https://repositorio.ufba.br/handle/ri/14361
Tipo: | Artigo de Periódico |
Título: | Effect of a conditional cash transfer programme on childhood mortality: a nationwide analysis of Brazilian municipalities |
Título(s) alternativo(s): | Lancet |
Autor(es): | Rasella, Davide Pereira, Rosana Aquino Guimarães Santos, Carlos Antonio de Souza Teles Paes-Sousa, Rômulo Barreto, Mauricio Lima |
Autor(es): | Rasella, Davide Pereira, Rosana Aquino Guimarães Santos, Carlos Antonio de Souza Teles Paes-Sousa, Rômulo Barreto, Mauricio Lima |
Abstract: | In the past 15 years, Brazil has undergone notable social and public health changes, including a large reduction in child mortality. The Bolsa Familia Programme (BFP) is a widespread conditional cash transfer programme, launched in 2003, which transfers cash to poor households (maximum income US$70 per person a month) when they comply with conditions related to health and education. Transfers range from $18 to $175 per month, depending on the income and composition of the family. We aimed to assess the effect of the BFP on deaths of children younger than 5 years (under-5), overall and resulting from specific causes associated with poverty: malnutrition, diarrhoea, and lower respiratory infections. Methods The study had a mixed ecological design. It covered the period from 2004—09 and included 2853 (of 5565) municipalities with death and livebirth statistics of adequate quality. We used government sources to calculate all-cause under-5 mortality rates and under-5 mortality rates for selected causes. BFP coverage was classified as low (0·0—17·1%), intermediate (17·2—32·0%), high (>32·0%), or consolidated (>32·0% and target population coverage ≥100% for at least 4 years). We did multivariable regression analyses of panel data with fixed-effects negative binomial models, adjusted for relevant social and economic covariates, and for the effect of the largest primary health-care scheme in the country (Family Health Programme).Findings Under-5 mortality rate, overall and resulting from poverty-related causes, decreased as BFP coverage increased. The rate ratios (RR) for the effect of the BFP on overall under-5 mortality rate were 0·94 (95% CI 0·92—0·96) for intermediate coverage, 0·88 (0·85—0·91) for high coverage, and 0·83 (0·79—0·88) for consolidated coverage. The effect of consolidated BFP coverage was highest on under-5 mortality resulting from malnutrition (RR 0·35; 95% CI 0·24—0·50) and diarrhoea (0·47; 0·37—0·61). Interpretation A conditional cash transfer programme can greatly contribute to a decrease in childhood mortality overall, and in particular for deaths attributable to poverty-related causes such as malnutrition and diarrhoea, in a large middle-income country such as Brazil. |
Palavras-chave: | Bolsa Familia Programme Public Health Reduction in Child Mortality Programa Bolsa Família Saúde Pública Redução Mortalidade Infantil |
Editora / Evento / Instituição: | LANCET |
Tipo de Acesso: | Acesso Aberto |
URI: | http://repositorio.ufba.br/ri/handle/ri/14361 |
Data do documento: | 2013 |
Aparece nas coleções: | Artigo Publicado em Periódico Estrangeiro (ISC) |
Arquivo | Descrição | Tamanho | Formato | |
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Davide Rasella. 2013.pdf | 178,99 kB | Adobe PDF | Visualizar/Abrir |
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