Conditional Cash Transfer Programs to Improve Child Health

| April 6, 2013 | 0 Comments

In 2008, The Lancet published a series on child development that reported an estimated 200 million children under the age of five worldwide are not fulfilling their potential for growth, cognition, or socio-emotional development.  To address these troubling statistics, many countries around the world have implemented social assistance packages known as conditional cash transfer programs.

In the short-term, conditional cash transfer programs aim to provide poor households with the income required to maintain a minimum standard of living. But the long-term goal of conditional cash transfer programs is to provide children with the necessary resources to accumulate human capital and to break the intergenerational transmission of poverty described above, raising the standard of living for their families in the future.

The rationale behind conditional cash transfer programs and their effects on health is quite simple: children from low-income families begin life at a disadvantage. They tend to have poorer health, lower levels of education, and are often ill-equipped to achieve a higher quality of life in adulthood than they had in childhood. The same will then be true for their children, which creates a generational cycle of poverty which is very difficult to break.

Conditional cash transfer programs are quite versatile; programs can be tailored to fit the needs of a particular country, and funds can be appropriated, and conditionalities can be implemented to target specific needs that require the most assistance. In designing conditional cash transfer programs, governments and aid organizations need to first evaluate the health care and educational infrastructure of the target country. If, as is often the case in many low-income and developing countries, these underlying systems are not providing satisfactory services, perhaps initial investments to improve them would lead to enhanced impacts on the overall health of the country in the long-run.


One of the conditionalities of Mexico’s Oportunidades program is mandatory nutrition and health education classes for all members of beneficiary families.

One of the most successful conditional cash transfer programs was Mexico’s Oportunidades program. Studies evaluating the effects of Oportunidades found evidence of increased use of preventative health services for children, increased attendance in school, and decrease in child labor attributable to the program. There was a nearly 40% decrease in illness rates of children aged 0-35 months after just two years in the program compared to baseline. Overall, there was evidence of increased height-for-age and decreased stunting, improved motor and language development, and increased cognitive performance for children in Oportunidades beneficiary families.

A key conditionality in many cash transfer programs is mandatory classroom attendance for school-aged children.

A key conditionality in many cash transfer programs is mandatory classroom attendance for school-aged children.

In looking to the future, it is clear that conditional cash transfer programs have the potential to create lasting improvements in child health outcomes around the globe. Dr. Kim Wilson, of the Harvard Catalyst Center Clinical and Translational Science Center, has experience working with these types of programs. Dr. Wilson acknowledged that “as a pediatrician practicing in resource-limited settings in the US and globally, it is often clear that the family that has come to see me needs much more than the clinical care I can offer.” This, Dr. Wilson believes, is where conditional cash transfer programs can have an enormous impact on health. She states that conditional cash transfer programs are so important because they are “providing the most marginalized families with critical resources to meet basic needs” and that “by addressing key social determinants… they have successfully contributed to reducing the equity gap in child health.”

In the year 2000, the United Nations released eight Millennium Development Goals to be achieved by 2015.  Numbers one and two on the list are to eradicate extreme poverty and hunger and to achieve universal primary education. These Millennium Development Goals and the goals of conditional cash transfer programs align very well. The social determinants of child health are undoubtedly key to achieving the eight worldwide health goals outlined by the United Nations. Governments, policy makers, and public health officials need to collaborate and work together to design interventions to address these social determinants, and conditional cash transfer programs have potential to be one effective solution.

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Category: Development, Online

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