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Conditional cash transfer (JUNTOS)

Programs

Overall impact:     Medium

Impact: 

  Positive

Strength: 

  Medium

Juntos is a conditional cash transfer program aimed at alleviating poverty by positively influencing health seeking behaviors and education among women. Mothers enrolled in Juntos are required to bring their children under age 2 years to health centers to monitor their growth and overall health, and they are also required to ensure their children enroll and attend school. In return, these mothers receive 200 Peruvian Soles every two months.

Literature Review

Impact: 

  Mixed

Strength: 

  Strong

 

The evidence of the impact of Juntos on stunting prevalence in Peru has been mixed. Some studies have found evidence of positive impact on stunting prevalence.1 2

These positive effects may have been mediated by effective targeting of poor households with young children and increased utilization of health services, demonstrated across several other studies. 3 4  5  6

However, several other studies have found negative or unclear associations between Juntos and stunting. 7 8  9  10  11

Quantitative Analysis

Impact: 

  Positive

Strength: 

  Medium

 

According to the linear mixed effects regression, Juntos significantly influenced stunting prevalence in the expected direction for the 2000-2016 period, but not for 2000-2007 or 2008-2016 periods. For the 2000-2016 period, a very low p-value (<0.0001) and high effect size mean that Juntos was strongly and significantly associated with stunting decline.

Based on the decomposition analysis, Juntos gains were significantly linked to HAZ increase in children 24-59 months of age over the 2000-2016 period. For this age group and period, Juntos contributed to a 14.0 percent explainable change in HAZ. However, there was no significant relationship between Juntos and HAZ for any other age groups or periods of analysis.

Qualitative Analysis

Impact: 

  Mixed

Strength: 

  Medium

 

According to participants, Juntos served as an effective incentive for families to use child health and education services.

Conclusion

Juntos was likely a very important contributor to stunting decline but may require longer-duration follow up for further assessment. Our ecological quantitative analyses supported positive impact of Juntos on stunting decline in the 2000 - 2016 period, even after adjusting for key confounders. This is very much in line with qualitative reports from stakeholders and literature that endorse Juntos’s critical role in improving child health and nutrition in Peru.

Back to Analysis

  1. 1
    Acosta, M, A. “The politics of success in the fight against malnutrition in Peru.” 2014; government strategies Juntos and Crecer appear to be important for reducing stunting
  2. 2
    Perova, E.”5 Years in Juntos: New Evidence on the Program’s Short and Long-Term Impacts.” 2012; likely increased utilization of health services, but no study of relationship with stunting; those who spent one year or more in program had stronger impact on food consumption
  3. 3
    Huicho L, Segura ER, Huayanay-Espinoza CA, de Guzman JN, Restrepo-Méndez MC, Tam Y, Barros AJD, Victora CG, Maliqi B, Mathai M, et al. Child health and nutrition in Peru within an antipoverty political agenda: a Countdown to 2015 country case study. Lancet Glob Heal [Internet]. BioMed Central; 2016 [cited 2017 Jun 1];4:e414-26.
  4. 4
    Acosta AM. Analysing success in the fight against malnutrition in Peru. IDS Working Paper - Institute for Development Studies. Brighton, United Kingdom: Institute of Development Studies, University of Sussex; 2011.
  5. 5
    Global Work Force Alliance. Mid-level health workers country case studies: Annex 12. Peru [Internet]. Geneva, Switzerland; 2013.
  6. 6
    Mayta-Tristán P, Poterico JA, Galán-Rodas E, Raa-Ortiz D. EL REQUISITO OBLIGATORIO DEL SERVICIO SOCIAL EN SALUD DEL PERÚ: DISCRIMINATORIO E INCONSTITUCIONAL. Rev Peru Med Exp Salud Publica [Internet]. 2014 [cited 2018 Jan 2];31:781-7.
  7. 7
    Andersen CT, Reynolds SA, Behrman JR, Crookston BT, Dearden KA, Escobal J, Mani S, Sanchez A, Stein AD, Fernald LC. Participation in the Juntos Conditional Cash Transfer Program in Peru Is Associated with Changes in Child Anthropometric Status but Not Language Development or School Achievement. J Nutr. 2015;145:2396-405.
  8. 8
    Sanchez A, Melendez G, Behrman J. The Impact of the Juntos Conditional Cash Transfer Programme in Peru on Nutritional and Cognitive Outcomes: Does the Age of Exposure Matter? [Internet]. Oxford, UK; 2016. Available from: www.younglives.org.uk
  9. 9
    Huicho, L. “Factors behind the success story of under-five stunting in Peru: a district ecological multilevel analysis.” 2017; may need a longer period of study to determine association
  10. 10
    Spray, A. “LEVERAGING SOCIAL PROTECTION PROGRAMS FOR IMPROVED NUTRITION.” 2015; despite achievements in poverty reduction and health services utilization, Juntos didn’t achieve expected reduction in chronic malnutrition
  11. 11
    Ruel MT, Alderman H. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? The Lancet. 2013;382(9891):536-51.