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Impact of the Family Health Program on infant mortality in brazilian municipalities

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  • Aquino, R.
  • De Oliveira, N.F.
  • Barreto, M.L.

Abstract

Objectives. We evaluated the effects of the Family Health Program (FHP), a strategy for reorganization of primary health care at a nationwide level in Brazil, on infant mortality at a municipality level. Methods. We collected data on FHP coverage and infant mortality rates for 771 of 5561 Brazilian municipalities from 1996 to 2004. We performed a multivariable regression analysis for panel data with a negative binomial response by using fixed-effects models that controlled for demographic, social, and economic variables. Results. We observed a statistically significant negative association between FHP coverage and infant mortality rate. After we controlled for potential confounders, the reduction in the infant mortality rate was 13.0%, 16.0%, and 22.0%, respectively for the 3 levels of FHP coverage. The effect of the FHP was greater in municipalities with a higher infant mortality rate and lower human development index at the beginning of the study period. Conclusions. The FHP had an important effect on reducing the infant mortality rate in Brazilian municipalities from 1996 to 2004. The FHP may also contribute toward reducing health inequalities.

Suggested Citation

  • Aquino, R. & De Oliveira, N.F. & Barreto, M.L., 2009. "Impact of the Family Health Program on infant mortality in brazilian municipalities," American Journal of Public Health, American Public Health Association, vol. 99(1), pages 87-93.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2007.127480_0
    DOI: 10.2105/AJPH.2007.127480
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    1. Ferreira-Batista, Natalia N. & Postali, Fernando Antonio Slaibe & Diaz, Maria Dolores Montoya & Teixeira, Adriano Dutra & Moreno-Serra, Rodrigo, 2022. "The Brazilian Family Health Strategy and adult health: Evidence from individual and local data for metropolitan areas," Economics & Human Biology, Elsevier, vol. 46(C).
    2. Cesur, Resul & Güneş, Pınar Mine & Tekin, Erdal & Ulker, Aydogan, 2017. "The value of socialized medicine: The impact of universal primary healthcare provision on mortality rates in Turkey," Journal of Public Economics, Elsevier, vol. 150(C), pages 75-93.
    3. Romero Rocha & Rodrigo R. Soares, 2010. "Evaluating the impact of community‐based health interventions: evidence from Brazil's Family Health Program," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 126-158, September.
    4. Maria Dolores Montoya Diaz & Adriano Dutra Teixeira, Fernando Antonio Slaibe Postali, Natalia Nunes Ferreira-Batista, Rodrigo Mor, 2019. "Primary health care coverage in Brazil: Assessment of the Family Health Program impacts on mortality at municipality level," Working Papers, Department of Economics 2019_42, University of São Paulo (FEA-USP), revised 12 Aug 2021.
    5. Anaka Aiyar & Naveen Sunder, 2024. "Health insurance and child mortality: Evidence from India," Health Economics, John Wiley & Sons, Ltd., vol. 33(5), pages 870-893, May.
    6. Natalia Nunes Ferreira‐Batista & Adriano Dutra Teixeira & Maria Dolores Montoya Diaz & Fernando Antonio Slaibe Postali & Rodrigo Moreno‐Serra & James Love‐Koh, 2023. "Is primary health care worth it in the long run? Evidence from Brazil," Health Economics, John Wiley & Sons, Ltd., vol. 32(7), pages 1504-1524, July.
    7. Gunes, Pinar Mine & Tsaneva, Magda, 2022. "The Effect of Brazil's Family Health Program on Cognitive Skills," IZA Discussion Papers 15784, Institute of Labor Economics (IZA).
    8. Mayara Lisboa Bastos & Dick Menzies & Thomas Hone & Kianoush Dehghani & Anete Trajman, 2017. "The impact of the Brazilian family health on selected primary care sensitive conditions: A systematic review," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-14, August.
    9. Bhalotra, Sonia R. & Rocha, Rudi & Soares, Rodrigo R., 2019. "Does Universalization of Health Work? Evidence from Health Systems Restructuring and Expansion in Brazil," IZA Discussion Papers 12111, Institute of Labor Economics (IZA).
    10. Gabriella Conti & Rita Ginja, 2023. "Who Benefits from Free Health Insurance?: Evidence from Mexico," Journal of Human Resources, University of Wisconsin Press, vol. 58(1), pages 146-182.
    11. Fernando Antonio Slaibe Postali & Maria Dolores M Diaz, Adriano Dutra Teixeira, Natalia Nunes Ferreira Batista, Rodrigo Moreno Serra, 2021. "Impact of primary care coverage on individual health: evidence from biomarkers in Brazil," Working Papers, Department of Economics 2021_01, University of São Paulo (FEA-USP).
    12. Angela R. Ghesquiere & Rogerio M. Pinto & Rahbel Rahman & Anya Y. Spector, 2015. "Factors Associated with Providers’ Perceptions of Mental Health Care in Santa Luzia’s Family Health Strategy, Brazil," IJERPH, MDPI, vol. 13(1), pages 1-10, December.
    13. Mauricio Reis, 2014. "Public primary health care and children’s health in Brazil: evidence from siblings," Journal of Population Economics, Springer;European Society for Population Economics, vol. 27(2), pages 421-445, April.
    14. Sonia Bhalotra & Rudi Rocha & Rodrigo R. Soares, 2020. "Can Universalization of Health Work? Evidence from Health Systems Restructuring and Expansion in Brazil," Working Papers 03, Instituto de Estudos para Políticas de Saúde.
    15. Bhalotra, Sonia & Rocha, Rudi & R. Soares, Rodigo, 2016. "Does universalization of health work? Evidence from health systems restructuring and maternal and child health in Brazil," ISER Working Paper Series 2016-16, Institute for Social and Economic Research.
    16. Letícia Xander Russo & Anthony Scott & Peter Sivey & Joilson Dias, 2019. "Primary care physicians and infant mortality: Evidence from Brazil," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-16, May.
    17. Fonseca Morello, Thiago, 2023. "Hospitalization due to fire-induced pollution in the Brazilian Amazon: A causal inference analysis with an assessment of policy trade-offs," World Development, Elsevier, vol. 161(C).
    18. Bancalari, Antonella & Bernal, Pedro & Celhay, Pablo & Martinez, Sebastian & Sánchez, María Deni, 2024. "An Ounce of Prevention for a Pound of Cure: Basic Health Care and Efficiency in Health Systems," IDB Publications (Working Papers) 13433, Inter-American Development Bank.
    19. Cesur, Resul & Gunes, Pinar Mine & Tekin, Erdal & Ulker, Aydogan, 2015. "The Value of Socialized Medicine: The Impact of Universal Primary Healthcare Provision on Birth and Mortality Rates in Turkey," IZA Discussion Papers 9329, Institute of Labor Economics (IZA).
    20. Mora-García, Claudio A. & Pesec, Madeline & Prado, Andrea M., 2024. "The effect of primary healthcare on mortality: Evidence from Costa Rica," Journal of Health Economics, Elsevier, vol. 93(C).
    21. Barnish, Maxwell S. & Tan, Si Ying & Robinson, Sophie & Taeihagh, Araz & Melendez-Torres, G.J., 2023. "A realist synthesis to develop an explanatory model of how policy instruments impact child and maternal health outcomes," Social Science & Medicine, Elsevier, vol. 339(C).

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