There is a growing concern that food or cash transfer programs may contribute to overweight and o... more There is a growing concern that food or cash transfer programs may contribute to overweight and obesity in adults. We studied the impact of Mexico's Programa de Apoyo Alimentario (PAL), which provided very poor rural households with cash or in-kind transfers, on women's body weight. A random sample of 208 rural communities in southern Mexico was randomly assigned to 1 of 4 groups: food basket with or without health and nutrition education, cash with education, or control. The impact on women's weight was estimated in a cohort of 301 O women using a difference-in-difference model. We compared the impact between the food basket and cash groups and evaluated whether the impact was modified by women's BMI status at baseline. With respect to the control group, the program increased women's weight in the food basket (550 :!: 21 O g; P = 0.0041 and the cash group (420 :!: 230 g; P= 0.032); this was equivalent to 70 and 53% increases in weight gain, respectively, over th...
The authors conducted a systematic review of impact evaluations of daycare interventions on the h... more The authors conducted a systematic review of impact evaluations of daycare interventions on the health, nutrition and development of children under five in low-income and middle-income countries. The review was limited to intervention studies controlling for potential self-selection of beneficiaries. Papers were excluded based on study scope, type and quality. Only six studies (conducted in Latin America) met the inclusion
There is a growing concern that food or cash transfer programs may contribute to overweight and o... more There is a growing concern that food or cash transfer programs may contribute to overweight and obesity in adults. We studied the impact of Mexico's Programa de Apoyo Alimentario (PAL), which provided very poor rural households with cash or in-kind transfers, on women's body weight. A random sample of 208 rural communities in southern Mexico was randomly assigned to 1 of 4 groups: food basket with or without health and nutrition education, cash with education, or control. The impact on women's weight was estimated in a cohort of 301 O women using a difference-in-difference model. We compared the impact between the food basket and cash groups and evaluated whether the impact was modified by women's BMI status at baseline. With respect to the control group, the program increased women's weight in the food basket (550 :!: 21 O g; P = 0.0041 and the cash group (420 :!: 230 g; P= 0.032); this was equivalent to 70 and 53% increases in weight gain, respectively, over that observed in the control group in a 23-mo time period. The greatest impact was found in already obese women: 980 :t 290 gin the food basket group (P = 0.001Iand670 :!: 320 gin the cash group (P= 0.019). lmpact was marginally significant in women with a preprogram BMI between 25 and 30 kg/m2: 490 :t 31 O g (P = 0.0551 and 540 :!: 360 g (P = 0.0671, respectively. No program impact was found in women with a BMI <25 kg/mi. Providing households with a considerable amount of unrestricted resources led to excess weight gain in an already overweight population. Research is needed to develop cost-effective behavior change communication strategies to complement cash and in-kind transfer programs such as PAL and to help beneficiaries choose healthy diets that improve the nutritional status of all family members.
Introduction:
Although investment in HIV/AIDS prevention has increased worldwide, it remains unce... more Introduction: Although investment in HIV/AIDS prevention has increased worldwide, it remains uncertain how the additional resources can be most efficiently allocated to maximize the number of infections averted, especially at the country, regional and local levels.
Methods: Data from developing countries in Africa, Asia and Latin America were reviewed on the allocation of HIV/AIDS prevention funds in relation to the prevalence of infection, as well as budgetary allocations for specific population groups at high risk of infection, such as sex workers, intravenous drug users and men who have sex with men. The variation in unit costs of voluntary counselling and testing in five countries was also examined.
Results: Evidence was found of three distinct sources of inefficiency in the allocation of HIV/AIDS prevention resources: inefficiency in the mix of interventions selected; inefficient targeting of key populations; and technical inefficiency in the production of HIV prevention services.
Conclusion: A general conceptual framework for evaluating the efficiency of HIV/AIDS prevention programmes at the country, regional and local levels is proposed. This framework stresses three equally important components of programme efficiency: cost-effectiveness (the choice of the mix of interventions); targeting (the choice of the mix of target populations); and technical efficiency (the delivery of prevention services at least cost).
