Menu ENN Search

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

Summary of published research1

The Bolsa Familia programme (BFP) in Brazil is the world’s largest conditional cash transfer programme. It reaches 5,564 municipalities in the 27 states of Brazil and about 11 million families (25% of the Brazilian population). The programme guarantees direct cash transfers to: families in poverty or extreme poverty (household income per capita below US$44 and below US$22 respectively in 2005-6), families with children 0-15 years of age and families with a pregnant or lactating woman.

A family enrolled in the cash transfer programme

In 2008, the age group for the children was extended to 17 years. In most cases, the cash transfer is paid to the reference female of the family group. The per capita income cut-offs and the values of cash transferred are readjusted every two years or so, by decree. The value per family depends on the poverty threshold and family composition. No nutrition supplement is distributed.

Once a family enrols, it must comply with certain health and education conditions to remain in the programme: i) a minimum school attendance of 85% of the monthly school hours for children 7-17 years old, ii) a health and nutrition agenda for beneficiary families with pregnant women, breastfeeding mothers or children under 7 years of age (pre-natal care, vaccination, health and nutrition surveillance).

A study that has just been published set out to examine the association between the BFP and the anthropometric indicators of nutritional status in children. Using the opportunity provided by vaccination campaigns, the Brazilian government promotes Health and Nutrition Days to estimate the prevalence of anthropometric deficits in children. Data collected in 2005-6 for 22,375 impoverished children under 5 years of age were employed to estimate nutritional outcomes among recipients of the BFP. All variables under study, namely child birth weight, lack of birth certificate, educational level and gender of family head, access to piped water and electricity, height for age, weight for age and weight for height, were converted into binary variables for regression analysis.

A family enrolled in the cash transfer programme

The subsequent analysis found that children from families exposed to the BFP were 26% more likely to have normal height for age than those from nonexposed 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 months and 36-59 months of age, respectively in children receiving the programme and no difference at 0-11 months of age.

The authors of the study note that others studies have found that the Gini index, an indicator of income distribution, remained stable in Brazil for many years but has dropped consistently since 2001. Almost one quarter of the drop is attributable to the BFP. Furthermore, propensity score analysis used in the baseline study for the BFP showed larger family expenditures among enrolled families than in the comparison groups, especially on food (US$172 more a year on food items).

The authors conclude that the BFP can lead to better nutritional outcomes in children between 12-59 months of age. However, longitudinal studies designed to evaluate the impact of the BFP are necessary to determine if the nutritional effects observed in the study can be attributed to the conditional cash transfer programme. Furthermore, there is a need to guarantee families in the BFP increased access to goods and services conducive to improved nutrition, which should in turn result in improved health. Similarly, to guarantee programme effectiveness, the Brazilian government needs to provide more and better services in the spheres of basic education, health, social protection and inclusion in the labour market.

Show footnotes

1Paes-Sousa. R, Santos.L and Miazaki. E 2011). Effects of a conditional cash transfer programme on child nutrition in Brazil. Bulletin of the World Health Organisation 2011; 89: 496-503. Published online: 29th April 2011

More like this

FEX: From the editor

This issue of Field Exchange gives extended coverage to a briefing paper just released by Oxfam and SC UK on the 2011 response to the Horn of Africa crisis. This paper argues...

FEX: Child stunting in Brazil

Summary of published research1 A study to assess trends in the prevalence and social distribution of child stunting in Brazil and to evaluate the effect of relatively recent...

FEX: Effect of an emergency cash transfer programme on weight gain and acute malnutrition risk in Niger

Research snapshot1 Assessment of the impact of emergency cash transfer programmes on child nutritional status has been difficult to achieve due to the considerable logistic...

FEX: Cash transfers and child nutrition

Summary of research1 Location: Global What we know: Cash transfer (CT) programming is an expanding form of social protection that has potential to improve child...

