Marta Rubio-Codina

Admixture in Latin America: Geographic Structure, Phenotypic Diversity and Self-Perception of Ancestry Based on 7,342 Individuals

The current genetic makeup of Latin America has been shaped by a history of extensive admixture between Africans, Europeans and Native Americans, a process taking place within the context of extensive geographic and social stratification. We estimated individual ancestry proportions in a sample of 7,342 subjects ascertained in five countries (Brazil, Chile, Colombia, México and Perú). These individuals were also characterized for a range of physical appearance traits and for self-perception of ancestry. The geographic distribution of admixture proportions in this sample reveals extensive population structure, illustrating the continuing impact of demographic history on the genetic diversity of Latin America. Significant ancestry effects were detected for most phenotypes studied. However, ancestry generally explains only a modest proportion of total phenotypic variation. Genetically estimated and self-perceived ancestry correlate significantly, but certain physical attributes have a strong impact on self-perception and bias self-perception of ancestry relative to genetically estimated ancestry.

Using the infrastructure of a conditional cash transfer program to deliver a scalable integrated early child development program in Colombia : cluster randomized controlled trial

Objective To assess the effectiveness of an integrated early child development intervention, combining stimulation and micronutrient supplementation and delivered on a large scale in Colombia, for children’s development, growth, and hemoglobin levels. Design Cluster randomized controlled trial, using a 2×2 factorial design, with municipalities assigned to one of four groups: psychosocial stimulation, micronutrient supplementation, combined intervention, or control. Setting 96 municipalities in Colombia, located across eight of its 32 departments. Participants 1420 children aged 12-24 months and their primary carers. Intervention Psychosocial stimulation (weekly home visits with play demonstrations), micronutrient sprinkles given daily, and both combined. All delivered by female community leaders for 18 months. Main outcome measures Cognitive, receptive and expressive language, and fine and gross motor scores on the Bayley scales of infant development-III; height, weight, and hemoglobin levels measured at the baseline and end of intervention. Results Stimulation improved cognitive scores (adjusted for age, sex, testers, and baseline levels of outcomes) by 0.26 of a standard deviation (P=0.002). Stimulation also increased receptive language by 0.22 of a standard deviation (P=0.032). Micronutrient supplementation had no significant effect on any outcome and there was no interaction between the interventions. No intervention affected height, weight, or hemoglobin levels. Conclusions Using the infrastructure of a national welfare program we implemented the integrated early child development intervention on a large scale and showed its potential for improving children’s cognitive development. We found no effect of supplementation on developmental or health outcomes. Moreover, supplementation did not interact with stimulation. The implementation model for delivering stimulation suggests that it may serve as a promising blueprint for future policy on early childhood development. Trial registration Current Controlled trials ISRCTN18991160.

Quality of Parenting Programs and Child Development Outcomes: The Case of Peru's Cuna Mas

This paper analyzes the association between quality of parenting programs and child development outcomes. It focuses on parenting programs delivered through home visits (i.e., home visiting programs) in which a paraprofessional works with the caregiver to improve parental practices, skills and knowledge of child development, with an application to the Peruvian national program Programa Nacional Cuna Mas. Home visiting quality is measured through the Home Visit Rating Scale, version A+2 (HOVRS-A+2), and child development outcomes through the Ages and Stages Questionnaires (ASQ-3) and the Bayley Scales of Infant and Toddler Development (Bayley-III). The empirical analysis used is descriptive in nature. Results show that home visiting quality scores are significantly associated with our measures of child development, but this association is not consistent across all measures.

Measuring Quality and Characterizing Cuna Mas Home Visits: Validation of the HOVRS-A+2 in Peru and of a Short Checklist for Use At-Scale

As home visiting programs continue to expand, it is crucial to develop cost-effective methods to monitor their quality that are feasible at-scale. This paper compares two instruments widely used among home visiting services in the US to a simpler checklist in the context of Peru’s Cuna Mas Program. The paper aims to document the structure, content and level of process quality of the Cuna Mas home visits. Its main contribution is to empirically identify a subset of twenty-seven items that focus on critical aspects of quality and that are feasible to collect on a routine-basis as part of program monitoring efforts.

Los primeros años de vida de los niños peruanos : una fotografía sobre el bienestar y el desarrollo de los niños del Programa Nacional Cuna Más

El Programa Nacional Cuna Mas (PNCM) atiende a ninos menores de 36 meses en zonas de pobreza y pobreza extrema con el objetivo de mejorar su nivel de desarrollo. El PNCM brinda dos servicios: el Servicio de Acompanamiento a Familias (SAF) en zonas rurales y el Servicio de Cuidado Diurno (SCD) en zonas urbanas. A partir de los datos de las lineas de base de las evaluaciones de impacto de ambos servicios, este documento describe y compara las caracteristicas de los ninos y ninas potencialmente beneficiarios y sus familias. Por lo general, los hogares de la muestra del SCD presentan mejores indicadores relacionados con el bienestar que los hogares del SAF: tipo de vivienda, nivel de riqueza, acceso a servicios, y mayor cantidad y variedad de materiales y actividades de juego. A pesar de ello, los niveles de desarrollo infantil son muy similares entre los ninos en las dos muestras. Asimismo, se nobservan brechas socioeconomicas en el desarrollo infantil mas marcadas en los ninos de la muestra del SAF que en los de la muestra del SCD. Si bien las muestras de analisis no tienen representatividad nacional, constituyen una inestimable fuente de informacion sobre el desarrollo infantil, la calidad del entorno familiar y las condiciones de vida de los ninos y ninas menores de 2 anos en hogares vulnerables en el Peru rural y urbano.