human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Despite significant global efforts to improve vaccination coverage against major childhood diseases , vaccination rates are below 90 % . To eradicate diseases such as measles , however , vaccination rates close to 95 % are needed . We use a r and omized experiment to investigate the effect of a dem and incentive , a conditional cash transfer program , in improving  vaccination coverage in rural Nicaragua . Double-difference estimates show the program led to large increases in vaccination coverage , and these result ed in vaccination levels greater than 95 % for some vaccines . Effects were especially large for children who are typically harder to reach with traditional supply-side interventions OBJECTIVES To evaluate the impact of Mexico 's conditional cash transfer programme on the quality of health care received by poor women . Quality is measured by maternal reports of prenatal care procedures received that correspond with clinical guidelines . METHODS The data describe retrospective reports of care received from 892 women in poor rural communities in seven Mexican states . The women were participating in an effectiveness study and r and omly assigned to incorporation into the programme in 1998 or 1999 . Eligible women accepted cash transfers conditional on obtaining health care and nutritional supplements , and participated in health education sessions . RESULTS Oportunidades beneficiaries received 12.2 % more prenatal procedures compared with non-beneficiaries ( adjusted mean 78.9 , 95 % Confidence Interval ( CI ) : 77.5 - 80.3 ; P < 0.001 ) . CONCLUSION The Oportunidades conditional cash transfer programme is associated with better quality of prenatal care for low-income , rural women in Mexico . This result is probably a manifestation of the programme 's empowerment goal , by encouraging beneficiaries to be informed and active health consumers BACKGROUND Many governments have implemented conditional cash transfer ( CCT ) programmes with the goal of improving options for poor families through interventions in health , nutrition , and education . Families enrolled in CCT programmes  receive cash in exchange for complying with certain conditions : preventive health requirements and nutrition supplementation , education , and monitoring design ed to improve health outcomes and promote positive behaviour change . Our aim was to disaggregate the effects of cash transfer from those of other programme components . METHODS In an intervention that began in 1998 in Mexico , low-income communities ( n=506 ) were r and omly assigned to be enrolled in a CCT programme  ( Oportunidades , formerly Progresa ) immediately or 18 months later . In 2003 , children ( n=2449 ) aged 24 - 68 months who had been enrolled in the programme their entire lives were assessed for a wide variety of outcomes . We used linear and logistic regression to determine the effect size for each outcome that is associated with a doubling of cash transfers while controlling for a wide range of covariates , including measures of household socioeconomic status . FINDINGS A doubling of cash transfers was associated with higher height-for-age Z score ( beta 0.20 , 95 % CI 0.09 - 0.30 ; p<0.0001 ) , lower prevalence of stunting ( -0.10 , -0.16 to -0.05 ; p<0.0001 ) , lower body-mass index for age percentile ( -2.85 , -5.54 to -0.15 ; p=0.04 ) , and lower prevalence of being overweight ( -0.08 , -0.13 to -0.03 ; p=0.001 ) . A doubling of cash transfers was also associated with children doing better on a scale of motor development , three scales of cognitive development , and with receptive language . INTERPRETATION Our results suggest that the cash transfer component of Oportunidades is associated with better outcomes in child health , growth , and development Summary Background Cash-transfer programmes can improve the wellbeing of vulnerable children , but few studies have rigorously assessed their effectiveness in sub-Saharan Africa . We investigated the effects of unconditional cash transfers ( UCTs ) and conditional cash transfers ( CCTs ) on birth registration , vaccination uptake , and school attendance in children in Zimbabwe . Methods We did a matched , cluster-r and omised controlled trial in ten sites in Manical and , Zimbabwe . We divided each study site into three clusters . After a baseline survey between July , and September , 2009 , clusters in each site were r and omly assigned to UCT , CCT , or control , by drawing of lots from a hat . Eligible households contained children younger than 18 years and satisfied at least one other criteria : head of household was younger than 18 years ; household cared for at least one orphan younger than 18 years , a disabled person , or an individual who was chronically ill ; or household was in poorest wealth