Programa Bolsa Família e o acompanhamento das condicionalidades na área de saúde

Senna, Mônica de Castro Maia; Brandão, André Augusto Pereira; Dalt, Salete Da

doi:10.1590/0101-6628.060

Cited by 8 publications

(13 citation statements)

References 4 publications

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“…Therefore, we expect the association between BFP participation and child mortality to be stronger in the poorest municipalities, since those have better targeting and coverage of the program. The basis for exploring stratification by municipal-level indicators of quality of BFP management is that there is evidence of considerable heterogeneity in these indicators among Brazilian municipalities [ 23 – 26 ], and that municipalities with better management and coverage of the program show stronger indicators of poverty reduction [ 27 ] and monitoring of program health conditionality [ 28 ]. We expect the association between BFP participation and child mortality to be stronger in municipalities with indicators of better CCT management, considering that there is greater monitoring of child health, immunization, and development in these contexts.…”

Section: Introductionmentioning

confidence: 99%

Conditional cash transfer program and child mortality: A cross-sectional analysis nested within the 100 Million Brazilian Cohort

et al. 2021

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Background Brazil has made great progress in reducing child mortality over the past decades, and a parcel of this achievement has been credited to the Bolsa Família program (BFP). We examined the association between being a BFP beneficiary and child mortality (1–4 years of age), also examining how this association differs by maternal race/skin color, gestational age at birth (term versus preterm), municipality income level, and index of quality of BFP management. Methods and findings This is a cross-sectional analysis nested within the 100 Million Brazilian Cohort, a population-based cohort primarily built from Brazil’s Unified Registry for Social Programs (Cadastro Único). We analyzed data from 6,309,366 children under 5 years of age whose families enrolled between 2006 and 2015. Through deterministic linkage with the BFP payroll datasets, and similarity linkage with the Brazilian Mortality Information System, 4,858,253 children were identified as beneficiaries (77%) and 1,451,113 (23%) were not. Our analysis consisted of a combination of kernel matching and weighted logistic regressions. After kernel matching, 5,308,989 (84.1%) children were included in the final weighted logistic analysis, with 4,107,920 (77.4%) of those being beneficiaries and 1,201,069 (22.6%) not, with a total of 14,897 linked deaths. Overall, BFP participation was associated with a reduction in child mortality (weighted odds ratio [OR] = 0.83; 95% CI: 0.79 to 0.88; p < 0.001). This association was stronger for preterm children (weighted OR = 0.78; 95% CI: 0.68 to 0.90; p < 0.001), children of Black mothers (weighted OR = 0.74; 95% CI: 0.57 to 0.97; p < 0.001), children living in municipalities in the lowest income quintile (first quintile of municipal income: weighted OR = 0.72; 95% CI: 0.62 to 0.82; p < 0.001), and municipalities with better index of BFP management (5th quintile of the Decentralized Management Index: weighted OR = 0.76; 95% CI: 0.66 to 0.88; p < 0.001). The main limitation of our methodology is that our propensity score approach does not account for possible unmeasured confounders. Furthermore, sensitivity analysis showed that loss of nameless death records before linkage may have resulted in overestimation of the associations between BFP participation and mortality, with loss of statistical significance in municipalities with greater losses of data and change in the direction of the association in municipalities with no losses. Conclusions In this study, we observed a significant association between BFP participation and child mortality in children aged 1–4 years and found that this association was stronger for children living in municipalities in the lowest quintile of wealth, in municipalities with better index of program management, and also in preterm children and children of Black mothers. These findings reinforce the evidence that programs like BFP, already proven effective in poverty reduction, have a great potential to improve child health and survival. Subgroup analysis revealed heterogeneous results, useful for policy improvement and better targeting of BFP.

