Heterogeneous impact of the social programme Oportunidades on use of contraceptive methods by young adult women living in rural areas

Lamadrid‐Figueroa, Héctor; Ángeles, Gustavo; Mroz, Thomas A.; Urquieta-Salomón, José E; Hernández-Prado, Bernardo; Cruz-Valdéz, Aurelio; Téllez‐Rojo, Martha María

doi:10.1080/19439341003599726

Cited by 21 publications

(38 citation statements)

References 6 publications

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“…We used a self-reported measure of Oportunidades exposure, and data were not available on length of program exposure; previous research among beneficiaries reported mixed results by length of exposure. 28,48 Women in our sample were asked about current exposure, so our measure may not have captured those who had been exposed, but left the program. We restricted our pregnancy models to women aged 15–19 to avoid including any pregnancies that could have occurred prior to program inclusion in 1998 or 2000.…”

Section: Discussionmentioning

confidence: 99%

“…In studies of data from Oportunidades’ experimental period, contraceptive use was higher among female heads of household exposed to the program than among their unexposed counterparts, 2,11 with greater change among the poorest women than among wealthier women; 48 no link was found between birth spacing and program exposure between 1998 and 2003. 2 One study reported a negative impact on pregnancy and childbirth among women younger than 20 during the short-term follow-up experimental period (1998–2000), although the finding was nonsignificant after controlling for education.…”

Section: Mexico’s Oportunidades Programmentioning

confidence: 98%

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The Oportunidades Conditional Cash Transfer Program: Effects on Pregnancy and Contraceptive Use Among Young Rural Women in Mexico

Darney

Weaver

Sosa-Rubí

et al. 2013

IPSRH

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CONTEXT Oportunidades is a large conditional cash transfer program in Mexico. It is important to examine whether the program has any direct effect on pregnancy experience and contraceptive use among young rural women, apart from those through education. METHODS Data from the 1992, 2006 and 2009 waves of a nationally representative, population-based survey were used to describe trends in pregnancy experience, contraceptive use and education among rural adolescent (15–19) and young adult (20–24) women in Mexico. To examine differences in pregnancy experience and current modern contraceptive use among young women, multivariable logistic regression analyses were conducted among matched 2006 samples of women with and without exposure to Oportunidades, predicted probabilities were calculated and indirect effects were estimated. RESULTS Over the three survey waves, the proportion of adolescent and young adult women reporting ever being pregnant stayed flat (33–36%) and contraceptive use increased steadily (from 13% in 1992 to 19% in 2009). Educational attainment rose dramatically: The proportion of women with a secondary education increased from 28% in 1992 to 46% in 2009. In multivariable analyses, exposure to Oportunidades was not associated with pregnancy experience among adolescents. Educational attainment, marital status, pregnancy experience and access to health insurance—but not exposure to Oportunidades—were positively associated with current modern contraceptive use among adolescent and young adult women. CONCLUSION Through its effect on education, Oportunidades indirectly influences fertility among adolescents. It is important for Mexico to focus on strategies to increase contraceptive use among young rural nulliparous women, regardless of whether they are enrolled in Oportunidades.

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Section: Discussionmentioning

confidence: 99%

Section: Mexico’s Oportunidades Programmentioning

confidence: 98%

The Oportunidades Conditional Cash Transfer Program: Effects on Pregnancy and Contraceptive Use Among Young Rural Women in Mexico

Darney

Weaver

Sosa-Rubí

et al. 2013

IPSRH

View full text Add to dashboard Cite

show abstract

“…When comparing women enrolled in the programme for six years with those enrolled for four years there was no significant difference, however, suggesting a flattening trend of the impact. Lamadrid-Figueroa et al (2010) further disaggregate the effects and find a markedly larger programme impact on contraceptive use for the poorest of the poor (a 25-40 percentage point increase) that can be attributed to Oportunidades. They hypothesise that it could be the case that the poorest subjects felt more compelled to attend the health talks in order to retain the benefits of the programme or, alternatively, that the very poorest group may have been the most marginalised with regards to knowledge about contraceptive practices.…”

