title: Health effects of 'Juntos', a conditional cash transfer programme in Peru.
abstract: In some countries, conditional cash transfer (CCT) programmes show an impact on maternal and child health. Juntos, the CCT programme in Peru, has been evaluated several times operationally, but seldom for maternal and child health outcomes. The objective of this study is to evaluate the impact of Juntos on children under 6 years, pregnant women and mothers of children under 17 years. Outcomes evaluated included (1) anaemia in women and children; (2) acute malnutrition in children; (3) post-partum complications in mothers; and (4) underweight and overweight in mothers. We identified Juntos eligible respondents from the Demographic and Health Surveys of Peru for years 2007 to 2013. Propensity score matching was used to identify comparable treatment and control groups, including eligible respondents enrolled in Juntos vs. those not enrolled in Juntos (individual-level analysis), as well as eligible respondents living in Juntos districts vs. those not residing in Juntos districts (district-level analysis). We then used generalized linear models to estimate prevalence ratios. Individual level analysis showed that Juntos reduced underweight in women (PR:0.39, 95%CI:0.18 - 0.85) and anaemia in children (PR:0.93, 95%CI:0.86 - 1.00). In the district level analysis, the programme was associated with a reduction of overweight in women (PR:0.94, 95%CI:0.90 - 0.98) and acute malnutrition in children (PR:0.49, 95%CI:0.32 - 0.73), but an increase in the prevalence of anaemia in children (PR:1.09, 95%CI:1.01 - 1.17). We found that Juntos had an effect on maternal and child health indicators, but further studies are required to overcome some limitations encountered here.
authors.affiliation: School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: José E
authors.initials: JE
authors.lastname: Pérez-Lu
authors.affiliation: School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Cesar
authors.initials: C
authors.lastname: Cárcamo
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada.|Institute for Health and Social Policy, McGill University, Montreal, Québec, Canada.
authors.forename: Arijit
authors.initials: A
authors.lastname: Nandi
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada.|Institute for Health and Social Policy, McGill University, Montreal, Québec, Canada.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Kaufman
mesh_terms: D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology* / Q000628:therapy; D015992:Body Mass Index; D002648:Child; D000067576:Child Health / Q000191:economics; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D044342:Malnutrition / Q000453:epidemiology* / Q000628:therapy; D000068097:Maternal Health / Q000191:economics; D009035:Mothers; D009752:Nutritional Status; D050177:Overweight / Q000453:epidemiology* / Q000628:therapy; D010349:Patient Compliance; D010568:Peru / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D011632:Public Assistance; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors; D013851:Thinness / Q000453:epidemiology* / Q000628:therapy
keywords: Health Policy; anaemia; child care; conditional cash transfer programmes; malnutrition; nutritional status; propensity score matching