Impact of the Mexican program for education, health, and nutrition (Progresa) on rates of growth and anemia in infants and young children: A randomized effectiveness study

  • JA R
  • Sotres-Alvarez D
  • JP H
 et al. 
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Abstract

Context: Malnutrition causes death and impaired health in millions of children. Existing interventions are effective under controlled conditions; however, little information is available on their effectiveness in large-scale programs. Objective: To document the short-term nutritional impact of a large-scale, incentive-based development program in Mexico (Progresa), which included a nutritional component. Design, Setting, and Participants: A randomized effectiveness study of 347 communities randomly assigned to immediate incorporation to the program in 1998 (intervention group; n = 205) or to incorporation in 1999 (crossover intervention group; n = 142). A random sample of children in those communities was surveyed at baseline and at 1 and 2 years afterward. Participants were from low-income households in poor rural communities in 6 central Mexican states. Children (N = 650) 12 months of age or younger (n = 373 intervention group; n = 277 crossover intervention group) were included in the analyses. Intervention: Children and pregnant and lactating women in participating households received fortified nutrition supplements, and the families received nutrition education, health care, and cash transfers. Main Outcome Measures: Two-year height increments and anemia rates as measured by blood hemoglobin levels in participating children. Results: Progresa was associated with better growth in height among the poorest and younger infants. Age- and length-adjusted height was greater by 1.1 cm (26.4 cm in the intervention group vs 25.3 cm in the crossover intervention group) among infants younger than 6 months at baseline and who lived in the poorest households. After 1 year, mean hemoglobin values were higher in the intervention group (11.12 g/dL; 95% confidence interval [CI], 10.9-11.3 g/dL) than in the crossover intervention group (10.75 g/dL; 95% CI, 10.5-11.0 g/dL) who had not yet received the benefits of the intervention (P = .01). There were no differences in hemoglobin levels between the 2 groups at year 2 after both groups were receiving the intervention. The age-adjusted rate of anemia (hemoglobin level

Author-supplied keywords

  • *anemia/di [Diagnosis]
  • *anemia/ep [Epidemiology]
  • *anemia/pc [Prevention]
  • *child growth
  • *child nutrition
  • *health education
  • *health program
  • Anemia [epidemiology]
  • Child
  • Cross-Over Studies
  • Dietary Supplements
  • EPPI-Reviewer 4
  • Growth
  • Health Promotion
  • Hemoglobins [metabolism]
  • Humans[checkword]
  • Infant[checkword]
  • Mexico
  • Nutrition Assessment
  • Poverty
  • Preschool[checkword]
  • Program Evaluation
  • Rural Population
  • Social Welfare
  • article
  • body height
  • clinical trial
  • controlled clinical trial
  • controlled study
  • crossover procedure
  • diet supplementation
  • fema
  • female
  • health care
  • hemoglobin determination
  • hemoglobin/ec [Endogenous Compound]
  • human
  • infant
  • lowest income group
  • major clinical study
  • male
  • malnutrition/ep [Epidemiology]
  • malnutrition/pc [Prevention]
  • priority journal
  • randomized controlled trial
  • rural area

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Authors

  • Rivera JA

  • D Sotres-Alvarez

  • Habicht JP

  • T Shamah

  • S Villalpando

  • J A Rivera

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