This paper examines the impact of the Bolsa Família Programme (PBF) on child mortality (CM) in the municipalities of the Brazilian semiarid region between 2004 and 2010. It utilizes a longitudinal ecological study with panel data to assess the program’s effect, considering social and demographic factors. The findings are valuable for policymakers and researchers interested in the effectiveness of conditional cash transfer programs in improving child health outcomes in developing regions.
Key Insights
PBF and FHS Impact on Child Mortality
The Bolsa Família Programme (PBF) and the Family Health Strategy (FHS) played significant roles in reducing child mortality (CM) in the Brazilian semiarid region. The study found a statistically significant negative association between PBF coverage and child mortality rates (CMRs). This suggests that increased coverage of these programs contributed to improved child health outcomes.
Impact of Prenatal Consultations and Illiteracy
Increased prenatal consultations were associated with a significant reduction in child mortality. Conversely, higher illiteracy rates were significantly associated with increased child mortality. This highlights the importance of both healthcare access and education levels in influencing child health outcomes.
Water Supply, Sanitation, and Fertility
The study revealed a significant positive association between inadequate water supply and sanitation and child mortality. Higher fertility rates were also associated with increased child mortality. These findings underscore the importance of addressing basic needs and reproductive health in efforts to reduce child mortality.
PBF and Healthcare Seeking
The PBF conditions encourage families to seek preventive health care for the most vulnerable groups, with important effects on the health of pregnant women and children. Beneficiaries are required to seek medical care focused on prevention, detection, and combat of diseases that occur during early childhood, such as malnutrition, diarrhea, anemia, and weight incompatible with height (Brasil, 2015).
Importance of Government Intervention
Constant government interventions, including measures that minimize the income gap experienced by the population, are important allies in combating CM. In addition, it is essential that the income of the people increases and that a better distribution of income exists.
Key Statistics & Data
- In 2010, the highest CMR was 45.4/1,000 live births in Olivença, Alagoas.
- The average CMR decreased by 13.3/1,000 live births during the study period (2004-2010).
- Average PBF coverage increased from 38.1% in 2004 to 54.3% in 2010.
- FHS coverage increased from 70.4% in 2004 to 91.3% in 2010.
- Average prenatal consultation coverage increased from 31.3% to 50.6%.
- The average total fertility rate (TFR) decreased from 2.8 to 2.2.
- The average illiteracy rate (15+ years) decreased from 32.8% to 27.8%.
- Individuals living in households with inadequate water and sanitation decreased from 18.8% to 17.1%.
Methodology
This longitudinal ecological study utilized the microdata of the 1,133 municipalities of the Brazilian semiarid region. A longitudinal database for the years 2004 to 2010 was created using Stata software version 12.0, which was used for data processing and analysis. Data sources included the Ministry of Social and Agrarian Development and the Atlas of Human Development in Brazil. A multiple linear regression for panel data with fixed effects was used.
Implications and Conclusions
The PBF and FHS programs significantly reduced child mortality in the Brazilian semiarid region. However, further improvements are needed to reach the levels of more advanced countries. To maintain the reduction, the following measures must be reinforced: reduction of illiteracy of persons aged 15 years or older and greater attention to water supply and sanitation conditions in households. To ensure that programmes actually reduce inequality and poverty in the Brazilian semi-arid region, it will be important to carefully monitor the impact of programmes and ensure the maintenance and improvement of public health infrastructure. Thus, the impact that the PBF has on the reduction of CM levels in the semiarid region will be better evidenced in a positive way, noting that this impact has been enhanced by the intervention of other factors. In addition, the rates have been reduced in the last decade at a faster rate than in any other time before the implantation of the PBF in 2004.
Key Points
- The Bolsa Família Programme (PBF) and Family Health Strategy (FHS) significantly reduced child mortality (CM) in Brazil's semiarid region.
- Increased prenatal consultations and reduced illiteracy rates were associated with lower child mortality.
- Inadequate water supply and sanitation, along with higher fertility rates, were associated with increased child mortality.
- The PBF encouraged families to seek preventive health care, particularly for pregnant women and children.
- The study highlights the importance of government interventions and income distribution in combating child mortality.
- Maintaining and improving public health infrastructure is crucial for ensuring the effectiveness of social programs like PBF.