Conditional transfer programs are increasingly popular, but the impact on household nutrient cons... more Conditional transfer programs are increasingly popular, but the impact on household nutrient consumption has not been studied. We evaluated the impact of the Programa de Apoyo Alimentario (PAU, a cash and in-kind transfer program, on the energy and nutrient consumption of poor rural households in Mexico. The program has been shown to reduce poverty. Beneficiary households received either a food basket (including micronutrient-fortified milk) or cash. A random sample of 206 rural communities in Southern Mexico w as randomly assigned to 1 of 4 groups: a monthly food basket with or without health and nutrition education, a cash transfer with a cost to the government equivalent to the food basket (14 USD/rno) with education, or control. The impact alter 14 mq, of exposure was estimated in a panel of 5823 households using a double difference regression modal with household fixed effects. PAL was associated with increases IP < 0.01) in the consumption of total energy (5-9%), energy from fruits and vegetables (24-28%), and energy from animal source foods (24- 39%1. lt also affected iron, zinc, and vitamin A and C consumption (P < 0.05). The consumption of energy and all nutrients was greater in the food basket group (P < 0.05). Cash and in·kind transfers in populations that are not energy. deficient should be carefully redesigned to ensure that pulling poor familias out of poverty leads to improved micronutrient intake but not to increased energy consumption.
Conditional transfer programs are increasingly popular, but the impact on household nutrient cons... more Conditional transfer programs are increasingly popular, but the impact on household nutrient consumption has not been studied. We evaluated the impact of the Programa de Apoyo Alimentario (PAL), a cash and in-kind transfer program, on the energy and nutrient consumption of poor rural households in Mexico. The program has been shown to reduce poverty. Beneficiary households received either a food basket (including micronutrient-fortified milk) or cash. A random sample of 206 rural communities in Southern Mexico was randomly assigned to 1 of 4 groups: a monthly food basket with or without health and nutrition education, a cash transfer with a cost to the government equivalent to the food basket (14 USD/mo) with education, or control. The impact after 14 mo of exposure was estimated in a panel of 5823 households using a double difference regression model with household fixed effects. PAL was associated with increases (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) in the consumption of total energy (5-9%), energy from fruits and vegetables (24-28%), and energy from animal source foods (24-39%). It also affected iron, zinc, and vitamin A and C consumption (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The consumption of energy and all nutrients was greater in the food basket group (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Cash and in-kind transfers in populations that are not energy-deficient should be carefully redesigned to ensure that pulling poor families out of poverty leads to improved micronutrient intake but not to increased energy consumption.
There is a growing concern that food or cash transfer programs may contribute to overweight and o... more There is a growing concern that food or cash transfer programs may contribute to overweight and obesity in adults. We studied the impact of Mexico&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Programa de Apoyo Alimentario (PAL), which provided very poor rural households with cash or in-kind transfers, on women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s body weight. A random sample of 208 rural communities in southern Mexico was randomly assigned to 1 of 4 groups: food basket with or without health and nutrition education, cash with education, or control. The impact on women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s weight was estimated in a cohort of 3010 women using a difference-in-difference model. We compared the impact between the food basket and cash groups and evaluated whether the impact was modified by women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s BMI status at baseline. With respect to the control group, the program increased women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s weight in the food basket (550 ± 210 g; P = 0.004) and the cash group (420 ± 230 g; P = 0.032); this was equivalent to 70 and 53% increases in weight gain, respectively, over that observed in the control group in a 23-mo time period. The greatest impact was found in already obese women: 980 ± 290 g in the food basket group (P = 0.001) and 670 ± 320 g in the cash group (P = 0.019). Impact was marginally significant in women with a preprogram BMI between 25 and 30 kg/m2: 490 ± 310 g (P = 0.055) and 540 ± 360 g (P = 0.067), respectively. No program impact was found in women with a BMI &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;25 kg/m2. Providing households with a considerable amount of unrestricted resources led to excess weight gain in an already overweight population. Research is needed to develop cost-effective behavior change communication strategies to complement cash and in-kind transfer programs such as PAL and to help beneficiaries choose healthy diets that improve the nutritional status of all family members.
The authors conducted a systematic review of impact evaluations of daycare interventions on the h... more The authors conducted a systematic review of impact evaluations of daycare interventions on the health, nutrition and development of children under five in low-income and middle-income countries. The review was limited to intervention studies controlling for potential self-selection of beneficiaries. Papers were excluded based on study scope, type and quality. Only six studies (conducted in Latin America) met the inclusion
There is a growing concern that food or cash transfer programs may contribute to overweight and o... more There is a growing concern that food or cash transfer programs may contribute to overweight and obesity in adults. We studied the impact of Mexico's Programa de Apoyo Alimentario (PAL), which provided very poor rural households with cash or in-kind transfers, on women's body weight. A random sample of 208 rural communities in southern Mexico was randomly assigned to 1 of 4 groups: food basket with or without health and nutrition education, cash with education, or control. The impact on women's weight was estimated in a cohort of 301 O women using a difference-in-difference model. We compared the impact between the food basket and cash groups and evaluated whether the impact was modified by women's BMI status at baseline. With respect to the control group, the program increased women's weight in the food basket (550 :!: 21 O g; P = 0.0041 and the cash group (420 :!: 230 g; P= 0.032); this was equivalent to 70 and 53% increases in weight gain, respectively, over th...
