title: A Conditional Cash Transfer Program in the Philippines Reduces Severe Stunting.
abstract: Pantawid, a conditional cash transfer (CCT) program in the Philippines, provided grants conditioned on health-related behaviors for children aged 0-5 y and schooling for those aged 10-14 y.
  
  
  
  We investigated whether Pantawid improved anthropometric measurements in children aged 6-36 mo.
  
  
  
  We estimated cross-sectional intention-to-treat effects using a 2011 cluster-randomized trial across 130 villages-65 treated and 65 control-with data collected after 31 mo of implementation. Anthropometry characteristics were measured for 241 children in treated areas and 244 children in control areas. Health service use for children aged 6-36 mo and dietary intake for those aged 6-60 mo also were measured. Outcome variables were height-for-age z scores (HAZs) and weight-for-age z scores (WAZs), stunting, severe stunting, underweight, and severely underweight. Impact also was assessed on perinatal care, institutional delivery, presence of skilled birth attendant, breastfeeding practices, immunization, growth monitoring and deworming, care-seeking, and children's intake of protein-rich foods.
  
  
  
  Pantawid was associated with a significant reduction in severe stunting [<-3 SD from WHO standards for healthy children; β = -10.2 percentage points (95% CI -18.8, -1.6 percentage points); P = 0.020] as well as a marginally significant increase in HAZs [β = 0.284 SDs (95% CI -0.033, 0.602 SDs); P = 0.08]. WAZs, stunting, underweight, and severely underweight status did not change. Concomitantly, several measures of health-seeking behavior increased significantly.
  
  
  
  To our knowledge, Pantawid is one of few CCT programs worldwide that significantly reduced severe stunting in children aged 6-36 mo; changes in key parenting practices, including children's intake of protein-rich foods and care-seeking behavior, were concurrent.
authors.affiliation: Development Research Group and ekandpal@worldbank.org.
authors.forename: Eeshani
authors.identifier: 0000-0001-9055-6296
authors.initials: E
authors.lastname: Kandpal
authors.affiliation: International Food Policy Research Institute, Washington, DC; and.
authors.forename: Harold
authors.identifier: 0000-0001-8019-6397
authors.initials: H
authors.lastname: Alderman
authors.affiliation: Development Research Group and.
authors.forename: Jed
authors.initials: J
authors.lastname: Friedman
authors.affiliation: Development Research Group and.
authors.forename: Deon
authors.identifier: 0000-0001-6650-2562
authors.initials: D
authors.lastname: Filmer
authors.affiliation: Social Protection and Labor, The World Bank, Washington, DC;
authors.forename: Junko
authors.initials: J
authors.lastname: Onishi
authors.affiliation: Social Protection and Labor, The World Bank, Manila, Philippines.
authors.forename: Jorge
authors.initials: J
authors.lastname: Avalos
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001835:Body Weight; D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D006130:Growth Disorders / Q000191:economics / Q000517:prevention & control*; D015438:Health Behavior; D006801:Humans; D007223:Infant; D009752:Nutritional Status; D010679:Philippines / Q000453:epidemiology; D015995:Prevalence; D011632:Public Assistance; D012959:Socioeconomic Factors; D013851:Thinness / Q000191:economics / Q000517:prevention & control*
keywords: Philippines; child nutrition; conditional cash transfers; stunting; transfers