The oportunidades programand child growth: Mexico perspectives

Abstract

Despite progress over the past decades, stunting remains a major public health problem in Mexico, highly concentrated among those living in poverty. The prevalence of stunting is highest in the country among beneficiaries of Mexico's principal social welfare program, Oportunidades. Oportunidades is a conditional cash transfer program, providing economic incentives for families to invest in themselves and provides specific benefits for education, health, and nutrition. Oportunidades has had an important impact on the growth of children in rural and urban Mexico. Beneficiary children who received the program over the course of the critical period (birth to 2 years of age) grow approximately 1 cm more than non-beneficiary children living in comparable circumstances. Over the 10 years that Oportunidades has existed in rural areas, the prevalence of stunting dropped from 44.3 to 21.8%. The impact is likely in part a direct result of consumption of the fortified food provided for children but use of the food by the population is not ideal. The impact on growth may also be related to the better economic conditions of the families and the influence that this might have on health, hygiene, and caregiving. Despite this positive impact, the challenge remaining to improve child growth in the Oportunidades beneficiary population is great. The prevalence of stunting is still high, over 35% in 2007 among some of the most vulnerable subgroups of the population. Investments to improve the quality of the nutrition and health education component of the program are urgently needed and should focus on the specific causes of growth faltering including breast and complementary feeding practices. The Oportunidades evaluation, as well as providing evidence of its accomplishments, has been extremely valuable to identify and provide evidence on how the program should be strengthened. This experience provides a valuable model of how program evaluation can be used for strengthening program design and implement.