Authored by: Dr. Luis Huicho, Director, Center for Research in Maternal and Child Health; Director of Research, Research Center for Integral and Sustainable Development, Universidad Peruana Cayetano Heredia, Lima, Peru Link to Bio
The impact of conditional cash transfer program in Peru (Juntos) as a stand-alone intervention on under-5 stunting, has not been conclusively demonstrated.
Different studies with different methodologic designs have been conducted to assess the impact of Juntos, and the results have shown little or no effect on under-5 stunting, although the effect on severe stunting tended to be more evident. Read more here.
More recently, my team conducted two studies using DHS as the main source of information. In the first one, through an ecological analysis conducted at departmental level through a multilevel mixed-effects linear regression, we found that a combination of factors accounted for the reduction in under-5 stunting from 2000 to 2012, with social determinants and out-of-health changes contributing more than proximal factors.1 In another study assessing the period 2000-2016, which included the mixed-effects linear regression and a decomposition analysis, we found that Juntos implementation had a significant association with stunting prevalence for the period 2000-2016. (Submitted).
In Peru, Juntos was aimed at reaching the poorest families. It was introduced in 2005 and scaled up quickly, reaching most of the country’s poor rural families. To receive a cash payment of USD 33 per month, mothers needed to access specific preventive and curative health services for themselves and their children on an ambitious schedule. For the complete list of Juntos requirements, read more here.
The available evidence suggests that conditional cash transfer programs like Juntos can impact the longitudinal growth of children by contributing to the reduction of poverty, increasing women's empowerment and reducing fertility rate, consequently allowing for better care and nutritional status of children. The Juntos program itself was not a specific driver of stunting reduction. Rather, it was a powerful enabler, contributing to a series of holistic investments across several sectors that collectively drove down stunting.
Likewise, in Kyrgyzstan during the post-independence period, the government maintained a small but well-targeted cash transfer program that, despite its size, put cash in the hands of families that needed it. The Universal Monthly Benefit (link) initially covered about ten percent of the population. It provided the poorest families with children between the ages of 18 months and 16 years with a grant of about 50 soms, or less than $1 per month. By targeting the poorest families with children, it reached children most at risk of stunting.
References
- 1 Sánchez A, Jaramillo M. Impacto del programa Juntos sobre nutrición temprana. Work Pap Ser [Internet]. 2012; Available from: https://ideas.repec.org/p/gad/doctra/dt61.html
- 2 Perova E, Vakis R. Welfare impacts of the “Juntos” Program in Peru; Evidence from a non-experimental evalaution [Internet]. 2009 [cited 2019 Apr 25]. Available from: http:www2.juntos.gob.pe/modulos/mod_legal/archivos/Evaluacion_Cuasi-Experimental1.pdf
- 3 Huicho L, Huayanay-Espinoza CA, Herrera-Perez E, Segura ER, Niño de Guzman J, Rivera-Ch M, Barros AJ. Factors behind the success story of under-five stunting in Peru: a district ecological multilevel analysis. BMC Pediatr. 2017 Jan 19;17(1):29. doi: 10.1186/s12887-017-0790-3.