Table 1 Selected Studies, CCT program, country, study design, SDH associated to beneficiaries and health outcomes

1

The impact of Mexico’s conditional cash transfer programme, Oportunidades, on birthweight [37]

Oportunidades

Mexico

Experimental

Low-income and underpriviliged locations (rural area), indigenous background

Estimation of the impact of the programme on birthweight in grams and low birth- weight (<2500 g)

Oportunidades beneficiary status was associated with higher birthweight (127.3 g) among participating women and a 4.6 percentage point reduction in low birthweight.

2

Empowering women: how Mexico’s conditional cash transfer programme raised prenatal care quality and birth weight [38]

Oportunidades

Mexico

Experimental

Low-income and underpriviliged locations (rural area), indigenous background

Estimation of the impact of the programme on birthweight in grams and low birth- weight (<2500 g)

Study showed that birth weight of beneficiaries are on average 127.3 g higher than non-beneficiaries and that the incidence of low birth weight is 44.5% lower among beneficiaries. They also found that the improvement in birth outcomes is entirely explained by better quality of prenatal care.

3

A healthier start: The effect of conditional cash transfers on neonatal and infant mortality in rural Mexico [24]

Progresa (later called Oportunidades)

Mexico

Experimental

Recipients had higher illiteracy rates and less access to electricity.

Evaluation of the impact of the Mexican conditional cash transfer program on infant and neonatal mortality

Progresa led to a large 17% decline in rural infant mortality among the treated, but did not reduce neonatal mortality on average. The benefit–cost ratio is between 1.3 and 3.6. Tests for heterogeneity show larger declines for some groups including those municipalities whose pre-program levels of mortality were above the median, and those that prior to the program had higher illiteracy rates, and less access to electricity.

4

Eradicating diseases: The effect of conditional cash transfers on vaccination coverage in rural Nicaragua [21]

Red de Proteccion Social

Nicaragua

Experimental

Low-income and underpriviliged locations, mother with a low educational level

Evaluation of the impact of the Nicaraguan program on vaccination coverage

Double-difference estimates showed the program led to large increases in vaccination coverage, and these resulted in vaccination levels greater than 95% for some vaccines

5

More evidence on the impact of India’s conditional cash transfer program, Janani Suraksha Yojana: Quasi-experimental evaluation of the effects on childhood immunization and other reproductive and child health outcomes [20]

Janani Suraksha Yojana

India

Quasi-experimental design

Low-income and underpriviliged locations, ethnicity background

Evaluation of the impact of JSY on immunization rates

Receipt of financial assistance from Janani Suraksha Yojana led to an increase in immunization rates ranging from 3.1) percentage points for one dose of polio vaccine to 9.1 percentage points in the proportion of fully vaccinated children.

6

Nutritional condition of children who benefit from the “Bolsa Família” programme in a city of northwestern São Paulo State, Brazil [31]

Bolsa Familia

Brazil

Observational, cross-section study

Low-income location

Assessment of Height for age, Weight for age, Weigh for height, BMI for age in z-scores for children enrolled in Bolsa Familia

8.8% of the children havedeficits concerning height/age and 4.2% have deficits concerning weight/age; 8.1% and 7.4% are overweight concerning weight/age and weight/height; 4.6% of the children under 2 years old have higher weight than the expected for their age and also for their height, and 7.8% of the children have low height for their age. The prevalence of weight deficit and excess in children observed in thisstudy were similar to those found in other regions of Brazil.

7

Estado nutricio de dos generaciones de hermanos(as) < de 5 años de edad beneficiarios(as) de Oportunidades, en comunidades rurales marginadas de Chiapas, México [39]

Oportunidades

Mexico

Observational, cohort study

Low-income and underprivileged location (rural area), ethnicity

Assessmeent of Height for age, Weight for age, Weigh for height of children enrolled in Oportunidades

43.4% of brothers and sisters evaluated in 2010–2011 showed stunting, underweight prevalence declined from 18% to 13.2%, wasting (low weight for height) increased from 8.1% to 10.4%. Overweight and obesity increased significantly by 12 percentage points among brothers and sisters, from 24.8% in 2002–2003 to 36.8% in 2010–2011.

8

The Combined Effects of the Expansion of Primary Health Care and Conditional Cash Transfers on Infant Mortality in Brazil, 1998–2010 [25]

Bolsa Familia

Brazil

Mixed ecological design, combining an ecological multiple-group design with a time-trend design

Low-income location

Evaluation of the effects of Bolsa Familia on postneonatal mortality

The association of higher Family Health Program (FHP) coverage with lower postneonatal infant mortality became stronger as BFP coverage increased.

9

Child health in rural Mexico: Has progresa reduced children’s morbidity risks? [23]

Progresa (lately called Oportunidades)

Mexico

Experimental

Low-income location

Impact of Progresa on child Morbidity (incidence of diarrhoea and acute respiratory infections)

Progresa contributed to reducing morbidity rates. The authors found that for both diseases under study, the Programme effect was mainly due to a decrease in the morbidity risks of children aged between 24 and 59 months. However, the evidence of a Programme effect was stronger for diarrhoea than for respiratory infections.