quintile . Between January , 2010 , and January , 2011 , households in UCT clusters collected payments every 2 months . Households in CCT clusters could receive the same amount but were monitored for compliance with several conditions related to child wellbeing . Eligible households in all clusters , including control clusters , had access to parenting skills classes and received maize seed and fertiliser in December , 2009 , and August , 2010 . Households and individuals delivering the intervention were not masked , but data analysts were . The primary endpoints were proportion of children younger than 5 years with a birth certificate , proportion younger than 5 years with up-to- date vaccinations , and proportion aged 6–12 years attending school at least 80 % of the time . This trial is registered with Clinical Trials.gov , number NCT00966849 . Findings 1199 eligible households were allocated to the control group , 1525 to the UCT group , and 1319 to the CCT group . Compared with control clusters , the proportion of children aged 0–4 years with birth certificates had increased by 1·5 % ( 95 % CI −7·1 to 10·1 ) in the UCT group and by 16·4 % ( 7·8–25·0 ) in the CCT group by the end of the intervention period . The proportions of children aged 0–4 years with complete vaccination records was 3·1 % ( −3·8 to 9·9 ) greater in the UCT group and 1·8 % ( −5·0 to 8·7 ) greater in the CCT group than in the control group . The proportions of children aged 6–12 years who attended school at least 80 % of the time was 7·2 % ( 0·8–13·7 ) higher in the UCT group and 7·6 % ( 1·2–14·1 ) in the CCT group than in the control group . Interpretation Our results support strategies to integrate cash transfers into social welfare programming in sub-Saharan Africa , but further evidence is needed for the comparative effectiveness of UCT and CCT programmes in this region . Funding Wellcome Trust , the World Bank through the Partnership for Child Development , and the Programme of Support for the Zimbabwe National Action Plan for Orphans and Vulnerable Children BACKGROUND  Mexico 's conditional cash transfer programme , Oportunidades , was started to improve the lives of poor families through interventions in health , nutrition , and education . We investigated the effect of Oportunidades  on children almost 10 years after the programme began . METHODS From April , 1998 , to October , 1999 , low-income communities were r and omly assigned to be enrolled in Oportunidades immediately ( early treatment , n=320 ) or 18 months later ( late treatment , n=186 ) . In 2007 , when 1093 children receiving early treatment and 700 late treatment in these communities were aged 8 - 10 years , they were assessed for outcomes including physical growth , cognitive and language development , and socioemotional development . The primary objective was to investigate outcomes associated with an additional 18 months in the programme . We used cluster-adjusted t tests and multivariate regressions to compare effects of programme participation for height-for-age , body-mass index ( BMI ) , and cognitive language and behavioural assessment scores in early versus late treatment groups . FINDINGS Early enrolment reduced behavioural problems for all children in the early versus late treatment group ( mean behaviour problem score -0.09 [ SD 0.97 ] vs 0.13 [ 1.03 ] ; p=0.0024 ) , but we identified no difference between groups for mean height-for-age Z scores ( -1.12 [ 0.96 ] vs -1.14 [ 0.97 ] ; p=0.88 ) , BMI -for-age Z scores ( 0.14 [ 0.99 ] vs 0.17 [ 1.06 ] ; p=0.58 ) , or assessment scores for language ( 98.8 [ 13.8 ] vs 98.4 [ 14.6 ] p=0.90 ) or cognition ( 98.8 [ 12.9 ] vs 100.2 [ 13.2 ] ; p=0.26 ) . An additional 18 months of the programme before age 3 years for children aged 8 - 10 years whose mothers had no education result ed in improved child growth of about 1.5 cm assessed as height-for-age [ corrected ] Z score ( beta 0.23 [ 0.023 - 0.44 ] p=0.029 ) , independently of cash received . INTERPRETATION An additional 18 months in the Oportunidades programme has independent beneficial effects other than money , especially for women with no formal education . The money itself also has significant effects on most outcomes , adding to existing evidence for interventions in early childhood . FUNDING Mexican Ministry of Social Development and the National Institutes of Child Health and Human Development BACKGROUND Scaling-up of effective preventive interventions in child and maternal health is constrained in many developing countries by lack of dem and . In Latin America , some governments have been trying to increase dem and for health interventions by making direct payments to poor households contingent on them keeping up-to- date with preventive health services . We undertook a public health programme effectiveness trial in