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Section: Introductionmentioning

confidence: 99%

Conditional cash transfer program and child mortality: A cross-sectional analysis nested within the 100 Million Brazilian Cohort

et al. 2021

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“…This result reinforces the idea that, while the Bolsa Família is a policy that seeks to promote the economic and social development of households living in poverty in the country 25 , and consequently reduce social vulnerability, the monitoring of health determinants is not achieving the expected effect. In health -where determinants relate to the monitoring of the vaccination schedule and the growth and development of children under seven years of age, prenatal and puerperium for pregnant women and participation in educational activities on breastfeeding and healthy eatingthe proportion of follow-up has been well below expectations, with an increasing trend in recent years 26 . Therefore, it is worth emphasizing that this variable can work as a proxy for social vulnerability, acting as a social indicator, in which women in this condition may evidence a greater risk during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…While socioeconomic inequalities have declined, social inequalities in the adequate use of prenatal care persist, especially among the poorest and least educated women 26 . Social inequality in health remains a major challenge for public health and consequently for maternal health.…”

Section: Discussionmentioning

confidence: 99%

Risco gestacional e desigualdades sociais: uma relação possível?

Garcia

Martinelli

Silva

et al. 2019

Ciênc. saúde coletiva

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Resumo O objetivo do estudo é analisar a associação entre as desigualdades sociais e o risco gestacional em regiões administrativas do estado do Espírito Santo. Estudo transversal, com base em duas regiões administrativas do estado do Espírito Santo. A amostra foi composta por 1.777 mulheres que realizaram o pré-natal nos municípios da Região Metropolitana da Grande Vitória (RMGV-ES) e Microrregião de São Mateus internadas nos estabelecimentos da rede pública de saúde, por ocasião do parto, entre 2010 e 2012/2013. Realizou-se Regressão Logística Multivariada para testar a associação entre variáveis sociais e risco gestacional. As variáveis que apresentaram nível de significância menor que 20% no teste Qui-quadrado foram utilizadas para o modelo final, permanecendo aquelas com significância menor que 5%. Encontrou-se associação entre alto risco gestacional e o local de moradia da mulher na RMGV-ES (OR = 1,74; IC 95% 1,32-2,28), a chefia da mulher na família (OR = 3,03; IC 95% 1,64-5,61), a escolaridade da chefia familiar menor que cinco anos (OR = 1,58; IC 95% 1,14-2,20) e o recebimento do benefício social “Bolsa Família” (OR = 1,46; IC 95% 1,04-2,03). Apesar de algumas variáveis sociais comporem a classificação do risco gestacional, outros fatores sociais revelaram-se como produtores do risco gestacional.

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“…Os indígenas que não têm esse acesso à ajuda do governo apresentam situação de maior vulnerabilidade para as condições de pobreza ou extrema pobreza. Estudos (16)(17)(18) mostram efeitos positivos em relação aos programas de transferência de renda no cenário da saúde e demonstraram impactos significativos para redução da desigualdade de distribuição de renda no Brasil.…”

Section: Discussionunclassified

Modelo Preditivo De Determinantes Socioeconômicos Da Tuberculose Em População Indígena Do Estado Do Pará, Brasil

et al. 2019

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Objetivo: desenvolver um modelo capaz de identificar a correlação entre determinantessocioeconômicos e incidência de tuberculose na população indígena do estado do Pará.Método: estudo analítico e quantitativo, no qual se construiu um modelo preditivo por meio deregressão de Poisson para 285 casos novos notificados no Sistema de Informação de Agravo eNotificação, no período de janeiro de 2010 a dezembro de 2015, no Estado do Pará.Resultados: partindo do modelo construído, pode-se confirmar que 86% do total de novos casosde tuberculose pode ser explicada pelas variáveis: recebimento de benefício social do governo,renda, escolaridade e sexo. A primeira variável foi considerada a mais significativa com nível dep<0.10.Conclusão: o modelo preditivo é útil como suporte para tomada de decisão, pois permite direcionarações de controle da tuberculose aos indivíduos sob maior risco: indígenas do sexo masculino, semescolaridade e que não recebem benefícios sociais.

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Programa Bolsa Família e o acompanhamento das condicionalidades na área de saúde

Cited by 8 publications

References 4 publications

Conditional cash transfer program and child mortality: A cross-sectional analysis nested within the 100 Million Brazilian Cohort

Conditional cash transfer program and child mortality: A cross-sectional analysis nested within the 100 Million Brazilian Cohort

Risco gestacional e desigualdades sociais: uma relação possível?

Modelo Preditivo De Determinantes Socioeconômicos Da Tuberculose Em População Indígena Do Estado Do Pará, Brasil

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