Section: Journal Of Developmentmentioning

confidence: 96%

Conditional cash transfers and health: unpacking the causal chain

Gaarder

Glassman

Todd

2010

Journal of Development Effectiveness

176

159

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This paper investigates whether conditional cash transfer (CCT) programmes that include health and nutrition components improve health and nutritional outcomes, and if so, which components of the programmes, or combination thereof, are important in achieving these improvements. Using evidence from Latin America, Africa, Asia and the Middle East, the paper adopts a theory-based approach that spells out the assumptions behind the expectation that the CCT interventions will have a measurable impact on health and nutrition outcomes. CCT impact evaluations provide unambiguous evidence that financial incentives work to increase utilisation of those key health services by the poor upon which the cash transfer is conditioned, if the beneficiaries have knowledge of this condition. However, results are mixed with respect to nutrition and health outcomes, suggesting that encouraging utilisation when the pertinence of services is unknown or of poor quality may not produce the expected effects. Incipient results from Mexico indicate, however, that service quality is not necessarily exogenous to the programme, but may be positively affected by giving the poor women skills, information, and social support to negotiate better care from healthcare providers. Findings from Mexico indicate that there are direct routes by which the cash transfers affect health, outside of the health sector interactions. In particular, the poverty alleviation achieved with the cash transfers may affect the mental health of beneficiaries, as well as their lifestyle choices. The main policy recommendation that ensues from this review is the need to find the right mix of incentives and regulation to improve the quality of care, while at the same time investing in the empowerment of users. Future research that explores the relative cost-effectiveness of investing in the supply versus the demand-side within the health system will be crucial, along with further research on the need for conditionalities. Other areas that could benefit from further evidence include morbidity outcomes from programmes other than Oportunidades, including mental health and chronic disease, impacts on health-related behaviours and attitudes, and how these factors affect outcomes, and the effects on out-of-pocket expenditure.conditional cash transfer interventions, theory-based approach, health and nutritional outcomes,

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“…Further, economically insecure women may engage in high-risk sexual behavior to procure money, food, or other goods [6–10]. In addition to these observational data, experimental evidence supports the hypothesis that economic interventions can improve reproductive health [11–14]. …”

Section: Introductionmentioning

confidence: 95%

Food Insecurity, Socioeconomic Status, and HIV-Related Risk Behavior Among Women in Farming Households in Tanzania

et al. 2013

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Food insecurity (FI) is associated with higher-risk sexual behavior in some studies. However, the overlap between FI and socioeconomic status (SES) has been poorly described. The study objectives were to: (1) determine the relationship between household FI and four dimensions of SES among sexually active Tanzanian women in farming households: expenditures, assets, flooring material of the home, and land ownership; and (2) determine whether FI is associated with higher-risk sexual behavior and relationship power. In male-headed households, FI was associated with assets, flooring material, and land ownership but not expenditures. There was no association between FI and the four dimensions of SES in female-headed households. Among women in male-headed households, but not female household heads themselves, severe FI was associated with a non-significant increase in the likelihood of being in a relationship because of material goods [adjusted prevalence ratio (PRa) = 1.76, 95 % confidence interval (CI) 0.81, 3.81] and was inversely associated with being able to ask partners to use condoms (PRa = 0.47, 95 % CI 0.25, 0.88). There was not a strong association between food security and relationship power. Our findings suggest that the association between FI and HIV risk behavior may differ depending on the type of household.

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Heterogeneous impact of the social programme Oportunidades on use of contraceptive methods by young adult women living in rural areas

Cited by 21 publications

References 6 publications

The Oportunidades Conditional Cash Transfer Program: Effects on Pregnancy and Contraceptive Use Among Young Rural Women in Mexico

The Oportunidades Conditional Cash Transfer Program: Effects on Pregnancy and Contraceptive Use Among Young Rural Women in Mexico

Conditional cash transfers and health: unpacking the causal chain

Food Insecurity, Socioeconomic Status, and HIV-Related Risk Behavior Among Women in Farming Households in Tanzania

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