The authors conducted a systematic review of impact evaluations of daycare interventions on the h... more The authors conducted a systematic review of impact evaluations of daycare interventions on the health, nutrition and development of children under five in low-income and middle-income countries. The review was limited to intervention studies controlling for potential self-selection of beneficiaries. Papers were excluded based on study scope, type and quality. Only six studies (conducted in Latin America) met the inclusion
There is a growing concern that food or cash transfer programs may contribute to overweight and o... more There is a growing concern that food or cash transfer programs may contribute to overweight and obesity in adults. We studied the impact of Mexico's Programa de Apoyo Alimentario (PAL), which provided very poor rural households with cash or in-kind transfers, on women's body weight. A random sample of 208 rural communities in southern Mexico was randomly assigned to 1 of 4 groups: food basket with or without health and nutrition education, cash with education, or control. The impact on women's weight was estimated in a cohort of 301 O women using a difference-in-difference model. We compared the impact between the food basket and cash groups and evaluated whether the impact was modified by women's BMI status at baseline. With respect to the control group, the program increased women's weight in the food basket (550 :!: 21 O g; P = 0.0041 and the cash group (420 :!: 230 g; P= 0.032); this was equivalent to 70 and 53% increases in weight gain, respectively, over that observed in the control group in a 23-mo time period. The greatest impact was found in already obese women: 980 :t 290 gin the food basket group (P = 0.001Iand670 :!: 320 gin the cash group (P= 0.019). lmpact was marginally significant in women with a preprogram BMI between 25 and 30 kg/m2: 490 :t 31 O g (P = 0.0551 and 540 :!: 360 g (P = 0.0671, respectively. No program impact was found in women with a BMI <25 kg/mi. Providing households with a considerable amount of unrestricted resources led to excess weight gain in an already overweight population. Research is needed to develop cost-effective behavior change communication strategies to complement cash and in-kind transfer programs such as PAL and to help beneficiaries choose healthy diets that improve the nutritional status of all family members.
Introduction:
Although investment in HIV/AIDS prevention has increased worldwide, it remains unce... more Introduction: Although investment in HIV/AIDS prevention has increased worldwide, it remains uncertain how the additional resources can be most efficiently allocated to maximize the number of infections averted, especially at the country, regional and local levels.
Methods: Data from developing countries in Africa, Asia and Latin America were reviewed on the allocation of HIV/AIDS prevention funds in relation to the prevalence of infection, as well as budgetary allocations for specific population groups at high risk of infection, such as sex workers, intravenous drug users and men who have sex with men. The variation in unit costs of voluntary counselling and testing in five countries was also examined.
Results: Evidence was found of three distinct sources of inefficiency in the allocation of HIV/AIDS prevention resources: inefficiency in the mix of interventions selected; inefficient targeting of key populations; and technical inefficiency in the production of HIV prevention services.
Conclusion: A general conceptual framework for evaluating the efficiency of HIV/AIDS prevention programmes at the country, regional and local levels is proposed. This framework stresses three equally important components of programme efficiency: cost-effectiveness (the choice of the mix of interventions); targeting (the choice of the mix of target populations); and technical efficiency (the delivery of prevention services at least cost).
Conditional transfer programs are increasingly popular, but the impact on household nutrient cons... more Conditional transfer programs are increasingly popular, but the impact on household nutrient consumption has not been studied. We evaluated the impact of the Programa de Apoyo Alimentario (PAU, a cash and in-kind transfer program, on the energy and nutrient consumption of poor rural households in Mexico. The program has been shown to reduce poverty. Beneficiary households received either a food basket (including micronutrient-fortified milk) or cash. A random sample of 206 rural communities in Southern Mexico w as randomly assigned to 1 of 4 groups: a monthly food basket with or without health and nutrition education, a cash transfer with a cost to the government equivalent to the food basket (14 USD/rno) with education, or control. The impact alter 14 mq, of exposure was estimated in a panel of 5823 households using a double difference regression modal with household fixed effects. PAL was associated with increases IP < 0.01) in the consumption of total energy (5-9%), energy from fruits and vegetables (24-28%), and energy from animal source foods (24- 39%1. lt also affected iron, zinc, and vitamin A and C consumption (P < 0.05). The consumption of energy and all nutrients was greater in the food basket group (P < 0.05). Cash and in·kind transfers in populations that are not energy. deficient should be carefully redesigned to ensure that pulling poor familias out of poverty leads to improved micronutrient intake but not to increased energy consumption.
