Participation in the Juntos Conditional Cash Transfer Program in Peru Is Associated with Changes in Child Anthropometric Status but Not Language Development or School Achievement.
BACKGROUND
It is unclear what effects a conditional cash transfer (CCT) program would have on child anthropometry, language development, or school achievement in the context of the nutrition transition experienced by many low- and middle-income countries.


OBJECTIVE
We estimated the association of participation in Peru's Juntos CCT with anthropometry, language development, and school achievement among children aged 7-8 y.


METHODS
We used data from the Young Lives Study of a cohort born between 2001 and 2002. We estimated associations of the Juntos program with height-for-age z score (HAZ), body mass index-for-age z score (BAZ), stunting, and overweight at age 7-8 y separately for children participating in the program for ≥2 y (n = 169) and children participating for <2 y (n = 188). We then estimated associations with receptive vocabulary and grade achievement among children who had been assessed at age 4-6 y before enrollment in Juntos (n = 243). We identified control subjects using propensity score matching and conducted difference-in-differences comparisons.


RESULTS
Juntos participation was associated with increases in HAZ among boys participating for ≥2 y [average effect of treatment among the treated (ATT): 0.43; 95% CI: 0.09, 0.77; P = 0.01] and for boys participating for <2 y (ATT: 0.52; 95% CI: 0.23, 0.80; P < 0.01). Among girls participating in the program for ≥2 y, BAZ declined (ATT: -0.60; 95% CI: -1.00, -0.21; P < 0.01) as did the prevalence of overweight (ATT: -22.0 percentage points; 95% CI: -42.5, -2.7 percentage points; P = 0.03). We observed no significant associations of Juntos participation with receptive vocabulary or grade attainment.


CONCLUSIONS
CCT program participation in Peru was associated with better linear growth among boys and decreased BAZ among girls, highlighting that a large-scale poverty-alleviation intervention may influence anthropometric outcomes in the context of the nutrition transition.
Divisions of Epidemiology and chrisandersen@berkeley.edu.
Christopher T
http://orcid.org/0000-0001-5599-6130
CT
Andersen
Community Health and Human Development, School of Public Health, University of California, Berkeley, CA;
Sarah A
SA
Reynolds
Departments of Economics and Sociology, and the Population Studies Center, University of Pennsylvania, Philadelphia, PA;
Jere R
JR
Behrman
Department of Health Science, Brigham Young University, Provo, UT;
Benjamin T
BT
Crookston
Micronutrient Initiative, New Delhi, India; Department of Global Health, School of Public Health, Boston University, Boston, MA;
Kirk A
KA
Dearden
Group for the Analysis of Development, Lima, Peru;
Javier
J
Escobal
Population Studies Center, University of Pennsylvania, Philadelphia, PA; Department of Economics, Fordham University, New York, NY; Institute for the Study of Labor, Bonn, Germany; and.
Subha
S
Mani
Group for the Analysis of Development, Lima, Peru;
Alan
A
Sánchez
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA.
Aryeh D
AD
Stein
Community Health and Human Development, School of Public Health, University of California, Berkeley, CA;
Lia C H
http://orcid.org/0000-0003-1555-4607
LC
Fernald
D015992:Body Mass Index; D002648:Child; D002657:Child Development; D002664:Child Nutritional Physiological Phenomena; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects / Q000191:economics; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006284:Health Plan Implementation; D006801:Humans; D007804:Language Development; D008297:Male; D050177:Overweight / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D010568:Peru / Q000453:epidemiology; D011203:Poverty / Q000517:prevention & control*; D015995:Prevalence; D011632:Public Assistance; D012737:Sex Factors
Juntos; Peru; body mass index-for-age; children; cohort study; conditional cash transfer; height-for-age; overweight; receptive vocabulary; stunting