Leroy Jef L, García-Guerra Armando, García Raquel, Dominguez Clara, Rivera Juan, Neufeld Lynnette M
Center for Evaluation Research and Surveys, National Institute of Public Health, Colonia Santa María Ahuacatitlán, CP 62508, Cuernavaca, Morelos, Mexico.
J Nutr. 2008 Apr;138(4):793-8. doi: 10.1093/jn/138.4.793.
The goal of this study was to evaluate the impact of Mexico's conditional cash transfer program, Oportunidades, on the growth of children <24 mo of age living in urban areas. Beneficiary families received cash transfers, a fortified food (targeted to pregnant and lactating women, children 6-23 mo, and children with low weight 2-4 y), and curative health services, among other benefits. Program benefits were conditional on preventative health care utilization and attendance of health and nutrition education sessions. We estimated the impact of the program after 2 y of operation in a panel of 432 children <24 mo of age at baseline (2002). We used difference-in-difference propensity score matching, which takes into account nonrandom program participation and the effects of unobserved fixed characteristics on outcomes. All models controlled for child age, sex, baseline anthropometry, and maternal height. Anthropometric Z-scores were calculated using the new WHO growth reference standards. There was no overall association between program participation and growth in children 6 to 24 mo of age. Children in intervention families younger than 6 mo of age at baseline grew 1.5 cm (P < 0.05) more than children in comparison families, corresponding to 0.41 height-for-age Z-scores (HAZ) (P < 0.05). They also gained an additional 0.76 kg (P < 0.01) or 0.47 weight-for-height Z-scores (P < 0.05). Children living in the poorest intervention households tended (0.05 < P < 0.10) to be taller than comparison children (0.9 cm, 0.27 HAZ). Oportunidades, with its strong nutrition component, is an effective tool to improve the growth of infants in poor urban households.
本研究的目的是评估墨西哥有条件现金转移支付计划“机遇计划”对居住在城市地区24个月龄以下儿童生长发育的影响。受益家庭可获得现金转移支付、一种强化食品(针对孕妇和哺乳期妇女、6至23个月龄儿童以及2至4岁低体重儿童)以及治疗性医疗服务等福利。计划福利以预防性医疗保健的利用情况以及参加健康和营养教育课程为条件。我们在一个由432名基线时(2002年)24个月龄以下儿童组成的样本中,估计了该计划实施2年后的影响。我们使用了差分倾向得分匹配法,该方法考虑了非随机的计划参与情况以及未观察到的固定特征对结果的影响。所有模型都控制了儿童年龄、性别、基线人体测量指标以及母亲身高。人体测量Z评分是根据世界卫生组织新的生长参考标准计算得出的。计划参与与6至24个月龄儿童的生长发育之间没有总体关联。基线时年龄小于6个月的干预家庭儿童比对照家庭儿童多生长1.5厘米(P<0.05),相当于年龄别身高Z评分(HAZ)增加0.41(P<0.05)。他们还额外增重0.76千克(P<0.01)或身高别体重Z评分增加0.47(P<0.05)。生活在最贫困干预家庭的儿童往往(0.05<P<0.10)比对照儿童更高(高0.9厘米,0.27 HAZ)。“机遇计划”因其强大的营养成分,是改善贫困城市家庭婴儿生长发育的有效工具。