Conditional transfer programs are increasingly popular, but the impact on household nutrient cons... more Conditional transfer programs are increasingly popular, but the impact on household nutrient consumption has not been studied. We evaluated the impact of the Programa de Apoyo Alimentario (PAL), a cash and in-kind transfer program, on the energy and nutrient consumption of poor rural households in Mexico. The program has been shown to reduce poverty. Beneficiary households received either a food basket (including micronutrient-fortified milk) or cash. A random sample of 206 rural communities in Southern Mexico was randomly assigned to 1 of 4 groups: a monthly food basket with or without health and nutrition education, a cash transfer with a cost to the government equivalent to the food basket (14 USD/mo) with education, or control. The impact after 14 mo of exposure was estimated in a panel of 5823 households using a double difference regression model with household fixed effects. PAL was associated with increases (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) in the consumption of total energy (5-9%), energy from fruits and vegetables (24-28%), and energy from animal source foods (24-39%). It also affected iron, zinc, and vitamin A and C consumption (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The consumption of energy and all nutrients was greater in the food basket group (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Cash and in-kind transfers in populations that are not energy-deficient should be carefully redesigned to ensure that pulling poor families out of poverty leads to improved micronutrient intake but not to increased energy consumption.
There is a growing concern that food or cash transfer programs may contribute to overweight and o... more There is a growing concern that food or cash transfer programs may contribute to overweight and obesity in adults. We studied the impact of Mexico&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Programa de Apoyo Alimentario (PAL), which provided very poor rural households with cash or in-kind transfers, on women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s body weight. A random sample of 208 rural communities in southern Mexico was randomly assigned to 1 of 4 groups: food basket with or without health and nutrition education, cash with education, or control. The impact on women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s weight was estimated in a cohort of 3010 women using a difference-in-difference model. We compared the impact between the food basket and cash groups and evaluated whether the impact was modified by women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s BMI status at baseline. With respect to the control group, the program increased women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s weight in the food basket (550 ± 210 g; P = 0.004) and the cash group (420 ± 230 g; P = 0.032); this was equivalent to 70 and 53% increases in weight gain, respectively, over that observed in the control group in a 23-mo time period. The greatest impact was found in already obese women: 980 ± 290 g in the food basket group (P = 0.001) and 670 ± 320 g in the cash group (P = 0.019). Impact was marginally significant in women with a preprogram BMI between 25 and 30 kg/m2: 490 ± 310 g (P = 0.055) and 540 ± 360 g (P = 0.067), respectively. No program impact was found in women with a BMI &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;25 kg/m2. Providing households with a considerable amount of unrestricted resources led to excess weight gain in an already overweight population. Research is needed to develop cost-effective behavior change communication strategies to complement cash and in-kind transfer programs such as PAL and to help beneficiaries choose healthy diets that improve the nutritional status of all family members.
The authors conducted a systematic review of impact evaluations of daycare interventions on the h... more The authors conducted a systematic review of impact evaluations of daycare interventions on the health, nutrition and development of children under five in low-income and middle-income countries. The review was limited to intervention studies controlling for potential self-selection of beneficiaries. Papers were excluded based on study scope, type and quality. Only six studies (conducted in Latin America) met the inclusion
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basket (550 :!: 21 O g; P = 0.0041 and the cash group (420 :!: 230 g; P= 0.032); this was equivalent to 70 and 53% increases in weight gain, respectively, over that observed in the control group in a 23-mo time period. The greatest impact was found in already obese women: 980 :t 290 gin the food basket group (P = 0.001Iand670 :!: 320 gin the cash group (P= 0.019). lmpact was marginally significant in women with a preprogram BMI between 25 and 30 kg/m2: 490 :t 31 O g (P = 0.0551
and 540 :!: 360 g (P = 0.0671, respectively. No program impact was found in women with a BMI <25 kg/mi. Providing households with a considerable amount of unrestricted resources led to excess weight gain in an already overweight population. Research is needed to develop cost-effective behavior change communication strategies to complement cash and in-kind transfer programs such as PAL and to help beneficiaries choose healthy diets that improve the nutritional status of all family members.
Although investment in HIV/AIDS prevention has increased worldwide, it remains uncertain how the additional resources can be most efficiently allocated to maximize the number of infections averted, especially at the country, regional and local levels.
Methods:
Data from developing countries in Africa, Asia and Latin America were reviewed on the allocation of HIV/AIDS prevention funds in relation to the prevalence of infection, as well as budgetary allocations for specific population groups at high risk of infection, such as sex workers, intravenous drug users and men who have sex with men. The variation in unit costs of voluntary counselling and testing in five countries was also examined.