FEX: Scalable integrated early child development programme using a conditional cash transfer programme in Colombia

Summary of research1 Location: Colombia What we know: Poverty and the associated poor nutrition and lack of psychosocial stimulation are associated with poor child...

FEX: How to engage across sectors: Lessons from agriculture and nutrition in the Brazilian School Feeding Programme

Summary of research* Location: Brazil What we know: Historically, successful collaboration between agriculture, nutrition and health sectors has proved challenging. What...

FEX: Briefing on the Bihar Child Support Programme, India

By Oxford Policy Management (OPM) India Oxford Policy Management (OPM) is a development and research based consultancy company that has 30 years' experience is providing...

FEX: Impact of a conditional cash transfer programme on determinants of child health in Colombia

Summary of research1 Location: Colombia What we know: Conditional cash transfer (CCT) programmes have demonstrated large impacts on child education, health and nutritional...

FEX: Child outcomes of cash transfer programmes in humanitarian and development contexts

Summary of research1 Location: Global What we know: Cash transfer programmes (CTPs) have a proven impact on poverty reduction and social protection but their overall impact...

FEX: Impact of child support grant in South Africa on child nutrition

Summary of research* Location: South Africa What we know: Stunting is an indicator of chronic undernutrition and is often linked to poverty-related factors. There is mixed...

en-net: Potential Negative Impacts of Cash Transfers on Nutrition Status

Dear All I am looking for information on the potential negative impacts of cash transfers on the nutrition status. I would grateful if you can share with me...

FEX: Impact evaluation of a cash-transfer programme for Syrian refugees in Lebanon

By Christian Lehmann and Daniel T. R. Masterson Daniel Masterson is a PhD student in Political Science at Yale University. Daniel worked for UNHCR in Syria in 2007 and 2008....

FEX: DRC experiences of cash assistance to non-camp refugees in Lebanon and Turkey

By Louisa Seferis Louisa is the MENA Regional Livelihoods & Cash Advisor for the Danish Refugee Council (DRC). She has worked for three years with the DRC for the Syrian...

FEX: Impact evaluation of cash, food vouchers, and food transfers among Colombian refugees and poor Ecuadorians in urban Ecuador

Summary of evaluation1 Evaluation headlines: Levels of food insecurity and associated anaemia are high amongst Columbian refugees and poor Ecuadorians in the northern...

FEX: Treatment of undernutrition in urban Brazil

Summary of research1 In Brazil, 6% of children aged less than 5 years suffer from height-forage (HAZ) deficit, while the prevalence of this condition is higher (8.2%) among...

FEX: An overview of REST’s implementation of the Productive Safety Net Programme

By The Relief Society of Tigray (REST) Mekelle Team The Relief Society of Tigray (REST) has been in existence in Ethiopia for over 30 years, starting out as a relatively small...

FEX: WHO consultation on management of moderate malnutrition in U5s

The WHO, in collaboration with UNICEF, WFP and UNHCR, hosted a second consultation to discuss the programmatic aspects of the management of moderate malnutrition in children...

FEX: Direct procurement from family farms for national school feeding programme in Brazil

Research By Claudia Rodriguez, Iris Emanuelly Segura, Ana Paula Cantarino Frasão de Carmo, Daniela Bicalho, Vanessa Manfre Garcia Souza, Flavia Schwartzman and...

FEX: Feasibility and effectiveness of preventing child malnutrition with local foods in Kenya

Summary of research1 One of the researchers (Rebecca Ashton) weighs a child The findings of a study to establish the operational feasibility and effectiveness of using locally...

FEX: Review of the micronutrient impact of multi-sectoral programmes focusing on nutrition

Summary of research1 Location: Global What we know: Common strategies to combat micronutrient deficiencies involve supplementation and fortification, breastfeeding promotion,...

Close

Reference this page

Effects of a conditional cash transfer programme on child nutrition in Brazil. Field Exchange 42, January 2012. p15. www.ennonline.net/fex/42/effects