1 Department of Public Health, Erasmus Mc, Rotterdam, The Netherlands; 2 London School of Economics and Political Science, LSE Health and Social Care, London, United Kingdom; 3 Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States of America.
Background: Conditional cash transfer programs (CCT) provide cash grants to poor households conditional on their participation in primary health care services and children´s attendance to school. CCT programs have been shown to improve child health and nutrition. While significant impacts have been observed on the mechanisms related to the conditionalities, less is known about other mechanisms. We examined the impact of CCT on variables related to the conditionalities such as preventive health services utilization; and not related to the conditionalities such as food consumption, knowledge and attitudes about caregiving practices, mother’s employment, and empowerment. Methods: Data came from the evaluation of Colombian CCT Program Familias en Accion (FA). 1,450 children aged 2 to 6 years and their families in 31 treatment municipalities were compared to 1,851 children from 65 matched control municipalities. Families were assessed in 2002, 2003 and 2005/6. We applied a difference-in-differences approach using logistic or linear regression, separately examining effects for urban and rural areas. Results: Participation in the FA program was associated with a significant increase in food consumption, as well as in the probability of using preventive healthcare services (OR= 1.85, 95% CI 1.03, 3.30) and growth and development check-ups (ß= 1.36, 95% CI 0.76, 1.95). The program did not influence other mechanisms not directly associated with the conditionalities, including maternal employment, women´s empowerment, and knowledge, attitudes and practices about caregiving practices. Conclusion: The CCT program influenced food consumption, as well as those behaviors directly associated with conditionalities, while having limited impacts on women’s employment, empowerment, and knowledge and attitudes.