An incentive-based program that now reaches 4.5 million families in Mexico is associated with lowering the rate of anemia and improving growth in low-income, rural infants and children, according to a study in the June 2 issue of the Journal of the American Medical Association (JAMA)
, a theme issue on Global Health.
Lead author Juan A. Rivera, Ph.D., Director of the Center for Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico, presented the findings of the study today at a JAMA media briefing at the National Press Club in Washington, D.C.
According to background information in the article, more than half of the yearly 10.8 million deaths of children younger than 5 years worldwide are attributed to malnutrition. Malnourished children who survive have a high risk of impaired health and function throughout life, which contributes to the intergenerational continuation of poverty. In developing countries more than one-quarter of all children younger than 5 years, about 150 million total, are estimated to be malnourished. Existing malnutrition interventions are effective under controlled conditions; however, little information is available on their effectiveness in large-scale programs.
Rivera and colleagues conducted a study to determine the short-term nutritional impact of the large-scale, incentive-based development welfare program in Mexico, Progresa (Program for Education, Health, and Nutrition, currently called Oportunidades). Progresa has been applied by the Mexican federal government since 1997. As part of the program, children and pregnant and lactating women in participating households received fortified nutrition supplements called papilla, and the families received nutrition education, health care, and cash transfers.
The families received the cash transfers if they complied with requirements concerning school attendance and maintaining certain health care appointments for services such as immunizations, well baby care and growth monitoring of children, prenatal and postnatal care, check-up visits for other family members, and a mandatory session on nutrition and health education.
The study included 347 communities randomly assigned to immediate incorporation to the program in 1998 (intervention group; n = 205) or to incorporation in 1999 (crossover intervention group; n=142). A random sample of infants in those communities was surveyed at baseline and at 1 and 2 years afterward. Participants were from low-income households in poor rural communities in 6 central Mexican states. Infants (N = 650) 12 months of age or younger (n = 373 intervention group; n = 277 crossover intervention group) were included in the analyses.