow-up to these papers, we designed a cluster-randomized trial to address the question of whether adding a parenting support program could help improve outcomes for children in Mexico, and this was the first time that group-based, parenting support was added to a cash transfer program, and represents a significant departure from the status quo in low- or middle income countries. We also examined effects of Mexico’s CCT program on prevalence of obesity, hypertension and diabetes in adults.

Findings:

Key findings from the Mexico work that there were benefits of the CCT program on children when they were 3-5 years old on height, weight, and early childhood development outcomes including language, cognition and behavior. These benefits were sustained in the children were 8-10 years old. Findings from the group-based, parenting support can improve child outcomes within the context of a CCT, but only when the two programs are integrated and mutually supportive. In a mediation analysis, we found that participation in the integrated arm of the study (CCT plus parenting support) was associated with a significant increase in the number of play activities that parents engaged in with their children, particularly shared storybook reading and singing. Given the widespread interest in cash transfer programs, the study provides evidence that these programs could be more effective at catalyzing upward mobility with a greater investment in child development.

Collaborators: Paul Gertler (UC Berkeley), Lynnette Neufeld (GAIN), Emily Ozer (UC Berkeley), Armando David (Instituto Nacional de Salud Publica).

Publications:

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

LCH Fernald, PJ Gertler, LM Neufeld

The Lancet 371 (9615), 828-837

10-year effect of Oportunidades, Mexico's conditional cash transfer programme, on child growth, cognition, language, and behaviour: a longitudinal follow-up study

LCH Fernald, PJ Gertler, LM Neufeld

The Lancet 374 (9706), 1997-2005

Poverty-alleviation program participation and salivary cortisol in very low-income children

LCH Fernald, MR Gunnar

Social science & medicine 68 (12), 2180-2189

Cash component of conditional cash transfer program is associated with higher body mass index and blood pressure in adults

LCH Fernald, PJ Gertler, X Hou