Honduras to assess this approach , contrasting it with a direct transfer of re sources to local health teams . METHODS 70 municipalities were selected because they had the country 's highest prevalence of malnutrition . They were allocated at r and om to four groups : money to households ; re sources to local health teams combined with a community-based nutrition intervention ; both packages ; and neither . Evaluation surveys of about 5600 households were undertaken at baseline and roughly 2 years later . Pregnant women and mothers of children younger than 3 years old were asked about use of health services ( primary outcome ) and coverage of interventions such as immunisation and growth monitoring  ( secondary outcome ) . Reports were supplemented with data from children 's health cards and government service utilisation data . Analysis was by mixed effects regression , accounting for the municipality-level r and omisation . FINDINGS The household-level intervention had a large impact ( 15 - 20 percentage points ; p<0.01 ) on the reported coverage of antenatal care and well-child check-ups . Childhood immunisation series could thus be started more opportunely , and the coverage of growth monitoring was markedly increased ( 15 - 21 percentage points ; p<0.01 . Measles and tetanus toxoid immunisation were not affected . The transfer of re sources to local health teams could not be implemented properly because of legal complications . INTERPRETATION Conditional payments to households increase the use and coverage of preventive health care interventions We examined the effects of Ecuador 's  Bono de Desarrollo Humano (BDH)--an unconditional cash transfer program that was rolled-out using a r and omized design --on health and development outcomes in very young children . Communities that were r and omly assigned to the treatment group began receiving the BDH  in 2004 and those r and omly assigned to the comparison group began receiving benefits two years later . Families enrolled in the BDH  received a monthly cash stipend ( $ 15USD ) representing an approximate 6 - 10 % increase in household income . Participants analyzed in this study are children aged 12 - 35 months from treatment ( n = 797 ) and comparison ( n = 399 ) communities in rural and urban Ecuador . Main outcomes measured were language skills ( the Fundación MacArthur Inventorio del Desarollo de Habilidades Comunicativas-Breve ) , height-for-age z-score , and hemoglobin concentration . Results indicate that in rural areas , being r and omized to receive the BDH in very early childhood led to significantly better performance on the number of words a child was saying , and on the probability that the child was combining two or more words . There were no significant effects on language development for children in urban areas and there were no effects on height-for-age z-score or hemoglobin concentration in rural or urban areas . A limited number of potential pathways with respect to cognitive/ language stimulation , health behaviors , and parenting quality were also explored . Findings indicate that compared to children in comparison areas , rural children in treatment areas were more likely to have received vitamin A or iron supplementation and have been bought a toy in the past six months . This study provides evidence for significant benefits of an unconditional cash transfer program for language development in very young children in rural areas A large body of research indicates that child development is sensitive to early-life environments , so that poor children are at higher risk for poor cognitive and behavioral outcomes . These developmental outcomes are important determinants of success in adulthood . Yet , remarkably little is known about whether poverty-alleviation programs improve children 's developmental outcomes . We examine how a  government-run cash transfer program for poor mothers in rural Ecuador influenced the development of young children .  R and om assignment at the parish level is used to identify program effects . Our data include a set of measures of cognitive ability that are not typically included in experimental or quasi-experimental studies of the impact of cash transfers on child well-being , as well as a set of physical health measures that may be related to 
    Output:
    
agent
The quality of evidence on the effect of financial incentives on breastfeeding practice s was low but seems to indicate a potential positive impact on receiving colostrum , early initiation of breastfeeding , exclusive breastfeeding and mean duration of exclusive breastfeeding .
There is no effect of financial incentives on immunization coverage although there was moderate quality evidence of conditional cash transfers leading to a small but non-significant increase in coverage of age-appropriate immunization .
