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The combined effects of the expansion of primary health care and conditional cash transfers on infant mortality in Brazil, 1998-2010

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  • Guanais, F.C.

Abstract

Objectives. I examined the combined effects of access to primary care through the Family Health Program (FHP) and conditional cash transfers from the Bolsa Familia Program (BFP) on postneonatal infant mortality (PNIM) in Brazil. Methods. I employed longitudinal ecological analysis using panel data from 4583 Brazilian municipalities from 1998 to 2010, totaling 54 253 observations. I estimated fixed-effects ordinary least squares regressions models with PNIM rate as the dependent variable and FHP, BFP, and their interactions as the main independent variables of interest. Results. The association of higher FHP coverage with lower PNIM became stronger as BFP coverage increased. At the means of all other variables, when BFP coverage was 25%, predicted PNIM was 5.24 (95% confidence interval [CI] = 4.95, 5.53) for FHP coverage = 0% and 3.54 (95% CI = 2.77, 4.31) for FHP coverage = 100%. When BFP coverage was 60%, predicted PNIM was 4.65 (95% CI = 4.36, 4.94) when FHP coverage = 0% and 1.38 (95% CI = 0.88, 1.89) when FHP coverage = 100%. Conclusions. The effect of the FHP depends on the expansion of the BFP. For impoverished, underserved populations, combining supply- and demand-side interventions may be necessary to improve health outcomes. Copyright © 2013 by the American Public Health Association®.

Suggested Citation

  • Guanais, F.C., 2013. "The combined effects of the expansion of primary health care and conditional cash transfers on infant mortality in Brazil, 1998-2010," American Journal of Public Health, American Public Health Association, vol. 103(11), pages 2000-2006.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2013.301452_9
    DOI: 10.2105/AJPH.2013.301452
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    Cited by:

    1. Alexandre Bugelli & Roxane Borgès Da Silva & Ladislau Dowbor & Claude Sicotte, 2021. "The Determinants of Infant Mortality in Brazil, 2010–2020: A Scoping Review," IJERPH, MDPI, vol. 18(12), pages 1-28, June.
    2. 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.
    3. 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).
    4. 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.
    5. 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.
    6. Benjamin M Hunter & Sean Harrison & Anayda Portela & Debra Bick, 2017. "The effects of cash transfers and vouchers on the use and quality of maternity care services: A systematic review," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-37, March.
    7. 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.
    8. Ciula, Raffaele, 2022. "The effects of Bolsa Familia on human development: systematic review approach," MPRA Paper 116768, University Library of Munich, Germany.
    9. Luis Henrique Paiva & Fábio Veras Soares & Flavio Cireno & Iara Azevedo Vitelli Viana & Ana Clara Duran, 2016. "The effects of conditionality monitoring on educational outcomes: evidence from Brazil’s Bolsa Família programme," Working Papers 144, International Policy Centre for Inclusive Growth.
    10. Lenel, Friederike & Priebe, Jan & Satriawan, Elan & Syamsulhakim, Ekki, 2022. "Can mHealth campaigns improve CCT outcomes? Experimental evidence from sms-nudges in Indonesia," Journal of Health Economics, Elsevier, vol. 86(C).
    11. Christopher Strader & Joanna Ashby & Dominique Vervoort & Aref Ebrahimi & Shoghi Agbortoko & Melissa Lee & Naomi Reiner & Molly Zeme & Mark G Shrime, 2020. "How much is enough? Exploring the dose-response relationship between cash transfers and surgical utilization in a resource-poor setting," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-12, May.
    12. Margaret E Kruk & Gavin Yamey & Sonia Y Angell & Alix Beith & Daniel Cotlear & Frederico Guanais & Lisa Jacobs & Helen Saxenian & Cesar Victora & Eric Goosby, 2016. "Transforming Global Health by Improving the Science of Scale-Up," PLOS Biology, Public Library of Science, vol. 14(3), pages 1-16, March.

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