10

Role of cash in conditional cash transfer programmes for child health, growth, and development: an analysis of Mexico’s Oportunidades [40]

Oportunidades

Mexico

Experimental

Households with a low-income level

Impact of Oportunidades on Height for age, Weight for age, Weigh for height, BMI for age, haemoglobin concentration, number of sick days in the 4 weeks before the survey

A doubling of cash transfers was associated with higher height-for-age Z score (β 0.20, 95% CI 0.09–0.30; p < 0·0001), lower prevalence of stunting (−0.10, −0.16 to −0.05; p < 0·0001), lower body-mass index for age percentile (−2.85, −5.54 to −0.15; p = 0.04), and lower prevalence of being overweight (−0.08, −0.13 to −0.03; p = 0.001). A doubling of cash transfers was also associated with children doing better on a scale of motor development, three scales of cognitive development, and with receptive language.

11

India’s Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation [28]

Janani Suraksha Yojana

India

Observational, case-control study

Low-income women with low- educational levels, ethnicity

Effects of JSY on child mortality (perinatal deaths per 1000 pregnancies and neonatal deaths per 1000 livebirths)

The poorest and least educated women did not always have the highest odds of receiving JSY payments. JSY had a significant effect on increasing antenatal care and in-facility births. In the matching analysis, JSY payment was associated with a reduction of 3.7 perinatal deaths per 1000 pregnancies and 2.3 neonatal deaths per 1000 livebirths. In the with-versus-without comparison, the reductions were 4.1 perinatal deaths per 1000 pregnancies and 2.4 neonatal deaths per 1000 livebirths

12

Effects of a conditional cash transfer programme on child nutrition in Brazil [29]

Bolsa Familia

Brazil

Observational, cross-section study

Low-income and underpriviliged locations, low-educational level of the head of the family, female headed household, houses with lack of piped water and electricity

Effect of Bolsa Familia on height for age, weight for age and weight for height z-scores

Children from families exposed to the BFP were 26% more likely to have normal height for age than those from non-exposed families; this difference also applied to weight for age. No statistically significant deficit in weight for height was found. Stratification by age group revealed 19% and 41% higher odds of having normal height for age at 12–35 and 36–59 months of age, respectively, in children receiving Bolsa Familia, and no difference at 0–11 months of age.

13

Effect of a conditional cash transfer programme on childhood mortality: a nationwide analysis of Brazilian municipalities [26]

Bolsa Familia

Brazil

Mixed ecological design, combining an ecological multiple-group design with a time-trend design

Municipalities with a lower socioeconomic status

Effects of Bolsa Familia on under-5 mortality rate

Under-5 mortality rate, overall and resulting from poverty-related causes, decreased as BFP coverage increased. The rate ratios (RR) for the effect of the BFP on overall under-5 mortality rate were 0.94 for intermediate coverage, 0.88 for high coverage, and 0.83 for consolidated coverage. The effect of consolidated BFP coverage was highest on under-5 mortality resulting from malnutrition (RR 0.35) and diarrhoea (0.47).

14

Effects of unconditional and conditional cash transfers on child health and development in Zimbabwe: a cluster-randomised trial [22]

Manicaland HIV/STD Prevention Project

Zimbabwe

Experimental

Low-income level, having orphans or being child-headed or eldery-headed household or having ill or disabled household member

Impact of the CCT on the proportion of chilren younger than 5 years with up-to-date vaccinations

The proportions of children aged 0–4 years with complete vaccination records was 3.1% greater in the UCT group and 1.8% greater in the CCT group than in the control group.

15

Brazil’s Conditional Cash Transfer Program Associated With Declines In Infant Mortality Rates [27]

Bolsa Familia

Brazil

Mixed ecological design, combining an ecological multiple-group design with a time-trend design

Municipalities with lower levels of child development and health services coverage

Association of Bolsa Familia on child mortallity rates (infant mortality rate, neonatal and postnatal mortality rate)

During the first five years of the program, BFP was associated with a significant 9.3% reduction in overall infant mortality rates, with greater declines in postneonatal mortality rates than in mortality rates at an earlier age and in municipalities with many users of Brazil’s Family Health Program than in those with lower use rates. There were also larger effects in municipalities with higher infant mortality rates at baseline.

16

Financial incentives in health: New evidence from India’s Janani Suraksha Yojana [40]

Janani Suraksha Yojana

India

Observational, cohort study

Low-income women with low- educational levels, ethnicity

Effects of JSY on neonatal or early neonatal mortality

The results showed that cash incentives to women were associated with increased uptake of maternity services but there is no strong evidence that the JSY was associated with a reduction in neonatal or early neonatal mortality.

17

Anthropometric assessment and food intake of children younger than 5 years of age from a city in the semi-arid area of the Northeastern region of Brazil partially covered by the bolsa família program [30]

Bolsa Familia

Brazil

Observational, cross-section study

Low-income locations and households with a lower probability of water supply

Assessing weight-for-age, height-for-age and weight-for-height z-scores of children enrolled in Bolsa Familia

Of the studied children, 4.3% were underweight, 9.9% were stunted and 14.0% were overweight. The nutritional status of children whose families receive the Bolsa Família financial aid was not significantly different from those whose families do not receive the aid. In both groups, the consumption of fruits and non-starchy vegetables was low and similar. Children from families who receive the aid were three times more likely to eat junk food.