Conclusions Financial incentives may have potential to promote increased coverage of several important child health interventions , but the quality of evidence available is low .
The more pronounced effects seem to be achieved by programs that directly removed user fees for access to health services .
Some indication of effect were also observed for programs that conditioned financial incentives on participation in health education and attendance to health care visits .
This finding suggest that the measured effect may be less a consequence of the financial incentive and more due to conditionalities addressing important informational barriers
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Despite significant global efforts to improve vaccination coverage against major childhood diseases , vaccination rates are below 90 % . To eradicate diseases such as measles , however , vaccination rates close to 95 % are needed . We use a r and omized experiment to investigate the effect of a dem and incentive , a conditional cash transfer program , in improving  vaccination coverage in rural Nicaragua . Double-difference estimates show the program led to large increases in vaccination coverage , and these result ed in vaccination levels greater than 95 % for some vaccines . Effects were especially large for children who are typically harder to reach with traditional supply-side interventions OBJECTIVES To evaluate the impact of Mexico 's conditional cash transfer programme on the quality of health care received by poor women . Quality is measured by maternal reports of prenatal care procedures received that correspond with clinical guidelines . METHODS The data describe retrospective reports of care received from 892 women in poor rural communities in seven Mexican states . The women were participating in an effectiveness study and r and omly assigned to incorporation into the programme in 1998 or 1999 . Eligible women accepted cash transfers conditional on obtaining health care and nutritional supplements , and participated in health education sessions . RESULTS Oportunidades beneficiaries received 12.2 % more prenatal procedures compared with non-beneficiaries ( adjusted mean 78.9 , 95 % Confidence Interval ( CI ) : 77.5 - 80.3 ; P < 0.001 ) . CONCLUSION The Oportunidades conditional cash transfer programme is associated with better quality of prenatal care for low-income , rural women in Mexico . This result is probably a manifestation of the programme 's empowerment goal , by encouraging beneficiaries to be informed and active health consumers BACKGROUND Many governments have implemented conditional cash transfer ( CCT ) programmes with the goal of improving options for poor families through interventions in health , nutrition , and education . Families enrolled in CCT programmes  receive cash in exchange for complying with certain conditions : preventive health requirements and nutrition supplementation , education , and monitoring design ed to improve health outcomes and promote positive behaviour change . Our aim was to disaggregate the effects of cash transfer from those of other programme components . METHODS In an intervention that began in 1998 in Mexico , low-income communities ( n=506 ) were r and omly assigned to be enrolled in a CCT programme  ( Oportunidades , formerly Progresa ) immediately or 18 months later . In 2003 , children ( n=2449 ) aged 24 - 68 months who had been enrolled in the programme their entire lives were assessed for a wide variety of outcomes . We used linear and logistic regression to determine the effect size for each outcome that is associated with a doubling of cash transfers while controlling for a wide range of covariates , including measures of household socioeconomic status . FINDINGS A doubling of cash transfers was associated with higher height-for-age Z score ( beta 0.20 , 95 % CI 0.09 - 0.30 ; p<0.0001 ) , lower prevalence of stunting ( -0.10 , -0.16 to -0.05 ; p<0.0001 ) , lower body-mass index for age percentile ( -2.85 , -5.54 to -0.15 ; p=0.04 ) , and lower prevalence of being overweight ( -0.08 , -0.13 to -0.03 ; p=0.001 ) . A doubling of cash transfers was also associated with children doing better on a scale of motor development , three scales of cognitive development , and with receptive language . INTERPRETATION Our results suggest that the cash transfer component of Oportunidades is associated with better outcomes in child health , growth , and development Summary Background Cash-transfer programmes can improve the wellbeing of vulnerable children , but few studies have rigorously assessed their effectiveness in sub-Saharan Africa . We investigated the effects of unconditional cash transfers ( UCTs ) and conditional cash transfers ( CCTs ) on birth registration , vaccination uptake , and school attendance in children in Zimbabwe . Methods We did a matched , cluster-r