Results:
Evidence was found of three distinct sources of inefficiency in the allocation of HIV/AIDS prevention resources: inefficiency in the mix of interventions selected; inefficient targeting of key populations; and technical inefficiency in the production of HIV prevention services.
Conclusion:
A general conceptual framework for evaluating the efficiency of HIV/AIDS prevention programmes at the country, regional and local levels is proposed. This framework stresses three equally important components of programme efficiency: cost-effectiveness (the choice of the mix of interventions); targeting (the choice of the mix of target populations); and technical efficiency (the delivery of prevention services at least cost).
Beneficiary households received either a food basket (including micronutrient-fortified milk) or cash. A random sample of 206 rural communities in Southern Mexico w as randomly assigned to 1 of 4 groups: a monthly food basket with or without health and nutrition education, a cash transfer with a cost to the government equivalent to the food basket (14 USD/rno) with education, or control. The impact alter 14 mq, of exposure was estimated in a panel of 5823 households using a
double difference regression modal with household fixed effects. PAL was associated with increases IP < 0.01) in the consumption of total energy (5-9%), energy from fruits and vegetables (24-28%), and energy from animal source foods (24- 39%1. lt also affected iron, zinc, and vitamin A and C consumption (P < 0.05). The consumption of energy and all nutrients was greater in the food basket group (P < 0.05). Cash and in·kind transfers in populations that are not energy. deficient should be carefully redesigned to ensure that pulling poor familias out of poverty leads to improved micronutrient intake but not to increased energy consumption.
basket (550 :!: 21 O g; P = 0.0041 and the cash group (420 :!: 230 g; P= 0.032); this was equivalent to 70 and 53% increases in weight gain, respectively, over that observed in the control group in a 23-mo time period. The greatest impact was found in already obese women: 980 :t 290 gin the food basket group (P = 0.001Iand670 :!: 320 gin the cash group (P= 0.019). lmpact was marginally significant in women with a preprogram BMI between 25 and 30 kg/m2: 490 :t 31 O g (P = 0.0551
and 540 :!: 360 g (P = 0.0671, respectively. No program impact was found in women with a BMI <25 kg/mi. Providing households with a considerable amount of unrestricted resources led to excess weight gain in an already overweight population. Research is needed to develop cost-effective behavior change communication strategies to complement cash and in-kind transfer programs such as PAL and to help beneficiaries choose healthy diets that improve the nutritional status of all family members.
Although investment in HIV/AIDS prevention has increased worldwide, it remains uncertain how the additional resources can be most efficiently allocated to maximize the number of infections averted, especially at the country, regional and local levels.
Methods:
Data from developing countries in Africa, Asia and Latin America were reviewed on the allocation of HIV/AIDS prevention funds in relation to the prevalence of infection, as well as budgetary allocations for specific population groups at high risk of infection, such as sex workers, intravenous drug users and men who have sex with men. The variation in unit costs of voluntary counselling and testing in five countries was also examined.
Results:
Evidence was found of three distinct sources of inefficiency in the allocation of HIV/AIDS prevention resources: inefficiency in the mix of interventions selected; inefficient targeting of key populations; and technical inefficiency in the production of HIV prevention services.
Conclusion:
A general conceptual framework for evaluating the efficiency of HIV/AIDS prevention programmes at the country, regional and local levels is proposed. This framework stresses three equally important components of programme efficiency: cost-effectiveness (the choice of the mix of interventions); targeting (the choice of the mix of target populations); and technical efficiency (the delivery of prevention services at least cost).
Beneficiary households received either a food basket (including micronutrient-fortified milk) or cash. A random sample of 206 rural communities in Southern Mexico w as randomly assigned to 1 of 4 groups: a monthly food basket with or without health and nutrition education, a cash transfer with a cost to the government equivalent to the food basket (14 USD/rno) with education, or control. The impact alter 14 mq, of exposure was estimated in a panel of 5823 households using a
double difference regression modal with household fixed effects. PAL was associated with increases IP < 0.01) in the consumption of total energy (5-9%), energy from fruits and vegetables (24-28%), and energy from animal source foods (24- 39%1. lt also affected iron, zinc, and vitamin A and C consumption (P < 0.05). The consumption of energy and all nutrients was greater in the food basket group (P < 0.05). Cash and in·kind transfers in populations that are not energy. deficient should be carefully redesigned to ensure that pulling poor familias out of poverty leads to improved micronutrient intake but not to increased energy consumption.