Malnutrition Clinical Trial
Official title:
Evaluating the Impact of the Programa de Apoyo Alimentaria
The Programa de Apoyo Alimentaria (PAL) started in 2003 and is targeted to communities in
Mexico that do not receive benefits from other federal food aid programs, have less than
2,500 inhabitants and a high level of marginalization. Marginalization is a term used in
Mexico for the multidimensional assessment of poverty in a community.
When the program started in 2003 it provided beneficiary households either a cash transfer
of 150 Mexican pesos (equivalent to approximately 14 USD at the time) per month or a monthly
food basket with a cost to the program of 150 pesos. The size of the cash transfer and the
amount of food was the same for all households, i.e. no adjustments for family size or
composition were made. The basket contained a number of staple and basic food products and
powdered whole milk (Liconsa), which is fortified with Zn, Fe, Vitamin C, and folate (Table
1). The composition of the food basket conformed to the Mexican norm for food aid programs
(NOM-169-SSA1-1998), which states that food transfers need to provide at least 20% of the
recommended daily energy and protein requirements. Beneficiary households were required to
attend nutrition and health education sessions and had to participate in program related
logistic activities in order to receive the benefits. These program conditionalities,
however, were not strictly enforced.
A community randomized controlled intervention trial was used to evaluate the impact of the
intervention. A random sample of 208 rural communities was drawn from the pool of eligible
communities in 8 of the poorest states in the South/Eastern region of Mexico (Chiapas,
Guerrero, Oaxaca, Quintana Roo, Tabasco, Campeche, Yucatan and Veracruz). Within each
community a random sample of 33 households was selected. The baseline survey was conducted
from October 2003 to April 2004. After baseline data collection, the 208 selected
communities (6,687 households) randomly assigned to one of four study groups: food basket
without education (52 communities, 1657 households), food basket with education (52
communities, 1680 households), cash transfer with education (53 communities, 1687
communities) or control (51 communities, 1663 households). Treatment allocation was carried
out by the Ministry of Social Development.
n/a
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label
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