and omised controlled trial in ten sites in Manical and , Zimbabwe . We divided each study site into three clusters . After a baseline survey between July , and September , 2009 , clusters in each site were r and omly assigned to UCT , CCT , or control , by drawing of lots from a hat . Eligible households contained children younger than 18 years and satisfied at least one other criteria : head of household was younger than 18 years ; household cared for at least one orphan younger than 18 years , a disabled person , or an individual who was chronically ill ; or household was in poorest wealth quintile . Between January , 2010 , and January , 2011 , households in UCT clusters collected payments every 2 months . Households in CCT clusters could receive the same amount but were monitored for compliance with several conditions related to child wellbeing . Eligible households in all clusters , including control clusters , had access to parenting skills classes and received maize seed and fertiliser in December , 2009 , and August , 2010 . Households and individuals delivering the intervention were not masked , but data analysts were . The primary endpoints were proportion of children younger than 5 years with a birth certificate , proportion younger than 5 years with up-to- date vaccinations , and proportion aged 6–12 years attending school at least 80 % of the time . This trial is registered with Clinical Trials.gov , number NCT00966849 . Findings 1199 eligible households were allocated to the control group , 1525 to the UCT group , and 1319 to the CCT group . Compared with control clusters , the proportion of children aged 0–4 years with birth certificates had increased by 1·5 % ( 95 % CI −7·1 to 10·1 ) in the UCT group and by 16·4 % ( 7·8–25·0 ) in the CCT group by the end of the intervention period . The proportions of children aged 0–4 years with complete vaccination records was 3·1 % ( −3·8 to 9·9 ) greater in the UCT group and 1·8 % ( −5·0 to 8·7 ) greater in the CCT group than in the control group . The proportions of children aged 6–12 years who attended school at least 80 % of the time was 7·2 % ( 0·8–13·7 ) higher in the UCT group and 7·6 % ( 1·2–14·1 ) in the CCT group than in the control group . Interpretation Our results support strategies to integrate cash transfers into social welfare programming in sub-Saharan Africa , but further evidence is needed for the comparative effectiveness of UCT and CCT programmes in this region . Funding Wellcome Trust , the World Bank through the Partnership for Child Development , and the Programme of Support for the Zimbabwe National Action Plan for Orphans and Vulnerable Children BACKGROUND  Mexico 's conditional cash transfer programme , Oportunidades , was started to improve the lives of poor families through interventions in health , nutrition , and education . We investigated the effect of Oportunidades  on children almost 10 years after the programme began . METHODS From April , 1998 , to October , 1999 , low-income communities were r and omly assigned to be enrolled in Oportunidades immediately ( early treatment , n=320 ) or 18 months later ( late treatment , n=186 ) . In 2007 , when 1093 children receiving early treatment and 700 late treatment in these communities were aged 8 - 10 years , they were assessed for outcomes including physical growth , cognitive and language development , and socioemotional development . The primary objective was to investigate outcomes associated with an additional 18 months in the programme . We used cluster-adjusted t tests and multivariate regressions to compare effects of programme participation for height-for-age , body-mass index ( BMI ) , and cognitive language and behavioural assessment scores in early versus late treatment groups . FINDINGS Early enrolment reduced behavioural problems for all children in the early versus late treatment group ( mean behaviour problem score -0.09 [ SD 0.97 ] vs 0.13 [ 1.03 ] ; p=0.0024 ) , but we identified no difference between groups for mean height-for-age Z scores ( -1.12 [ 0.96 ] vs -1.14 [ 0.97 ] ; p=0.88 ) , BMI -for-age Z scores ( 0.14 [ 0.99 ] vs 0.17 [ 1.06 ] ; p=0.58 ) , or assessment scores for language ( 98.8 [ 13.8 ] vs 98.4 [ 14.6 ] p=0.90 ) or cognition ( 98.8 [ 12.9 ] vs 100.2 [ 13.2 ] ; p=0.26 ) . An additional 18 months of the programme before age 3 years for children aged 8 - 10 years whose mothers had no education result ed in improved child growth of about 1.5 cm assessed as height-for-age [ corrected ] Z score ( beta 0.23 [ 0.023 - 0.44 ] p=0.029 ) , independently of cash received . INTERPRETATION An additional 18 months in the Oportunidades programme has independent beneficial effects other than money , especially for women with no formal education . The money itself also has significant effects on most outcomes , adding to existing evidence for interventions in