Health outcomes of the Bolsa Família program among Brazilian Amazonian children

Abstract

OBJECTIVE: One of the primary objectives of Brazil’s conditional cash transfer program, Bolsa Família, is to break the intergenerational transmission of poverty by improving human capital via conditionalities. In this study, we hypothesized that health indicators of Bolsa Família participants would be comparable to those of other local children who were nonparticipants after two years of follow-up in the city of Acrelândia, Acre state, Western Brazilian Amazon. METHODS: Data from a population-based longitudinal study were analyzed to examine school enrollment, vaccination coverage, height and body mass index for age z-scores, and biomarkers of micronutrient deficiencies (iron and vitamin A) between Bolsa Família participants (n = 325) and nonparticipants (n = 738). RESULTS: Out of 1063 children 10 years and younger included in the 2007 baseline survey, 805 had anthropometric measurements and 402 had biochemical indicators in the 2009 follow-up survey. Prevalence rate ratio (PRR) for non-enrollment in school at 4 years of age was 0.58 (95%CI: 0.34–1.02) when comparing Bolsa Família participants with nonparticipants. No difference was found for vaccination coverage, which was insufficient for most vaccine-preventable diseases. Bolsa Família participants were less likely to show a positive change in body mass index for age z-scores compared with nonparticipants (PRR = 0.81, 95%CI: 0.70–0.95), while a positive change in height for age z-scores was similar in the groups. No differences in micronutrient deficiencies were found between groups after 2 years. CONCLUSIONS: Early school enrollment and consistent nutritional indicators between Bolsa Família participants and nonparticipants suggest Bolsa Família was facilitating similarities between groups over time.

Hunger and Its Associated Factors in an Urban Cluster in the Western Brazilian Amazon: A Population-Based Study

“…Low schooling, which was also associated with MSFI in the present study, makes it difficult to enter the formal job market, implying an increase in informal ("under-the-table") work and low pay, constituting a marker of inequity that favors the perpetuation of food insecurity [20]. Regarding claims that the Programa Bolsa Família (Family Allowance Program) rectifies late enrollment, school attendance, and truancy rates of children from poorer families, there is evidence that these children leave school prematurely [27]. It should be stressed that an increase in the schooling of the population is a basic requirement for the interruption of the generational cycle of poverty [28].…”

Socioeconomic and nutritional aspects of pregnant women assisted by Programa Bolsa Família: cohort NISAMI

“…Therefore, on the basis of researches, it is debated that the PBF encourages families to search for preventive health care, in which the basic health services for the most vulnerable groups are strengthened as a consequence of the PBF conditionalities, with positive effects in the health of pregnant women and children 12,32 .…”

Hunger and Its Associated Factors in the Western Brazilian Amazon: a Population-based Study

“…Regarding claims that the Programa Bolsa Família (Family Allowance Program) recti es late enrolment, school attendance, and truancy rates of children from poorer families, there is evidence that these children leave school prematurely [26]. It should be stressed that an increase in the schooling of the population is a basic requirement to break free of the generational cycle of poverty [27].…”