Eeshani Kandpal1, Harold Alderman2, Jed Friedman3, Deon Filmer3, Junko Onishi4, Jorge Avalos5. 1. Development Research Group and ekandpal@worldbank.org. 2. International Food Policy Research Institute, Washington, DC; and. 3. Development Research Group and. 4. Social Protection and Labor, The World Bank, Washington, DC; 5. Social Protection and Labor, The World Bank, Manila, Philippines.
Abstract
BACKGROUND: 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. OBJECTIVE: We investigated whether Pantawid improved anthropometric measurements in children aged 6-36 mo. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
RCT Entities:
BACKGROUND: 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. OBJECTIVE: We investigated whether Pantawid improved anthropometric measurements in children aged 6-36 mo. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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: Sirajuddin Sirajuddin; Saifuddin Sirajuddin; Amran Razak; Ansariadi Ansariadi; Ridwan M Thaha; Toto Sudargo Journal: J Public Health Res Date: 2021-04-14
Authors: Yefu Zhang; Meimei Ji; Jiaojiao Zou; Tong Yuan; Jing Deng; Lina Yang; Mingzhi Li; Hong Qin; Jihua Chen; Qian Lin Journal: Int J Environ Res Public Health Date: 2018-03-15 Impact factor: 3.390