138 CHAPTER 8


ics as the importance of a diversified diet affected eating habits among ben- eficiaries and no evidence that the nutritional supplement provided to small children (papilla) crowded out the acquisition of calories. There was no evi- dence of a difference in food prices faced by PROGRESA and control house- holds (Hoddinott, Skoufias, and Washburn 2000, 36). Several years later, Oportunidades also demonstrated an impact on dietary diversity with increased frequency of consumption of fruits and vegetables for children ages two through four. However, there was no impact on the number of foods consumed (Hernandez-Prado and Hernandez-Avila 2006, 91). In Honduras, neither demand-side nor supply-side PRAF interventions dem-


onstrated an impact on food consumption or dietary diversity. This is likely to have been due to the small size of the transfer, which represented less than 3.6 percent of average beneficiary expenditure (IFPRI 2003b, 69). However, according to another food consumption analysis using longitudinal data from 2000 to 2002, there was variation in food quality according to the educational level of the household head. In households where the household head had a primary school education, there was an increase in consumption of health- ier foods such as meat, fish, eggs, dairy, and fruits. Conversely, in households where the household head had no education, changes in consumption took the form of increased oils, fats, and junk food (Wiesmann and Hoddinott 2007).


Nutrition The nutritional outcomes of interest measured in CCT evaluations are stunting and iron-deficiency anemia. Two indicators are used to assess stunting: preva- lence of stunting among children (usually from birth to age two, sometimes from birth to age five) and mean HAZ, an expression of anthropometric values as a given number of standard deviations below or above the international reference mean or the median value for healthy children. Iron-deficiency ane- mia is measured as a hemoglobin level under 11 grams per deciliter. Although some CCT programs have demonstrated success in improving the nutritional status of child beneficiaries in terms of both reduced stunt- ing and reduced anemia, there is considerable variation among programs, with some programs demonstrating no impact or even negative impacts (Figures 8.5 and 8.6). According to the randomized evaluation comparing treatment and control groups before and after program implementation, conducted from 1997 to 1999, PROGRESA reduced the probability of child stunting by 10 percentage points among children ages twelve through thirty-six months (Hoddinott 2010) and increased average child height by 1–4 percent (Gertler and Boyce 2001). More recent estimates by Hoddinott found a reduction of 7.3 percentage points in stunting prevalence among children under age three and a reduction


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