title: Effect on child cognitive function of increasing household expenditure in Indonesia: application of a marginal structural model and simulation of a cash transfer programme.
abstract: BACKGROUND
  Parental investments in children are an important determinant of human capability formation. We investigated the causal effect of household expenditure on Indonesian children's cognitive function between 2000 and 2007. We also investigated the effect of change in mean cognitive function from a simulation of a hypothetical cash transfer intervention.
  
  
  METHODS
  A longitudinal analysis using data from the Indonesian Family Life Survey (IFLS) was conducted including 6136 children aged 7 to 14 years in 2000 and still alive in 2007. We used the inverse probability of treatment weighting of a marginal structural model to estimate the causal effect of household expenditure on children's cognitive function.
  
  
  RESULTS
  Cumulative household expenditure was positively associated with cognitive function z-score. From the marginal structural model, a 74534 rupiah/month (about US$9) increase in household expenditure resulted in a 0.03 increase in cognitive function z-score [β=0.32, 95% confidence interval (CI) 0.30-0.35] Based on our simulations, among children in the poorest households in 2000 an additional ≈ US$6-10 of cash transfer resulted in a 0.01 unit increase in cognitive function z-score, equivalent to about 6% increase from the mean z-score prior to cash transfer. In contrast, children in the poorest household in 2007 did not benefit from an additional ≈ US$10 cash transfer. We found no overall effect of cash transfers at the total population level.
  
  
  CONCLUSIONS
  Greater household expenditure had a small causal effect on children's cognitive function. Although cash transfer interventions had a positive effect for poor children, this effect was quite small. Multi-faceted interventions that combine nutrition, cash transfer, improved living conditions and women's education are required to benefit children's cognitive development in Indonesia.
authors.affiliation: School of Population Health, University of Adelaide, SA, Australia, Department of Sociology, Faculty of Social and Political Science, Gadjah Mada University, Yogyakarta, Indonesia, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia and School of Social and Community Medicine, University of Bristol, Bristol, UK School of Population Health, University of Adelaide, SA, Australia, Department of Sociology, Faculty of Social and Political Science, Gadjah Mada University, Yogyakarta, Indonesia, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia and School of Social and Community Medicine, University of Bristol, Bristol, UK amelia.maika@adelaide.edu.au.
authors.forename: Amelia
authors.initials: A
authors.lastname: Maika
authors.affiliation: School of Population Health, University of Adelaide, SA, Australia, Department of Sociology, Faculty of Social and Political Science, Gadjah Mada University, Yogyakarta, Indonesia, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia and School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Murthy N
authors.initials: MN
authors.lastname: Mittinty
authors.affiliation: School of Population Health, University of Adelaide, SA, Australia, Department of Sociology, Faculty of Social and Political Science, Gadjah Mada University, Yogyakarta, Indonesia, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia and School of Social and Community Medicine, University of Bristol, Bristol, UK School of Population Health, University of Adelaide, SA, Australia, Department of Sociology, Faculty of Social and Political Science, Gadjah Mada University, Yogyakarta, Indonesia, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia and School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Sally
authors.initials: S
authors.lastname: Brinkman
authors.affiliation: School of Population Health, University of Adelaide, SA, Australia, Department of Sociology, Faculty of Social and Political Science, Gadjah Mada University, Yogyakarta, Indonesia, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia and School of Social and Community Medicine, University of Bristol, Bristol, UK School of Population Health, University of Adelaide, SA, Australia, Department of Sociology, Faculty of Social and Political Science, Gadjah Mada University, Yogyakarta, Indonesia, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia and School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: John
authors.initials: J
authors.lastname: Lynch
mesh_terms: D000293:Adolescent; D002648:Child; D002657:Child Development; D003071:Cognition; D005260:Female; D006801:Humans; D007214:Indonesia; D007360:Intelligence; D008137:Longitudinal Studies; D008297:Male; D011632:Public Assistance / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors
keywords: Household expenditure; Indonesia; cognitive function; inverse probability of treatment weighting; marginal structural model; time-varying confounder; time-varying exposure