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Author: search.filters.author.Gustavo AcostaStart date: 2020

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    Impact of micronutrient supplementation on chronic childhood malnutrition in Peru
    (Universidad Peruana Cayetano Heredia, Facultad de Medicina Alberto Hurtado, 2020-10-16)
    Chronic childhood malnutrition (CCM) affects mental and physical development of children. In the long-term, a high incidence of CCM generates a vicious circle of inequality and poverty. Therefore, evaluating the impact of interventions to ameliorate CCM may be a useful indicator of implemented policies. Objective: to evaluate the impact of micronutrient supplementation on chronic childhood malnutrition in Peru from 2014-2017. Methods: Data from Encuesta Demográfica y de Salud Familiar (ENDES) from 2014-2017 including children from 6 to 59 months of age were gathered. A two-step quantitative estimation was applied. First, the sample was balanced using Entropy Balancing (EB) and Machine Learning (ML). Second, differences in two variables were estimated, probability of having CCM and the Z score among those with CCM. Results: having consumed some micronutrient increases the probability of having CCM. A positive effect on the Z score was found above 54.1 sachets consumed. Results did not change after adjusting for covariates. Conclusions: micronutrient supplementation has a negative effect in reducing CCM, a positive effect was found at bigger consumptions.
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    Impact of the Qali Warma school feeding program on chronic child malnutrition
    (Universidad del Pacífico Press, 2021-01-01)
    Este artículo aporta evidencia del impacto de Qali Warma sobre la anemia y la desnutrición crónica en niños de 3 a 5 años. Los resultados empíricos se obtienen por medio de una evaluación cuantitativa de dos pasos. Primero se usan técnicas de entropy balancing y machine learning para lograr un grupo control comparable que permita obtener estimaciones robustas. Luego se realizan regresiones para estimar el efecto del programa sobre las variables de interés. Se usan datos de la Encuesta Demográfica y de Salud Familiar de los años 2014 a 2017. Al parecer, Qali Warma no tendría efectos sobre la anemia ni sobre la desnutrición crónica, al menos en el rango de edad estudiado.
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    Effects of Peru's National School Feeding Program (Qali Warma) on Overweight and Obesity Among Children Aged 36–59 Months
    (Multidisciplinary Digital Publishing Institute (MDPI), 2026-06-01)
    Background: School feeding programs aim to improve child nutrition, and they may influence weight outcomes insofar as program modalities and household responses alter children's total energy intake. This is especially relevant in countries facing the double burden of malnutrition, where undernutrition and micronutrient deficiencies coexist with rising overweight and obesity. This study estimates the effect of Peru's former National School Feeding Program on obesity and excess weight among children aged 36 to 59 months under a selection-on-observables identification strategy and assesses whether impacts differ across operational modalities, particularly breakfast-only versus breakfast plus lunch and ready-to-eat rations versus foods delivered for preparation. Methods: We use repeated cross-sectional microdata from the Demographic and Health Survey (ENDES) pooled over 2014 to 2018 and link them to administrative information. The sample includes 18,959 children aged 36 to 59 months. To improve comparability, we estimate propensity score weights targeting the average treatment effect on the treated (ATT) using a machine learning generalized boosted model (GBM), and assess covariate balance using standardized mean differences and Kolmogorov–Smirnov statistics. Identification assumes conditional independence given observed covariates and overlap (common support). Main estimates rely on weighted probit models with fixed effects, progressively adding exposure duration, modality indicators, and controls. Distributional effects are examined using quantile regression on the continuous weight-for-height z-score. Results: Without differentiating modalities, beneficiary status is not associated with a statistically significant change in obesity, while pooled baseline estimates indicate a statistically significant higher probability of excess weight. Modality-specific results show that obesity declines only when Qali Warma is delivered as breakfast plus lunch through products to be prepared (approximately −1.0 percentage point in parsimonious models and −0.4 percentage points after controls). Evidence for excess weight is directionally consistent by modality but less conclusive once controls are included. Conclusions: Qali Warma's effects on early-childhood weight outcomes depend on implementation modality. Evaluations of school feeding programs should incorporate operational heterogeneity, particularly during program redesign.
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