title: Conditional cash transfer programs and the health and nutrition of Latin American children.
abstract: OBJECTIVE
  To 1) describe the benefits, conditions, coverage, funding, goals, governance, and structure of well-established conditional cash transfer programs (CCTs) in Latin America and 2) identify their health and nutritional impacts among children under 5 years old.
  
  
  METHODS
  A realist review was conducted. CCTs were included if they met the following inclusion criteria: 1) current national-level program; 2) coverage of at least 50% of the target population; 3) continuous operation at scale for 10+ years; 4) clear description of structure, funding sources, and governance; 5) both health/nutrition- and education-related conditions for participation; and 6) available impact evaluation studies with health, development, and/or nutrition indicators among children under 5 years old. Three CCTs (one each in Brazil, Colombia, and Mexico) met the criteria.
  
  
  RESULTS
  There was consistent evidence that the three CCTs selected for review had positive impacts on child health and nutrition outcomes in their respective countries. In all three countries, the programs were scaled up and positive impacts were documented relatively quickly. All three programs had strong political support and clear and transparent governance structures, including accountability and social participation mechanisms, which might explain their success and sustainability.
  
  
  CONCLUSIONS
  CCTs in Latin America have had a positive impact on child health and nutrition outcomes among the poorest families. A key challenge for the future is to reform these programs to help families move out of not only extreme poverty but all poverty in order to lead healthy and productive lives, as called for in the post-2105 Sustainable Development Goals.
authors.affiliation: Independent Health and Nutrition Consultant, Storrs, Connecticut, United States of America.
authors.forename: Sofia
authors.initials: S
authors.lastname: Segura-Pérez
authors.affiliation: Pan American Health Organization, Washington, District of Columbia, United States of America.
authors.forename: Rubén
authors.initials: R
authors.lastname: Grajeda
authors.affiliation: Professor of Epidemiology and Public Health, Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America.
authors.forename: Rafael
authors.initials: R
authors.lastname: Pérez-Escamilla
mesh_terms: D001938:Brazil; D002675:Child, Preschool; D003105:Colombia; D005378:Financial Support; D006801:Humans; D007223:Infant; D007843:Latin America; D008800:Mexico; D009752:Nutritional Status; D016730:Program Development / Q000191:economics* / Q000379:methods; D015397:Program Evaluation; D012201:Reward