early childhood . FUNDING Mexican Ministry of Social Development and the National Institutes of Child Health and Human Development BACKGROUND Scaling-up of effective preventive interventions in child and maternal health is constrained in many developing countries by lack of dem and . In Latin America , some governments have been trying to increase dem and for health interventions by making direct payments to poor households contingent on them keeping up-to- date with preventive health services . We undertook a public health programme effectiveness trial in Honduras to assess this approach , contrasting it with a direct transfer of re sources to local health teams . METHODS 70 municipalities were selected because they had the country 's highest prevalence of malnutrition . They were allocated at r and om to four groups : money to households ; re sources to local health teams combined with a community-based nutrition intervention ; both packages ; and neither . Evaluation surveys of about 5600 households were undertaken at baseline and roughly 2 years later . Pregnant women and mothers of children younger than 3 years old were asked about use of health services ( primary outcome ) and coverage of interventions such as immunisation and growth monitoring  ( secondary outcome ) . Reports were supplemented with data from children 's health cards and government service utilisation data . Analysis was by mixed effects regression , accounting for the municipality-level r and omisation . FINDINGS The household-level intervention had a large impact ( 15 - 20 percentage points ; p<0.01 ) on the reported coverage of antenatal care and well-child check-ups . Childhood immunisation series could thus be started more opportunely , and the coverage of growth monitoring was markedly increased ( 15 - 21 percentage points ; p<0.01 . Measles and tetanus toxoid immunisation were not affected . The transfer of re sources to local health teams could not be implemented properly because of legal complications . INTERPRETATION Conditional payments to households increase the use and coverage of preventive health care interventions We examined the effects of Ecuador 's  Bono de Desarrollo Humano (BDH)--an unconditional cash transfer program that was rolled-out using a r and omized design --on health and development outcomes in very young children . Communities that were r and omly assigned to the treatment group began receiving the BDH  in 2004 and those r and omly assigned to the comparison group began receiving benefits two years later . Families enrolled in the BDH  received a monthly cash stipend ( $ 15USD ) representing an approximate 6 - 10 % increase in household income . Participants analyzed in this study are children aged 12 - 35 months from treatment ( n = 797 ) and comparison ( n = 399 ) communities in rural and urban Ecuador . Main outcomes measured were language skills ( the Fundación MacArthur Inventorio del Desarollo de Habilidades Comunicativas-Breve ) , height-for-age z-score , and hemoglobin concentration . Results indicate that in rural areas , being r and omized to receive the BDH in very early childhood led to significantly better performance on the number of words a child was saying , and on the probability that the child was combining two or more words . There were no significant effects on language development for children in urban areas and there were no effects on height-for-age z-score or hemoglobin concentration in rural or urban areas . A limited number of potential pathways with respect to cognitive/ language stimulation , health behaviors , and parenting quality were also explored . Findings indicate that compared to children in comparison areas , rural children in treatment areas were more likely to have received vitamin A or iron supplementation and have been bought a toy in the past six months . This study provides evidence for significant benefits of an unconditional cash transfer program for language development in very young children in rural areas A large body of research indicates that child development is sensitive to early-life environments , so that poor children are at higher risk for poor cognitive and behavioral outcomes . These developmental outcomes are important determinants of success in adulthood . Yet , remarkably little is known about whether poverty-alleviation programs improve children 's developmental outcomes . We examine how a  government-run cash transfer program for poor mothers in rural Ecuador influenced the development of young children .  R and om assignment at the parish level is used to identify program effects . Our data include a set of measures of cognitive ability that are not typically included in experimental or quasi-experimental studies of the impact of cash transfers on child well-being , as well as a set of physical health measures that may be related to 
    Output:
    