Effects of a Conditional Cash Transfer Program on Children's Behavior Problems

OBJECTIVES. Governments are increasingly using conditional cash transfer programs to reduce the negative effects of poverty on children's development. These programs have demonstrated benefits for children's nutrition and physical development, but the effect of conditional cash transfers on children's behaviors has not been systematically evaluated. The objective of this study was to evaluate the effects of a conditional cash transfer on children's behavior by using a quasi-experimental design. METHODS. In 1997, the Mexican government initiated a large-scale conditional cash transfer (Oportunidades) in 506 very poor rural communities. Oportunidades provided cash transfers that were contingent on visits to medical practitioners, consumption of nutritional supplementation, and school enrollment. In 2003, an assessment of 4- to 6-year-old children in these households was conducted, and outcomes were compared with children from 152 additional poor rural communities who had been recruited by using rigorous matching procedures. The primary outcome measure for this analysis was maternal report of behavior problems in terms of anxiety/depressive and aggressive/oppositional symptoms. Analyses reported here compared 778 children from beneficiary households who had received 3.5 to 5.0 years of exposure to the program and a comparison group of 263 children who had received no exposure to the program at the time of assessment but whose families later enrolled in the program. RESULTS. Participation in Oportunidades was associated with a 10% decrement in aggressive/oppositional symptoms but was not associated with significant decrements in anxiety/depressive symptoms or total problem behaviors while controlling for covariates. Effects of treatment did not differ by children's gender or ethnicity. CONCLUSIONS. Although this large-scale conditional cash transfer program for poor Mexican families did not directly address children's behavior problems, it found evidence of indirect effects on children's behavior. Results suggest that interventions that focus on investing in basic human capital needs may exert longer term ripple effects on children's development. Pediatrics 2009; 123: e630-e637