Social protection and cash transfers: To strengthen families affected by HIV and AIDS

SOCIAL PROTECTION IN THE CONTEXT OF HIV AND AIDS 23

dence of delayed school initiation and fewer grades completed for individuals who were malnourished as children. The authors conclude that a median preschooler in the sample could have started school 7 months earlier, com- pleted 0.7 additional grades, and grown 4.6 centimeters taller if she had attained the median height in a developed country (Alderman, Hoddinott, and Kinsey 2003, as cited in Behrman, Alderman, and Hoddinott 2004, 373). Behrman et al. (2003) find that Guatemalan children ages six through twenty- four months receiving a nutritional supplement experienced a significantly higher probability of attending school and of passing first grade (Behrman et al. 2003, as cited in Behrman, Alderman, and Hoddinott 2004, 373). Additional evidence comes from a study of 79 countries with data on edu-

cation and stunting, which found that every 10 percent increase in stunting was associated with a reduction of 7.9 percent in the proportion of children reaching the final grade of primary school. A similar study including 64 coun- tries found that every 10 percent increase in the prevalence of poverty reduced by 6.4 percent the likelihood that children would enter the final grade of primary school (Grantham-McGregor et al. 2007, 63). A study in the Philippines found that an increase of 1 standard deviation in the stature of malnourished children would increase the schooling they completed by nearly 18 months and reduce their probability of repeating first grade by around 9 percent (Glewwe, Jacoby, and King 2001). Beyond delayed school entry and reduced completion, malnourished chil-

dren often experience a reduced capacity to learn. Stunted children (in Bra- zil, China, India, Jamaica, Malaysia, Nepal, the Philippines, Turkey, and Viet- nam) and boys in Guatemala have been found to be more likely than healthy children to have lower achievement levels and poorer grades. Stunting was also associated with lower scores on cognitive tests in Ecua-

dor, Guatemala, and the Philippines (Pollitt et al. 1995; Martorell 1995, 1999, cited in Berman, Alderman, and Hoddinott 2004, 368; Grantham-McGregor et al. 2007). Stunted children were more likely to have lower achievement scores and poorer cognitive ability in Chile, Ethiopia, Guatemala, India, Indo- nesia, Kenya, Peru, and Vietnam. Stunting at twenty-four months was associ- ated with lower cognition at age nine in Peru and with lower IQ at eight and eleven years of age in the Philippines (Grantham-McGregor et al. 2007, 63). In Guatemala, children exposed to a high-energy, high-protein nutritional supplement performed better on tests of knowledge, reading and vocabulary, numeracy, and information processing (Pollitt et al. 1995, 1116S). Furthermore, according to studies from Barbados (Galler et al. 1983; Galler 1984), Guatemala (Pollitt, Gorman, and Metallinos-Katasaras 1991), and Jamaica (Richardson, Birch, and Ragbeer 1975), individuals who were severely mal- nourished as young children were less well liked by their peers and were unhappier than classmates who had been well nourished as children. Previ-

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